HOLISTIC CONCEPTS OF HEALTH AND DISEASE

SUMMARY
In Western holistic concepts, disease seldom arises from a single cause. Three or more factors
in combination may be needed for the dis-ease to become manifest. These factors upset the
balance between the external and internal environments and overload the capacity of the
adaptive mechanisms.
In Chinese concepts, dis-ease occurs when the balance of the vital energy (Qi) in the
acupuncture (AP) Channels2 is disturbed. This arises as a result of external or internal insults
overcoming the body's defences. Chinese and unorthodox concepts recognise many more
forces which can cause dis-ease (and many more ways of controlling dis-ease) than are
recognised by orthodox science.
There is considerable agreement between progressive, holistic Western concepts and ancient
Chinese concepts of dis-ease. In both philosophies, any dietary, medical, physical,
psychological or other treatment which restores the balance of Qi or the balance between the
external and internal environments will automatically restore health. The exception is in cases
where irreparable damage has occurred, for instance, death of nerve cells, inoperable
malignant cancer, extensive fibrosis of the liver or kidneys etc, or where physical damage
renders self-healing impossible (for instance in tuberculous spinal injury, severe dislocation of
joints etc).
Theorem: the BODY HEALS ITSELF by its own defence/adaptation mechanisms.
Medicines, surgery, acupuncture etc do not cure disease!
Implications:
a. Orthodox and unorthodox medicine may help the organism to heal itself and to
adapt to its new reality. (This is the best therapy).
b. Orthodox and unorthodox medicine may suppress the symptoms/remove dis-eased
organs or functions. (This is inferior therapy).
c. Orthodox and unorthodox medicine may fail to help the patient, due to incorrect
understanding of the case or because the defence mechanisms can not be activated
sufficiently. (This is useless "therapy").
INTRODUCTION
A dictionary-definition of holism is: "A philosophical theory according to which a
fundamental feature of nature is the existence of wholes which are more than the composite
assembly of the parts and which always tend to become more highly developed and complex".
A transcendant element is inferred, i.e. something greater than the sum of the parts.
A poet's definition of mysticism is: "Man's dialogue with God, Man-in-the-world-and-why"
(Brendan Kennelly 1983).

By definition, a holistic concepts involve all possible component parts, how they interact (fit
together), how they fit into the larger plan of Nature and (in the end) an artistic-intuitive
search for aspects of the transcendant immaterial blueprint which religious people call God
or atheistic physicists see as the infinite interchange of matter and energy. Holism and holistic
concepts of health, disease and medicine contain elements of scientific medicine, art, poetry
and mysticism.
Mechanistic materialistic medicine has blind spots. It tends to label "Man-who-dialogueswith-God" as duped, irrational or mad. It tends to look on "Man-in-the-World" through halfblind eyes. It does not recognise transcendant "Whys".
Ancient Chinese medical philosophy states that "Man stands between Heaven and Earth." In
modern concepts, this can be translated as: "The organism is the product of (embodies the
characteristics of) Heaven (spirit, mind, non-material forces) and Earth (food, physical
environment, material forces)." This can also be translated as: "The organism is influenced by
spiritual, psychic arid non-earthly forces (cosmic, solar, lunar forces) as well as forces in its
immediate environment (nutrition, climate, electro- magnetic and geophysical forces)".
Other factors which influence the organism include hereditary influences and the internal
environment (emotions, neuroendocrine system).
Health in man and animal may be defined as harmony within the internal environment and
with the external environment. The organism has adapted successfully to stimuli from its
internal and external environment and can carry on its natural functions in a variable
(changing) world. Thus, health is not an absolute state. It is a relative state which depends on
the environment. For instance, it might not be healthy (normal) for men to have a heart rate
of 84 and a PCV of 57 in Holland, but for men living high up in the Andes or in Mexico City
these could be normal, healthy values.
Dis-ease arises when there is disharmony or imbalance/maladaptation between the internal
and external environment, or within the internal environment. Dis-ease seldom arises from a
single cause. A combination of three or more factors may be needed for the dis-ease to
become manifest. The combination overloads the body's adaptive (homeostatic) mechanisms.
It follows that dis-ease may be treated by removing the causes singly or in combination
and/or by enhancing the adaptive/homeostatic mechanisms.
Holistic medicine, including acupuncture (AP) and homoeopathy, must be seen against this
holistic (unified) theory of health and dis-ease. AP is only one modality among many which
can be used to help the adaptive mechanisms. Other forms of therapy which work in the same
direction will usually complement the effects of AP. Whatever can be done to remove the
causes or to neutralise them will increase the probability of cure.
The concepts which will be discussed now are based mainly on concepts of human health and
dis-ease but many of them apply also to animals.
YIN-YANG, DUALITY, RELATIVITY
Thousands of years before the Bible spoke of Good and Evil, the Chinese developed the
concepts of duality and relativity. To them, nothing was absolute, but was a mixture of
opposing forces, Yin (the passive or negative force) and Yang (the active or positive force).

"Yin and Yang are the source of creation and the cause of destruction of all things": Chinese
concepts of Yin and Yang were essential, fundamental parts of this world view. The YinYang principle referred to opposites. Everything in creation has its opposite. Yin-Yang
referred to female-male, below-above, earth-heaven, passive-active, front-back, dark-bright,
etc.
The totally balanced system has equal amounts or Yin and Yang. Neither could exist in
isolation, (i.e.) there is always some Yin in Yang and some Yang in Yin. Each was necessary
for the other (interdependence) yet each opposed the other (inter-opposition). Balance or
equilibrium was maintained by the mutual antagonism, yet mutual dependence of opposing
forces. For example, for life to exist (as we know it on our planet) we need a balance of
sunlight and darkness. If there was perpetual sunlight or perpetual darkness, life on the planet
would cease. Similarly, in the family there must be Yin and Yang. If both husband and wife
are Yang (active, bossy) there are family arguments, and if both are Yin (passive, inactive the
marriage will be dull, apathetic and uncreative. Either way, the lack of balance (antagonism
between Yin and Yang) leads to poor family life.
On the other hand, the male (Yang) may have some Yin characteristics (gentleness, laziness)
and the female (Yin) may have some Yang characteristics (strong-mindedness, creativity). If
the Yin-Yang balance is maintained, the marriage (unity) can be very stable.
This concept of Yin-Yang was applied to everything in Chinese life - art, politics, philosophy,
medicine, architecture, etc. In medicine, Yin-Yang referred to hypo-hyper states, solid organshollow organs, female genitalia-male genitalia etc. Chronic dis-eases were Yin, acute diseases were Yang, etc. Table 1 shows some other examples of Yin-Yang.
Table 1. Examples of Yin and Yang (states of relative opposition)
Yin Water Ice Cold Female Passive Dark Material Solid
Yang Fire Steam Hot Male Active Bright Immaterial Gas
Yin Slow Centripetal Precipitation Winter Night Downwards Inner
Yang Fast Centrifugal Evaporation Summer Day Upwards Outer
Yin Solid organs LU SP HT KI PC LV CV Below waist Dorsal Medial lower
Yang Hollow organs LI ST SI BL TH GB GV Above waist Ventral Lateral upper
Yin Inhibition Relaxation Hypo- (deficient) Chronic Cold Moon
Yang Excitation Contraction Hyper- (excess) Acute Hot Sun
Yin Parasympathetic Diastole Flaccid
Yang Sympathetic Systole Erect
CHANGE, RHYTHMS, CYCLES
The concept of CHANGE is fundamental to Chinese thought. Everything in existence must
change in a ceaseless cycle of anabolism (building up) and catabolism (breaking down).
Nothing is permanent. All great civilizations were aware of the rhythms and cycles in nature:

a. the seasonal cycle

b. the lunar and tidal cycle
c. the mating-birth-growth-death cycle (d) the sexual (menstrual and male) cycles.
We have the activity-rest, the day-night cycles, sunspot cycles, political cycles. Internal
(diurnal) cycles include the cardiac cycle (systole-diastole), respiratory cycle, hormone
secretion cycle etc. All of life and nature follows cyclic patterns.
Yin-Yang concepts imply continuous transformation, change and movement. Nothing is
static. Day must become night. Winter must become Summer, (i.e.) Yin reaches a limit and
transforms into Yang. Yang reaches a limit and transforms into Yin. Substance (Yin)
transforms into function (Yang) and function transforms into substance.
The Monad or wheel symbolises the cycle: endless and beginningless revolution. Within the
Monad, we see the Yin-Yang symbol also. Yin changes to Yang and Yang changes to Yin in a
changing, yet changeless cycle. Thus, mountains become flat land and flat land becomes
mountains. Rock becomes sand and sand becomes rock. Thus, tears and laughter are opposite
yet essential parts of the same whole.
RELATIVITY: Yin and Yang are seen as relative states. Summer is Yang relative to winter
(Yin) but a cold, wet summer is Yin relative to a normal summer and a warm, dry winter is
Yang relative to a normal winter. The head is Yang relative to the chest (Yin), but the chest is
Yang relative to the feet (Yin). In the male (Yang) childhood, adulthood and old age are
relatively Yin, Yang and Yin respectively. In the female (Yin) childhood, adulthood and old
age are relatively Yang, Yin and Yang respectively.
BALANCE AND TRANSFORMATION: Yin or Yang can not exist in isolation. They need
each other and they change into each other. The circle is complete, without beginning, middle
or end.
If there is no day, there is no night. If there is no excitation, there is no inhibition. The balance
of Yin-Yang is a dynamic, changing state. There is seldom exact balance, with equal amounts
of Yin and Yang. For instance in Summer, daylight exceeds darkness (Yang is predominant)
but in Winter, darkness exceeds daylight (Yin is predominant). Equal amounts of Yin and
Yang (night and day) occurs only at the equinoxes (March 2lst and September 23rd). The
limits of Yin and Yang are seen, for example at the Winter solstice (December 2lst) when Yin
is maximal (relative to Yang) and Summer solstice (June 2lst) when Yang is maximal. This
transformation of Yin to Yang and Yang to Yin is a natural, universal phenomenon. It is
natural for Yin to predominate at certain times and Yang to predominate at other times, in
dynamic cycles.
WESTERN EXAMPLES OF DUALITY: In modern medical and scientific concepts, the
idea of duality and relativity is accepted easily. We know that homeostasis in the body is
maintained by mutually antagonistic yet mutually dependent systems. For instance, health
requires the balance (harmony) of Yin-Yang : sleep-wakefulness; flexor muscles-extensor
muscles; parasympathetic-sympathetic systems; feedback-feedforward systems; inhibitoractivator; relaxation-contraction; sensory-motor systems; corpus luteum-follicle; calcitoninparathyroid hormone; receptor-ligand etc. We also know that an excess or deficiency of any
one of these can lead to imbalance in the system. In time, this may lead to dis-ease.

Thus, the Chinese concept of Yin-Yang is not as incomprehensible as it may seem at first
glance. It is similar to western ideas of duality-relativity. But it preceded our concept and use
of binary theory (the idea of on-off, as used in modern computers) by thousands of years.
Indeed, those who appreciate the beautiful symmetry of Chinese Yin-Yang philosophy have
no difficulty in accepting the probability of advanced concepts in physics and astronomy etc
such as ; gravity-antigravity; matter-antimatter; expanding space-black holes; time-negative
time.
INTERDEPENDENCE, INTERACTIONS IN THE BODY
There was a story about the relative importance of the organs. They were arguing among
themselves: "I am the most important", said the brain. "I do all the thinking, make all the
decisions and control the lot of you!". "Not at all", said the heart. "I am more important
because I keep you alive by pumping blood, oxygen and glucose up to you and I take away all
your waste for disposal!". "Hold on!" said the liver. "I am the most important. I am
responsible for glucogenesis and detoxification. Without me, both of you would be in
trouble!". "Bull-shit!", growled the stomach. "Without me, you three would starve to death!".
The argument grew fierce. The spleen, lungs, gallbladder, bones, muscles et al all had their
spake.
Meanwhile, the anus (which had not said a word) got fed up with all the arguing and ballyhoo.
Muttering "I'll show them who is boss!", it seized up tight and said nothing (kept its mouth
shut). After a few days of severe constipation, colic and toxaemia set in. The stomach lost its
appetite, the liver was unable to cope with the toxins, the heart went into failure and the brain
began to grow faint. At the last moment, the brain screamed to the anus: "All right, you win!".
The anus relaxed and all was well3 .
Although moral of the original joke was: "Don't underestimate an Ass-Hole!", there is an
obvious moral for clinicians also. There is interdependence and interaction between the
organs, functions, and emotions of the body.
We saw earlier that the Chinese regarded man as a unity of Yin-Yang in body-spirit.
Psychosomatic medicine also sees man as a unity of mind (spirit) and soma. Thus,
interactions between these components of the organism influence the health (balance) of the
organism. Psyche influences Soma and Soma influences Psyche. Those who ignore this reality
have a very incomplete view of factors influencing health. In vet medicine, it would appear
that the animal psyche plays a less important role in dis-ease than the psyche in human
medicine. Nevertheless, the animal psyche is important and can be harnessed in many
practical ways, as any experienced animal handler knows. The psyche (and psychic energy) of
the therapist can (and should) be focused to help/love and beam compassion into the psyche
of the willing patient, animal or human.
The Chinese were aware of the unity of the psyche-soma and of the interdependence of the
organs and emotions. Disorders of the heart may influence the kidneys and lungs, and viceversa. Disorder of the liver-gallbladder may influence the stomach. Chinese medical
philosophy developed a complete schema of interdependence between the organs in the Five
Phase Cycle. The Five Phase Theory and its uses in medicine are discussed in another
paper, to which the reader is referred.

INTERACTIONS WITH EXTERNAL ENVIRONMENT

The organism does not exist in isolation. All living organisms survive by a process of
adaptation to their external (and internal) environments. Those who can not adapt
successfully must suffer as a result. The organism acts upon and is influenced by natural
forces in its external environment. Environmental factors are not often considered but are very
important nonetheless. They include Cosmic, Solar and Lunar forces, climatic changes,
electromagnetic fields, geographical conditions and geophysical fields. (In a later section, we
will examine other external factors).
The effects of cosmic and solar forces on animal health are poorly defined. Effects of the
moon on health include a tendency to haemorrhage during new and full moon. Surgical
complications are less likely to arise if major surgery is avoided for a few days before and
after new and full moon.
Many years ago, Harold Burr, USA, recorded the electrical potentials of trees, day after day
for many years. He found a cyclical change in potentials related to moon phase, day v night
and sunspot activity. Maximum DC electrical potentials occurred at new and full moon; in
daytime; and at peak sunspot activity. Minimum potentials occurred at quarter and threequarter moon phase; at night and at minimum sunspot activity. He found similar changes in
electrical potentials in humans.
Robert Becker (Veterans Administration Hospital, Syracuse, New York) and others have
reported that people are more irritable at new and full moon and that violent crimes (rape,
murder, assault, suicide) and admissions to psychiatric hospitals are more common at these
times. The English word lunatic is derived from the Latin luna (Moon) and tic (fit,
convulsion). Epileptic fits, convulsions and hallucinations are more likely to arise at these
times also. I am unaware of published work on the effects of the full and new moon on animal
dis-ease, but I suspect that neuromuscular disorders such as convulsions in dogs and grass
(hypomagnesaemic) tetany in cows may be more common at these times also.
Geophysical forces: For thousands of years, in all civilisations, certain people claimed to be
able to find water under the ground, using instruments like Y sticks (divining rods)
pendulums, etc. When the diviner passes across underground streams, an involuntary
muscular contraction causes the instrument to react. The diviner tries to locate exactly the
course of the stream. He then tries to find the place where one or more other streams intersect
(usually at different depths). The hole for the well is sunk at this point. Diviners explain this
phenomenon by claiming that the water, running in fissures in the underground rocks, creates
a distortion in the magnetic field above the fissure. The body of the diviner reacts as a
biosensor to this alteration by an involuntary muscular contraction. (See the paper on psychic
methods of diagnosis and therapy in AP and homoeopathy).
Diviners in Europe, Australia, Africa and America have reported that many dis-eases in man
and animals are associated with strong reactive points over these streams. Insomnia,
arthritis rheumatism, asthma and cancer have been associated with these places. Where cattle
or other animals are confined to a stall or pen directly over these geophysical reaction
points, chronic disorders can arise, such as poor growth, chronic ketosis and infertility.
Orthodox treatment is often unsuccessful in these cases. If, however, the animals are moved to
a stall/pen which is free of reactive points, the condition usually disappears quickly.

Electromagnetic Fields (EMF): It is known that many species are extremely sensitive to
weak EMFs. Some cases of chronic dis-ease may be associated with these EMFs such as
those created by high-voltage cables , electric cables underground, electrical equipment
(electric blankets, TV and VDU screens etc. Other electro-magnetic and gravitational
influences include eclipses, planetary alignments, thunder-storms etc.
Effects of climate: Exposure to cold, damp weather when animals are turned out to pasture
in the Spring are often associated with outbreaks of grass tetany and muscular degeneration
(white muscle dis-ease, associated with selenium deficiency). There is evidence that cattle can
sometimes eat large amounts of ergot (Claviceps purpurea) with no effects if they are warm
and dry. If, however, the weather is very cold and the lower limbs are wet or freezing (as in
cold, damp cow-sheds in winter) severe outbreaks of ergotism (gangrene of the limbs etc) can
follow.
Effects of diet and food-sensitivity/intolerance: The diet is one of most obvious
environmental factors affecting animal health. Deficiencies or imbalances in total intake of
dry matter, its energy, protein, mineral and vitamin status, are well studied and need no further
comment. The diet may also influence health if it contains plant, organic or inorganic poisons.
In man, the role of masked (hidden) allergies to common feedstuffs, drugs, contact and
inhalant-allergens has been recognised only in recent years. Many chronic dis-eases are
associated with a hypersensitivity or intolerance, hidden allergy to common foods etc
(Randolph; Mackarness; Coca; Breneman).
Diagnosis of masked allergy is based on systematic elimination of specific items from the
diet or the environment of the patient for a period of 8-14 days or so. Then the patient is
challenged orally, sublingually or nasally with each suspect food, etc in single tests. If a
violent reaction occurs within 0-2 hours after challenge, the food etc is eliminated completely
from the diet. Following this, the health of the patient improves dramatically. The role of these
masked allergies in animal dis-ease is not yet as well established as in human dis-eases.
INTERACTIONS BETWEEN EXTERNAL AND INTERNAL ENVIRONMENT
Signals or stimuli from the external environment are transmitted to the internal environment
in many ways. The sensory nervous system transmits stimuli of touch, taste, smell, sight and
hearing. These signals are transmitted to the spinal cord and, via the ascending tracts, to the
brain and higher centres. Sensory input may activate segmental, intersegmental and
supraspinal reflexes. It may also activate the autonomic nervous system and the
hypothalamus-pituitary etc. The role of the nervous system and the endocrine system in
adaptation responses is well discussed by other authors (4, 14).
External stimuli and internal sensory stimuli may reach the internal environment by another
route, the PRIMITIVE NERVOUS SYSTEM of Becker and his colleagues in New York.
They postulated the existence of two systems which can transmit information in the body : (a)
the neuroendocrine system as already described, and (b) a slow acting non-nervous system
analogous to the primitive nervous system of plants and lower animals. This Primitive
Nervous System acts by sensing alterations in the electrical potentials at the skin5 and in
damaged organs and tissues. The DC current of injury is transmitted along planes of low
electrical impedance (the AP Channels) and is boosted (amplified) at the AP points. This
system switches on when injury grossly alters the normal electrical potential. When healing
occurs, the electrical potentials return to normal and switch off the system.

The ancients, mystics and many moderns accept that humans and animals have a psychic
(sixth) sense. By Yin-Yang philosophy that sense implies a psychic transmission force also.
These are the bases of telepathy, divination, telekinesis, kinaesthesia, prayer-healing, spells,
incantations, symbolic healing rituals, magic (black- and white-) etc. In spite of the ridicule of
many scientists, telepathy, telepathic diagnosis and telepathic healing or injury (voodoo,
black-magic) are realities for many people (see the paper on Psychic Methods of Diagnosis
and Treatment in AP and homoeopathy).
The Chinese name for the AP point (Xue) means "hole". The Chinese have claimed for
centuries that influences such as heat, damp, cold, dryness, wind and physical injury can gain
direct access to the body via the "body holes" (the AP points). Electro-magnetic forces may
gain entry through the "leaky holes" in the same way, as the AP points are characterised as
zones of high DC potential/low electrical resistance. We know that lightning tends to strike in
certain places which have low electrical resistance. (Diviners claim that all lightning strikes at
strong geophysical reactive points, low-resistance "holes" in the earth). AP points may attract
EMF and external signals in the same way as a lightning conductor attracts lightning. The
skin and mucous membranes are the interfaces between the external and internal
environment; the AP points are the "leaky places" on the skin, which connect the external and
internal environments. The AP system is also said to connect all the organs and body parts
with each other, via planes of higher electrical permeability/lower impedance.
CHINESE CONCEPTS OF HEALTH AND DISEASE
The Chinese concept of Qi represents the vital life force. All living things contain Qi. Balance
of Qi in the body maintains health. Imbalance of Qi (excess Yin or excess Yang, deficient Yin
or deficient Yang) causes ill-health. Absence of Qi occurs at death. Qi is obtained from the
lungs (oxygen, air) and the food (nutrients). It circulates to every cell in the body, via the
Channel-Organ System (COS) and blood stream.
Qi interacts with genetic influences, immunity to infections and non- specific resistance to
trauma, poisons and dis-ease, autonomic balance and hormone balance. If the degree of insult
disturbs the balance of Qi, dis-ease results. See diagram:
DISEASE (+) HEALTH (-) DISEASE
External insults: Trauma, dietary imbalance, allergies, infection, parasitism, poisons,
pollution, stresses, cosmic, solar, lunar, EMF, geophysical- forces, climatic changes.
Internal insults: Genetic susceptibility, uncontrolled emotions; auto-immune diseases,
autonomic and hormonal disturbance, reflex effects of injury.
The life energy (Qi) has its Yin and Yang aspects, seen as the typical energy in the Yin and
Yang Channels.
Dis-ease arises when the Qi is disturbed by any deficiency, excess or blockage of Yin or Yang
energy in the Channel-Organ System (COS). Abnormality is a relative state caused by a poor
adaptation to internal or external changes, associated with an abnormal excess or deficiency
of energy in one or more Channels. a. Excess Yin will consume (weaken) Yang. Deficient
Yang will allow a relative excess of Yin. In both cases, there is a relative net excess of Yin.
This causes Yin (Cold) Syndromes. b. Excess Yang will consume (weaken) Yin. Deficient

Yin will allow a relative excess of Yang. In both cases there is a relative net excess of Yang.
This causes Yang (Hot) Syndromes. c. Excess of Yin or excess of Yang causes conditions
known as Shi (excess) Syndromes. d. Deficiency of Yin or deficiency of Yang causes
conditions known as Xu (deficiency) Syndromes.
Chinese combinations allow 4 main Syndromes Cold Shi, Cold Xu, Hot Shi and Hot Xu
Syndromes.
In Shi (excess) Syndromes, the body resistance (anti-pathogenic defence systems) are
relatively normal and the cause of dis-ease is usually external.
In Xu (deficiency) Syndromes, body resistance is relatively weak, and the dis-ease has
usually gained the interior and is more serious.
AP therapy is different for Shi and Xu Syndromes. In the Shi (excess) Syndromes, a sedation
technique (Xie) is used (In Shi, use Xie). In the Xu (deficiency) Syndromes, a tonification
technique (Bu) is used (In Xu, use Bu). These are discussed in other papers (Five Phase
Theory and its Use in Medicine and Techniques of Stimulation of the AP Points) to which
the reader is referred.
WESTERN CONCEPTS OF HEALTH AND DISEASE
In a given case, the cause of dis-ease (the insult) may appear to be simple. For instance, a herd
of cattle may show depigmentation of the coat, enteritis, abortion/stillbirth /neonatal deaths
and infertility. Blood tests may show severe copper deficiency. One may be tempted to
assume that copper deficiency is the main cause, or the only cause. However, further
examination may show that infection and parasitism are involved also and the role of these
may not be appreciated fully. If very detailed investigation were done, other factors (for
instance excess of iron, molybdenum, lead or zinc and stress factors) may also be present.
In practice, herd supplementation with copper salts could restore health and fertility. If,
however, the other factors were corrected singly or together, the same good result could be
obtained even without copper supplementation.
Similarly, outbreaks of infectious dis-ease in young calves (enteritis, pneumonia, septicaemia,
oomphalitis, etc) may suggest very heavy bacterial challenge as the main cause. On further
examination, however, it may be found that the herd is deficient in trace-minerals (Cu, Co,
Se, Zn) which are essential to herd immunity. Control of the "infectious disease" in these
cases may be achieved by adequate supplementation of the calves with the correct traceelements. Prevention, in subsequent years, is based on supplementation of the pregnant cows,
so that the calves are born with adequate trace-mineral status and the dams' colostrum is
adequate in antibody. Of course, improvement in the housing and hygiene on the farm will
also help.
CONCLUSION
The best chance for healing or cure depends on:

a. recognition that the organism is influenced by many more forces than orthodox
concepts consider;
b. removing or alleviating as many causal factors as possible and/or

c. stimulating the defence systems or homeostatic- adaptive systems of the body.

It follows that many conditions respond to a wide variety of treatments, singly or in

combination. These treatments include orthodox medical or surgical methods, physiotherapy,
desensitisation to allergens, alteration of diet or lifestyle, relaxation therapy, hypnosis,
psychiatric care etc. AP is extremely valuable in stimulating the adaptive mechanisms. This
will be discussed in another paper (AP for immunomediated disorders).
Unorthodox therapies, such as homeopathy, cytotherapy, chiropractic, osteopathy,
"neutralising" geophysical forces, radiaesthesia, laying on of hands etc may also be effective
in man and animals but the absence of controlled studies has limited their acceptance and their
use.
FURTHER READING MATERIAL
1. Becker, R.O. (Veteran's Administration Hospital, Upstate Medical Centre, Syracuse, New
York 13210, USA). Over 100 scientific publications on tissue regeneration, electrical
potentials, the primitive nervous system, AP and geo- physical effects on health.
2. Breneman, J.C. (1978) The basics of food allergy. Charles C. Thomas, Springfield,
Illinois.
3. Burr, H.S. (1972) Blueprint for immortality: the electric patterns of life. Neville
Spearman Ltd., London. (or) Burr, H.S. (1973). The Fields of Life: our links with the
universe. Ballantyne Books Inc., New York.
4. Buxton-Hopkin, D.S, (1976) James Reilly and the autonomic nervous system: a
prophet unheeded: Annals of Royal College of Surgeons of England, 60, 108-116.
5. Coca,A.F. (1978). The pulse test: easy allergen detection. Arco Books, c/o Thorson's
Books, Wellingborough, Northants, England.
6. Graves,T. (1977) Dowsing techniques and applications. Penguin Books, Harmondsworth,
UK.
7. Journal of the British Society of Dowsers. Quarterly journal from: The Secretary B.S.D.,
Sycamore Cottage, Hastingleigh, Ashford, Kent, UK.
8. Mackarness,R. (1976) Not all in the mind. Pan Books, London.
9. Ostrander,S. and Schroeder,L. (1977) Psychic discoveries behind the iron curtain.
Abacus Books (Sphere Books), London.
10. Randolph,T.G. (1951) Food allergy. Charles C. Thomas, Springfield, Illinois, U.S.A.
11. Randolph,T.G. (1965) Ecologic orientation in medicine: comprehensive environmental
control in diagnosis and therapy. Annals of Allergy, 23, 7-22.
12. Russell,E.W. (1971) Design for destiny. Neville Spearman Ltd., London.
13. Russell, Edward W. (1973) Report on radionics: science of the future. Neville
Spearman Ltd., London.
14. Selye,H. (1976) Stress in health and disease. Butterworths, London.
15. Watson,L. (1973) Supernature. Hodder and Stoughton, London.
16. Watson,L. (1979) Lifetide. Hodder and Stoughton, London.
17. Mann,F. (1973) AP Cure of many Diseases. Heinemann Medical Books, London.
18. Austin,M. (1974) AP Therapy. Turnstone Books, London.
19. Connolly,D. (1979) The Law of the Five Elements. Centre for Traditional AP, American
City Building, Columbia, Maryland 21044, USA.
HOMOEOPATHY AND AP

AP and homoeopathy make an excellent therapeutic partnership. Homoeopathic remedies may

be given orally or by injection into the AP points chosen to fit the case. Austrian, German and
French Vets are using this method successfully.
The British Vet Homoeopathic Society was founded in the UK in 1987. Contact the British
Vet Association, 7 Mansfield St., London W1M 0AT for details.
Further information on U.K. Supply Houses and Homoeopathic Materia Medica (by Allen
or Boericke or Boenninghausen or Clarke or Kent) from: Royal Homoeopathic Hospital,
Great Ormond St., London; Nelson's Pharmacy, 73, Duke Street, London; Ainsworth's
Pharmacy, London
TEXTBOOKS ON HOMOEOPATHIC THEORY AND PRACTICE
McLeod,G. (1978) Treatment of horses by Homoeopathy. Health Science Press,
Holsworthy, Devon, UK.
Roberts,H.A. (1976) Principles and Art of Cure by Homoeopathy. Health Science Press,
Holsworthy, Devon, UK.
ESSENTIAL READING, EXCELLENT BACKGROUND
Tyler,M.L. (1975) Homoeopathic Drug Pictures. Health Science Press, Holsworthy, Devon,
UK.
1

1 Esker Lawns, Lucan, Dublin, IRELAND. Fax: 353-46-25187; Tel: 353-46-25214 (lab);
353-1-6281-222 (home)
2
Throughout this text, the following convention is used for the codes for the Channel-Organ
System (COS): LU=Lung; LI=Large Intestine; ST=Stomach; SP=Spleen-Pancreas;
HT=Heart; SI=Small Intestine; BL=Bladder, with BL40=WeiZhong; KI=Kidney;
PC=Pericardium, Heart Constrictor, or Circulation-Sex; TH=Triple Heater/Endocrine;
GB=Gall Bladder; LV=Liver; CV=Conception Vessel (ventral midline); GV=Governor Vessel
(dorsal midline). Other authors may use different conventions.
3
Joking aside, the miracle of life outside the womb begins with the first breath and ends with
the last. LU function is the most important of all vital Qi functions. All the other organs and
functions die within minutes if starved of oxygen (part of the Qi of air). Body energies at their
lowest ebb, the Qi cycle ends in LV at 0100-0300h (0300 is known as the dead hour of night).
The new Qi cycle begins in LU at 0300-0500h.
4
Swedish research, published in 1992, has suggested a causal link between EMFs from high
voltage transmission lines and leukaemia/brain tumours in people.
5
The skin is a more important organ than generally is realised. It is a powerful organ of
elimination. It also acts as the terminal for viscerocutaneous and cutaneovisceral reflexes and
similar reflexes, which are the basis of AP effects.

APPENDIX
Holistic concepts integrate those of advanced physics with traditions of the shaman/
witchdoctor/ priest-priestess healer of many ancient cultures. They involve a belief that

everything in creation is linked in a universal, if intangible, energy field (E = mc2); that each
cell of the body has an electromagnetic field which reflects the state of the cell; that the
healthy organism is a bioelectric entity, with a balanced, integrated set of fields; that a very
wide range of stimuli (external, internal and genetic) can modulate (beneficially or adversely)
the bioelectric fields in the organism; that focused thought can interact with the universal and
personal energy field; that there is no past and no future, merely a continuous present; that
field effects interact with cellular metabolism etc.
In the definition of the dictionary, many aspects of Holistic Concepts of Health and Disease
are arcane or occult (something which is restricted to the fraternity/sorority; secret, hidden).
Holistic (transcendent) medicine recognises many more causes and therapies of dis-ease than
does mechanistic (scientific) medicine.
Many scientifically-trained professionals have a religious belief, in which the healing arts
(medical or veterinary) are human expressions of a divine vocation, similar to priesthood or
humanitarian service. In human frailty, they attempt to realise the "will of God" (as revealed
by the Christ, the founders of other great religions and the mystics) "to love one another" and
"to heal the sick". They believe that the mind/soul is often involved in dis-ease and that
healing of the disturbed mind/soul can often be more important than mechanical correction of
physical lesions. They believe that the mind of the patient (and of those who know the patient)
can influence the outcome of psycho-somatic disease.
An inherent part of holistic medicine is the desire to understand when, where, how and why
the patient is ill (diagnosis) and what to do about it i.e. what methods of therapy may help
the patient most.
When diagnosing, many holistic practitioners positively seek the help of our Creator. They
also seek the patient's help by an internal (mental) dialogue: if I am to help you most
effectively, you must please show me where and what is your main problem! When treating,
they will/visualise/ project healing to the patient as a routine part of what they do: I open
myself to the healing energy of the Creator, who heals all pain and suffering. I transmit to you
the healing energies with my love and with the love of our Creator.
Many holistic practitioners believe that a drug administered with love and compassion is of
more benefit to a patient that the same drug administered mechanically or dispassionately.
Great healers (believing that they act as channels for a benevolent Creator/Universal Life
Force) can dispense with the drug altogether.
Fragments of my unpublished prose and verse follow. They may give some slants on this
student's impressions of some of these concepts.
PATRICK KAVANAGH'S WORLDS: MINE AND NOT MINE
(Extracts from an unpublished work by P.A.M. Rogers).
Patrick Kavanagh (K) was a great poet, one of the greatest in the English language since W.B.
Yeats. You may wonder what on earth a dead Irish poet has to do with Holistic Concepts of
Health and Disease! I choose to discuss K's life and work, as they illustrate the paradoxical
(Yin-Yang, positive and negative) nature of humanity, the power of mind to be creative or
destructive, the struggle between rationalism and blind belief. Most of all, they allow

discussion of materialistic-atheistic versus mystical-transcendent values. For poets and many

holistic practitioners mysticism is the foundation of their work and their search for "why".
K was born on a small farm in Inniskeen, on the borders of Monaghan, Armagh and Louth
(Ireland) on October 21, 1904. He died in a Dublin Nursing Home on November 30, 1967
after suffering years of cancer and alcoholism.
Though his body, bones and brain are long since dead and decomposed, K's warrior-spirit is
alive and thriving! In his poetry, he is a warrior, a Christ-like champion of the poor and
oppressed. His verses scream out human dis-ease (loneliness, pain, injustice, poverty and
ignorance). They also sing out one recipe for optimal human health, the desire of the human
soul to transcend the weakness and imperfection of this life. They acknowledge the joy and
beauty of life (the only life that we really know) and the fearful wondering if there can be
anything waiting on the other side of the Veil.
My comments on Kavanagh and his worlds are my impressions of his work. References and
page numbers are shown as (CP5), where 5 is the page number in his COMPLETE POEMS.
References from his novel the GREEN FOOL are coded (GF). LAPPED FURROWS and
SACRED KEEPER (by his brother, Peter) are coded (LF) and (SK) respectively.
He was aware of the human condition: frailty, loneliness, frustration, the isolation of the
artist and the need for love, the false friendship of the bottle, the transience of life and the
battle to survive.
K was a paradox, an Irish version of a Zen riddle:... some said a great artist, others,
ambiguously, a fiddle... (CP300). He was:... the representative of those/ clay-faced sucklers of
spade handles,/ bleak peasants for whom Apollo blows... (CP30).
KAVANAGH THE POET : K wanted to find his own truths. Mysticism, Man's dialogue
with God, Man-in-the-world-and-why was the foundation stone of his work: At the foot of a
Cross is the Utterness/ of humanity/ every atom of clay,/ every worn stone/ becomes your
wish for beauty/ the world cannot own... (SK8).
K had held fast to reason as the guiding principles for most of his life. But human actions and
their expression are a mixture of reason and instinct (unreason). Alcoholism is
"unreasonable", as is faith. In the end of his life, he wrote: The day I walked out on reasonthat old plodder/ (but you didn't)/ was the best day of my life... (CP351)
K was a beggar but rich in spirituality, a dour loner and a black comedian. He was said to
have been a plagiarist but he was also a creative genius. He meditated constantly on the place
of humanity in nature and on the conflict and similarities between the pagan and Christian
ways. He was a visionary/mystic, a Catholic/pagan.
The paradoxical riddles in K's life and work, his dualism (love/hate, joy/despair) and his
undoubted consciousness of these suggest leanings towards the spirit of Zen Buddhism. He
throws out a mighty challenge and no challenge: "my purpose in life is to have no purpose".
Again, he said: Philosophy's graveyard- only dead men analyse/ the reason for existence./...
The world began this morning, God-dreamt and full of birds.../ O come all ye youthful
poets and try to be more human (CP225)

Humanity is a mixture of good and evil, gentleness and brutality. The conflict and tension
between opposites has always been part of poetry and of life.
K was a very astute observer of nature- light, wind, landscape, animal- and humanbehaviour. His readers, especially those from rural backgrounds, can feel the textures, see the
pictures, hear the sounds of his ideas: A dog lying on a torn jacket under a heeled-up cart,/ a
horse nosing along the posied headland, trailing/ a rusty plough..../ October playing a
symphony on a slack wire paling (CP80)
SELF-EXAMINATION: I go from you as a snail/ into my twisted habitation./... I know
the shallow ways/ of self (CP63).
If it is to be of universal import, poetry must contain a high degree of self-examination. It
must examine and question accepted conventions and all the so-called basic dogmas and
truths: birth/death, growth/senility, immaturity/maturity. It must also address human reaction
to more abstract values and emotions- love/hate, God/Devil, good/evil, subjective/objective
realities randomness/meaning of existence, etc.
Am I merely an amalgamation of things, bits and pieces strung together? Am I my profession,
an ethical reality? Am I my feet, my penis, hands, one hand clapping in a Zen temple, the
other severed in the surgeon's bin? Am I the sin of my ancestors, the mind-creation of my
children, wife? Shall I pay the price for them? (Rogers).
FIERCE HONESTY AND LOVE OF TRUTH: K knew that nothing can be known fully
and that people who assume that it can commit a crime against wonder: ...The poet wrote it
down as best he knew/ as integral and completed as the emotion/ of men and women cloaking
a burning emotion/ in the rags of the commonplace, will permit him (CP124)
Science, psychology and literary assessment rely on analysis, the breaking down and tearing
apart of complex things and ideas into their components in an attempt to understand how they
all fit together in the complete picture. This attempt, unless done with sensitivity and wonder,
is of itself an act of destruction, a desecration:... we shall not ask for reason's payment/...
nor analyse God's breath in common statement (CP125)
The dissected flower, butterfly, mind (or writer's work!) is a sad sight. K's comic vision
sensed the vulgarity of such analysis. He was also sceptical of "objective" science. K was
convinced that rational thought and scientific exploration are but one aspect of human
search for subjective truth: Now I have to sit down and think/ a world into existence; you
cannot borrow/ anyone else's... (CP296)
Objective truth depends on at least one observer. The more observers who agree, the more
objective the truth is for them, in other words objective truth is arrived at by a consensus of
subjective truth and ... Truth's insanity/ is a spell that all men must hold to; when they
wake/ not even dust is left for all their striving (CP182)
TRUTH VERSUS FANTASY: ... If truth is certainty and our world uncertain, our world is
fantasy. The main certainty for us is death, the main uncertainty what then?
My truth/reality may be your fantasy/nightmare. Our interpretation of the world is imperfect
and subjective. It depends on our senses, our training and, to some extent, on instinct/intuition

to fill in missing pieces of the image. Reason can be defective, a fact well known to those who
work with psychiatric patients.
Dream-trance/hypnosis: In occult traditions thought (dream, conception, will) precedes
action (foundation, construction, reality). The Spirit(s) breathe(s) the dream/idea, which may
strike a number of people at the same time. Nothing is more powerful than an idea which has
reached its time. If enough people want something to be (to happen), it will, at least for them.
The dream precedes the blueprint, which precedes the Taj Mahal. Directed or controlled
visualisation (daydream) is a powerful tool.
Truth/reality is primarily opposite in trend to dream/fantasy but the seeds of one lie in the
other and the opposites of each lie in each. One can lead to the other. Dreams or fantasy can
have a basis in truth/reality and can develop into it, as in precognitive dreams or medical
diagnosis/healing using the inner (sixth) sense. Truth/reality can have a basis in dream/
fantasy and can develop into it, as in human endeavour in the First World to solve the
problems of the Third World. One fingerless hand claps, as in most aspects of nature.
TRAGI-COMEDY: "tragedy is underdeveloped comedy" (SK106) and "some crucial/
documents of sad evil... may yet/... fuel the fires of comedy" (CP296)
PAGANISM, NATURE WORSHIP AND ATHEISM: New life, new day./ A half-pilgrim
saw it as a rabbiter/ poaching in wood sees/ primeval magic among the trees (CP113). Prayer,
worship and meditation were directed towards the spirits, or towards the material
manifestation of their power- hence sun and moon worship; sacrifices to the sea and the
forest; festivals of spring, summer, harvest etc: And you who have not prayed/ the
blackbird's evening prayer/ will kneel all night dismayed/ upon a frozen stair (CP64)
Many of the places of Christian pilgrimage were originally sacred, or "places of power", in
earlier pagan cultures. Many Irish "Holy Wells" flowed healing water long before the
Christian era.
As is the case with all thinkers, K often questioned if life had any meaning which can be
discerned by human mind: Mind is a poor scholar/ O blind mind/ when is spun your chilly
firmament/ souls nothing find (CP12)
The occult is based on dualism (white- black, good- evil). Adepts choose the left or right path,
both of which are powerful. They pray/meditate in the belief that concentrated thought is
concentra-ted energy and can cause the desired effect to happen, if only by bolster-ing their
own self-confidence and resolve. Benevolent or malign human thought can be potentiated by
calling in the heavies- benevolent or malign entities.
Apart from powers vested in the spirit world, occult traditions recognised special powers in
certain natural phenomena. These forces could be harnessed by people for good or evil. One
could draw healing power from a tree, an underground stream, the wind etc: It is there! Earth
force! Life force!... Feel it flow: pins and needles tingling, Kundalini spreading. Scalp, neck,
back, arms, trunk, loins, legs electric. Feel the Power and hold it within! (Rogers)
"They who live by the sword shall die by the sword". "As you sow, so shall you reap".
Occult traditions teach, as does the Judaeo-Christian:... Thought and Word are straining
hounds./ Once unleashed, they track and course/ the distance of the universe./ They nurture

life or inflict savage wounds./ By day they turn their master's chosen game./ At night fall, they
return/ (often matted in dried mud, torn,/ bloody, thorned, panting, lame)/ home to their lair.
They paw and gnaw/ on parboiled heads and other gory chow./ They gorge as hungry hounds
know how,/ then circle down to rest in the tangled straw/ synapses of their slipper's demon
mind/ or wag their tails and nose his godly hand (Rogers)
Positive thoughts produce positive effects, as in healing prayer/Lourdes, telepathic healing.
Negative thoughts produce negative effects, hence the use of curses, spells, voodoo etc in
occult, pagan and satanic rituals. But the thoughts, or their clones, return to the sender.
ORIENTAL CONCEPTS AND ZEN: loser of the self to others is, through others, finder of
the self.
Oriental philosophy is based on duality, the interplay of opposite forces. It holds that all
created things depend on interplay of Yin-Yang energies or Qi- the vital or life force: Chained
by a leathery navel cord to sweet-and-sour earth and pulled towards the celestial by fierce
magnetic force, must our soft centres rip apart on that cosmic rack? Between the foolish and
the wise, man lies. Between the glowing stars and groaning ice, man lies. Between laughter
and tears, man lies. God-Satan fights in him. Hope-despair lurches his heart. Love-hatred
savages his mind. Nun-Harlots turn his head and in a vital world many living souls are dead
(Rogers).
The symbol of Yin-Yang Qi is the Monad, a circle divided in halves by a wavy line, so that it
resembles two fish, head to tail. How many city-dwellers have seen the sharp line of
demarcation between the north- and south- faces of a Toblerone of milled peat on a frosty
January morning? The north face (Yin) is white with frost and the south face (Yang) is brown
and the dividing line between the two runs along the top of the Toblerone. It is an amazing
sight when seen for the first time but is shrugged at, as something absolutely natural, by those
who know the bogs. It is one of the best examples of the oriental concept of Yin-Yang for
visual display.
K was aware of nature's laws. In describing the North-facing side of hills, he wrote: My hills
hoard the bright shillings of March/ while the sun searches in every pocket (CP13)
Yin (material, solid) and Yang (immaterial, ethereal) are merely different forms or states of
energy. These realities, depend for their definition on each other. Yin (passive) and Yang
(active) can not exist without each other. Yin and Yang transform (change) into each other
and return to the original state (Yin to Yin, passivity to activity to passivity). Good and evil,
antagonistic yet complementary fundamental energies must find expression.
Night and day, winter and summer, ice and fire, death and birth are common realities. In Zen
they are neither evil nor good. They just are. Good and evil are only words. It is the personal
choice and direction of action or inaction which matters to the Zen Master.
The concept of natural rhythms and change is central to Yin-Yang theory: See Master Sun, sail
in at dawn, dip away at dusk. See Mistress Moon, slip in at dusk, pale away at dawn. But in
the night the sun is there and in the day the moon, there and not there at the same time, like
Santa Claus and God (Rogers)

Conception, birth, puberty, parenthood, menopause, death (reincarnation?) are all part of the
seasons of life. There is a time for activity and a time for rest. All action/interaction involves
input or output of energy, creation and destruction, and transformation, i.e. involves dynamic,
inevitable change. Yet, the whole system stays in balance, with nothing added and nothing
taken away. All of nature consists of change and no change. Yin-Yang theory predated
Einstein's relativity theory by over 5000 years: The Newgrange sign is clear and penetrates
the soul.... The whorls and spirals,... deeply etched in granite cry aloud: "The reality of life
and death is change! The reality of change is death and life! Listen and act if you dare!". The
eagle understood. He saw his death and rebirth, found great inner peace (Rogers)
Zen Buddhism is rooted in concepts of Tao (the Way), the paradox, the way of change
and no change, the way of Yin to Yin and Yang to Yang. It is the way of reason and unreason
(intuition).
An exercise of Zen meditation is to wrestle with a riddle to which there can be no
reasonable answer- the paradoxical KOAN. A typical piece of Zen verse depicts a crag
(Yang), valley (Yin), each merging into the other (change).
K was a great, if unwitting, poet of the oriental Zen Yin-Yang tradition:
... the boortree that has a curse but also a blessing (CP155). "Suddenly I remember something
that makes me sad and, curiously enough, I am happy then" (SK122). "... people are hated
because they are loved" (SK320). But now I will hate till my hate/ comes out the other side
of the world as love,/ love in Australia (CP218). K's statements that "to be willing to be
nothing is one of the best ways of being something" (SK222), that "his purpose was to have
no purpose", that "tragedy is underdeveloped comedy" in the most profound sense (SK106)
and that "the right way is wrong" (CP347) are characteristic of the Zen KOAN.
The comic poet and the Zen Master have a lot in common. Evil does not faze the Zen Master.
He/she accepts evil with the same serene detachment as good. Both are equally valid
realities:... praise, praise praise/ the way it happened and the way it is (CP322). Evil does not
subdue or even arrest the comic poet because his/hers is the superb sanity of knowing what
really matters (Kennelly).
In typical Zen riddles, K confounds thinkers and poets who take themselves too seriously in
seeking to explore the unexplorable:... There are no answers/ to any real question (CP237,
238)/... no answer, no message from experience won,/ advice forever explores the banal/ so let
us walk along the banks of the canal... (CP279)
or to those writers who try to explain the unexplainable: The only true teaching/ subsists in
watching/ things moving or just colour/ without comment from the scholar (CP287)
CHRISTIAN FAITH: The way I see it, all that went before is gone, work, rest, good, sin, but
sparrows still find grain. Today is incarnation, birth, death and resurrection, wheel, spoke and
axle, hub and rim of universe (Rogers). Child there is light somewhere/ under a star,/
sometime it will be for you/ a window that looks inward to God (CP7). I saw Christ today/
at a street corner stand,/ in the rags of a beggar he stood/ he held ballads in his hand (CP27)
For faith to have value, believers must wrestle constantly with unbelief. K had many doubts.
Talking to himself, he said: you... take up religion bitterly/ which you laughed at in your
youth,/ well not actually laughed/ but it wasn't your kind of truth (CP223) but he wanted to

accept the idea of a personal God: Only God thinks of the dying sparrow/ in the middle of a
war (CP115). But the concept posed problems for him in later life, as it does to many who
want to say (and believe) "Amen!". If the personal Ear of God listens to the millions who pray
for specific, selfish, intentions, poor God must be weary, if not downright confused. K touches
on this: A secret lover/ is saying Three Hail Marys.../ that... will bring/ Cathleen O'Hara...
home to him./... Cathleen herself is saying/ (three more)... to bring/ somebody else home to
her.../ What is the Virgin Mary now to do? (CP176)
K's idea of prayer was one of worship, praise and wonder at the beauty of creation (nature),
a sense of oneness with the Creator and all things created, rather than a plea to supernatural
beings for special treatment of the self: ... You plough, you sow, you reap, you buy and sell/
and sing and eat and sleep. All is well/ done/ in the name of the Holy One (CP181).
For him, the search for truth and its expression in poetry was real prayer, the praise and
worship of the Spirit in mortal flesh, the childlike affirmation of the utter dependence of
humanity on the benevolence of the Energy behind nature.
The Circle is the Father/ Diameter His Son/ Spirit the mathematical centre/ thus truth is
known/ in all turning wheels/ in all tumbling clowns/ as in the firmament deep/ where the
Prophet drowns (CP67)
But, as in other things, K was paradoxical: The poet's task is not to solve the riddle/ of Man
and God but buckleap on a door/ and grab his screeching female by the middle/ to the
music of a melodeon (preferably), roar/... up lads and thrash the beetles (CP248)
HUMANISM, ATHEISM, SCIENCE: (Knowledge said... ): This is the only way/ of truth ./
And the fool in me/ buried God's lantern in dark clay/ that an angel might not see (CP41)
K had difficulty in resolving the conflict between intelligence/rationality and blind or
reluctant obedience to religious dogma and practice. The self-reliance and pride of atheistic
humanism is exemplified in the "scientific" search for truth.
Many scienti-sts and thinkers believe that natural phenomena can be reduced ultimately to
physical/chemical reactions governed by a complex set of equations. By reducing nature to
equations, they remove all the wonder and mystery. Analysis may quantify the elements in the
beetle's iridescent wing but can it reconstruct the beetle's ash to fly again? Can Science weigh
the human soul or take the pulse of God? Atheistic scientists would not be:... afraid when the
sun opened a flower,/... never astonished/ at a stick carried down a stream/ or at the undying
difference in the corner of a field (CP180)
No scientist has seen a quark but the reality of quarks is inferred from effects which can be
explained by their existence. No scientist has yet seen God through his/her telescope. Ergo,
God does not exist- God is not given the status of the quark: Way out among the distant
stars, or hidden in a quark,/ or in the pure song of the lark, or in the deeds of dark,/ or in the
thunder and the rain, or in the desert dry,/ or in the fission of the bomb, or in the human cry,/
or in the slowly rotting leaf that births a giant tree,/ or in the plastic micro-chip, or in the
depths of me,/ mc squared equals E! I kneel and adore THE E:/ at one with the Universe!
(Rogers)

Einstein's Law of Relativity states that energy is neither created nor destroyed; it merely
changes form. Mass and energy are interchangeable. Yet, the whole system stays in balance,
with nothing added and nothing taken away. All of nature consists of change and no change.
Ancient Yin/Yang and Zen theory predated these concepts by over 5000 years.
K saw science as a game for creatures of limited consciousness. FOR EMINENT
PHYSICISTS is one of his best religious poems, in which he implies that faith in God wins
him rather than reliance on science. The poem is so good that it said it all in less words that
this commentary: God must be glad to see them play/ like kittens in the sun/ delighted with
the wisps of hay/ blown from His haggard on a breezy day.../ Time's kittens, have your fun
(CP147)
REPENTANCE: We have sinned.../ Let us lie down again/ deep in anonymous humility and
God/ may find us worthy material for His hand (CP256)
Sin, guilt and repentance mean different things to different people. The human reality is that
we are human. To be human is to err. Some belief systems call this sin and demand a personal
and social expression of guilt (confession) and sorrow for it (repentance). Where possible,
recompense is expected.
Honest people admit to having made some serious mistakes, or having failed to hit the desired
ethical target. This recognition of human frailty, with a sense of praise, worship and total
dependence on God/Nature is the basis for all healing of mind and body.
O divine Baby in the cradle/ all that is joy in me/ is that I have saved from the ruin/ of my
soul your Infancy (CP71)
K admitted failure in the end and threw himself in God's hands, even though doubts about
the existence of life after death had recurred again (1965): ... heaven if there is such/ a place
which I doubt very much (CP344). One wonders if those lines flashed through his mind at
his last conscious moment, or if he died composing some new and violently beautiful poem to
the Creator or a poem simply praising human ability to defy poverty, pain, darkness and
silence.
CONCLUSIONS: We are all conditioned in our beliefs, morality and behaviour by family,
school and immediate society. Most parents try to pass on their sense of values to their
children. Parents would resent the charge that they try to "condition the children to the same
taboos and fears which make a mess of their own emotional, mental, spiritual and sexual
lives" but, in many cases, this is what the system (home + school + church + society) really
does: She held the strings of her children's Punch and Judy,/ and when a mouth opened/ it was
her truth that the dolls would have spoken/ if they hadn't been made of wood and tin (CP99)
Professionals are conditioned by teachers, drug companies, peer-pressure and our own
clinical experience. While much of our conditioning is very useful, much is unhelpful- it
does not solve our clinical problems. It is possible to delete obsolete or faulty software/ideas
from our brains' storage area/memory and to reprogramme with worthwhile or experimental
software/ideas by interfacing with holistic practitioners, artists, mystics and poets. I urge you
to try it. If the new software is unhelpful, that can be scrubbed also!

Life is for loving and living, for growth and decay, for experimentation and failure. It is
not for futile talk or unfelt prayer: He saw the sunlight and begrudged no man/ his share
of what the miserly soil and soul/ gives in season to the ploughman (CP96)
Teaching depends on the knowledge, instinct and communication skills of the teacher and on
the ability and willingness of the student to learn. The great teacher may have many
students or only one. But one is enough because that one may teach many.
K believed that the great poets... never teach us anything... they... provide us with an orgy of
sensation and nothing else or more (SK220). I believe that K was wrong. He undervalued the
priesthood of the great poets and the sermons on love, hate, hope and despair in his own life
and work. In 1957 he said that malice is only another name for mediocrity. People need not
be mediocrities if they accept themselves as God made them. God only makes geniuses
(SK326). What a teaching if there are students to listen!
REFERENCES TO KAVANAGH'S LIFE AND WORK
Kavanagh, Patrick. Ploughman and other Poems. 1936. Macmillan, London.
Kavanagh, Patrick. The Green Fool. 1938, 1987. Penguin Modern Classics.
Kavanagh, Patrick. Tarry Flynn. 1948, 1975. Penguin Modern Classics.
Kavanagh, Patrick. The Complete Poems (Collected, arranged and edited by Peter
Kavanagh). 1972, 1984, 1987. Goldsmith Press, Newbridge, Ireland.
Kavanagh, Peter. Lapped Furrows. 1969. The Peter Kavanagh Hand Press, New
York.
Kavanagh, Peter. Sacred Keeper. A biography of Patrick Kavanagh. 1979. The
Goldsmith Press, The Curragh, Ireland.
Kennelly, B. Irish Poets in English. 1973. Editor Sean Lucy, The Mercier Press,
Cork and Dublin.
O'Brien, D. Patrick Kavanagh. Bucknell University Press, U.S.A.
O'Loughlin, M. After Kavanagh. 1985. The Raven Arts Press, Finglas, Dublin.
Warner, A. Clay is the Word. 1973. Dolmen Press.
Warner, A. A Guide to Anglo-Irish Literature. 1981. Chapter 9: Patrick
Kavanagh. Gill and Macmillan, New York.
CONCEPTS OF UNITY Unpublished verse by P.A.M. Rogers
MUNDANE ARCANE
Long and slender/ needles of fine steel/ are symbols of another way./ One Master inserts two
tips/ through the eye of a third.../ voila, a Chinese dowsing-rod/ to find the leaking point./
Another reads the pulses,/ with sorcerer's intent,/ or reads the tongue/ to find the locus/ of the
block. A third simply feels/ above the horse's hooves/ for watery holes. He nods/ when his
finger drowns/ in Sandefjord.
In her sanctum/ an adept gazes/ at crystal fire./ The prayer dream/ grows, water-cries/ and
claws for birth./ In the next village,/ the cripple, laughing madly,/ walks.
REVOLT AND GOVERNMEN

THE CIRCLE (Yin-Yang)

Two fish fill the circle./ Lovers circle and clinch/ and fall into the circle./ A tireless snake/
swallows its tail./ Where is the rattle, the venom ?/ Hidden away as potential energy/ to please
the child or put/ the demented out of misery ?
Atoms and universes show/ the power of revolution/ and Einstein proclaimed/ ex cathedra the
dogma/ of the unity of matter and energy./ So to infinity are the Word, the Flesh/ and the Light
interchangeable./ Nothing is lost, nothing gained/ in the endless cosmic dance./ Hexagrams
from ancient yarrow sticks/ or from random number generators/ point the ultimate reality :/
change is the source and end of all/ change is revolution !/ Wheels roll on ; all is change/ and
nothing changes anyway.
THE STAR (THE FIVE PHASES)
The inner calm, the balance/ between atoms and the universe,/ the hidden seabed and the
clouded peak,/ the human states, the blues, the joys,/ lie in the circle around the star.
The tips of the Five Point Star/ sow seeds of revolt and government./ As fire begets the ash of
earth,/ Earth-mother births her shining/ and so around the clockwise wheel/ the change brings
life and growth/ and death. The wheel and pentagram roll on,/ Government and revolution
live in harmony./ As water controls fire,/ fear controls desire
but if water overheats,/ fire rebels, attacks,/ turning it to steam/ and desire flares, then flickers
out./ So are all the elemental attributes controlled/ in flux. Creation and destruction/ vie as
equals in the turning wheel./ Nuclei disintegrate. Nuclei fuse./ Seal-pups clubbed to death ; a
V of swans in flight./ Did Einstein get his calculations right ... ?
BRUSH STROKES ON A CANVAS
Jagged crag, what is your need ?/ To lose my stoneness in beauty,/ avalanche, granite-chipped,
myriad shaped,/ mica glistened, marble streaked,/ thunder down into the shrouded valley.
Empty valley, what is your need ?/ To be seeded with sound, colour, form,/ swell the senses,
mind to consciousness,/ flood my fullness up my fertile slopes,/ overflow to other empty
craters.
Crag and valley fuse, explode,/ disintegrate, reform to emptiness and stone again./ The canvas
satisfies the painter's eye/ and palette, brushes, paint/ sleep the easel sleep of waiting.
UNIVERSES REFLECTE
FLOW
Two lifeless planets, coldly orbiting,/ attracted and repelled in silent dance/ around two lonely
suns, hurtle onward
with their suns through nothingness,/ collide with a sixteen-pointed star,/ cruising too hungrily
to enter Eden.
Blueprinted by a thirsty Architect,/ eighteen sparkling planets realign./ We have ignition !
H2O is formed.

The flow is fierce, the tides are strong./ The Artist claps in glee/ as the seething sea pounds
puffing holes.
From its heavings, from its froth,/ live erupts unstoppable.
EBB
Sea-sculpted from Easky shale,/ pools at the high-tide mark/ swirl, dart- twisted by stranded
fish,/ their water of life break-dancing to elemental rhythms. Salty source/ and final leveller of
seer and fool,/ sea-fields grassed with bubble-weed and wrack,/ sliding ruin of the careless
foot.
Mines of gold and silver flashes,/ crab and shrimp, joy of urchins/ dangling threads for
treasures/ and the treasures released unharmed.
Winkles, algae, plankton/ teem in landlocked space-time./ Birth-grunts of dinosaurs imprint/
on cliffs and human stains dissolve in salt-spray. Water-born lifetimes/ of centuries, years,
seconds,/ riff the surface, sink/ like skipping-stones/ but mirrors reflect the user/ and images
of glory reappear.
ON THE 37th ANNIVERSARY OF THE FOUNDING OF THE PEOPLE'S REPUBLIC OF
CHINA
Ming Ming and Ping Ping were gone/ but over the well-trimmed Embassy lawn,/ echoed the
crunching of bamboo on skulls./ Kaleidoscopes of bamboo-shoots, green and tender/ and
dissident shoots, scarlet and brutalised/ floated in the air against a sea of blood/ and righteous
bullets./ Feudal lords, sated/ and peasants ground to poverty and blank despair/ whispered
from the Ballsbridge trees./ Sweat dripped from heat-struck oxen./ Terrible diseases fought
each other/ to be first in the land./ A rapist laughed as he buttoned up/ but his mouth became a
giant O/ as his severed head was shown to the crowd./ More warriors clashed among the
flowers/ before they petrified. The unlucky ones/ lost their arms in a Dublin hospital/ but the
arm of Wu Song-Fook,/ severed by an unguarded band-saw,/ was replanted to his living trunk/
by a macro-team of microsurgeons/ in a Shanghai hospital./
Opium the religion of the people no more./ The opiate receptors, deep in the brain,/ now
explain the potency/ of tiny needles in the skin./ Miracles of ancient sciences,/ the needles,
moxa, herbs,/ help the hopeless cases./ The soldier, paralysed by a stroke,/ drives again the
army truck./ The polio child walks without her braces,/ which recycle endlessly./ The dumb
speak./ Miracles of our science/ irrigate the fields, yield four crops/ of living rice. And
paddyfields yield/ fish and ducks and not a Paddy poacher to be seen./
We try to understand but fail,/ our superior politeness wearing thin./ Chinese fiddles and
strings/ create their weird cacophonies,/ background to the high-pitched and bass/ voices of
the Beijing Opera./ The artists move as if on strings themselves./ Are they mindless
marionettes/ or experts far beyond our dreams ?/ We strain to catch the meanings/ where there
are none for us./ Twirling his fourth glass of wine,/ a shrewd observer mutters/ that it is all
above him./ Good on you mate-/ there are others less perceptive!/
The gulf of comprehension narrows/ slightly when we realise/ the discipline and method/
behind the sounds and movements./ Control, control ! A game of mastery/ with different rules

and codes from ours./ The dawning as the black eyes smile/ into the puzzled blue :/ THEY are
Chinese. They are CHINESE./ This is their way, perfect in its form/ and execution.
More images mirage on the lawn./ Slender women run on unbound feet,/ free and equal with
their men ;/ laughing children point at the bearded ones ;/ workers meditating at the factory
lathe ;/ Tai Ch'i in the streets,/ control of mind and body,/ bees in the hive where there is no
queen ;/ one thousand million on the march to peace ;/ a flawless pearl, sand-itched from the
Yellow River -/ love, respect, morality and strength,/ a fearsome combination, backed by
boundless hope./
To the next thirty-seven years/ and their kaleidoscopic clones,/ Kampe ! Kampe,
Ambassador !/ Between our heres and there 's a bridge is built/ but treat your rebels without
guilt !
RIVER SCENE
The ferryman spent his days/ poling people to and fro./ Monks and merchants, poor and rich/
passed their hurried way,/ missing the ferryman's wink/ and the banyan tree.
Content in the banyan shade,/ sat a hardened Buddhist monk/ remembering his debauched
youth,/ a youth of silk and softness,/ perfumes, musk and wine./ All his urgent needs were
met./ Nothing needed now/ but the river's confidence/ and its womb-like murmuring.
River, your questions ?/ What sought you of the burning eyes, excited face ?/ To know the
unknown./ What sought you of the burnt-out eyes and ashen face ?/ To unknow the known./
What is the time between your coming and your going ?/ A wasted lifetime./ Return to the
watery peace from whence you came !
The monk caught the ferryman's wink -/ they knew the river's age and of its wisdom./ What is
the answer, river ?/ Monk and ferryman, hear me well !/ You must choose your heaven and
hell./ Now is the time to live or die./ Now is the time to laugh or cry,/ fast or eat, wake or
sleep./ Now is the time of knowing.
Virgin to the bed of shame,/ foetus on the draining-board,/ soldier in the sights,/ death of a
loved child -/ there is no going back./ Unknowing is the dark finality./ Be, my friends ! Just
be/ or choose and be done with questions.
VIVE LA DIFFERENCE
US
He wears last-year's baggy pants,/ discordant jacket, any shirt./ She disapproves in her
aesthetic agony./ She sees herself a queen in seamless silk./ He sees the price in coolie's sweat.
She sees red flowers, pearled with dew./ He sees the thorns, the horse manure./ She is pricked
as she captures her dream./ He ignores the perfume/ as he digs their common grave/ in the
shadow of the unseen rose.
She of the spirit, he of the flesh/ at the middle time of life/ live a charade/ unless they
understand the wheel/ and compromise.

THEM
"Vive la difference !" some say,/ as if the fact is static./ But I wonder about wheels and
rhythms,/ cycles turning.
The adult male is hard,/ his softness locked away/ by the evidence of his witnesses/ until, at
sixty-five or so,/ the witnesses withdraw the evidence,/ springing softness from its prison./
The ripe female is soft,/ her hardness camouflaged by egg-stuff/ until the ova yield to
menopause./ Hormonal brake released, she grows a beard/ and talks bass tones.
Testosterone and oestrogen, the fighting twins,/ secreted from the same cells in the embryo,/
compete for sexual expression/ in body and in mind./ The different responses are statistically
significant,/ programmed parts of our humanity./ Brutality responds to nature's nudge/ but all
things pass in time./ C'est la vie !
JACK AND MARY SPRATT
For fifty years they shared a home/ whose solid walls absorbed/ the joy and hate, laughter/
and the sound of grinding teeth./ Their bioclocks were three hours out of phase -/ best times
for both were rare./ Although they died three years apart,/ their coffins touch.
Her life was spotless,/ regulated by strict rules./ Her dream was changelessness,/ defying
seething tides of change./ He lived undisciplined,/ driven by escapist dreams/ to change the
world,/ yet sure that nothing changes./ She was rooted in the earth and things,/ but sometimes
soared./ He hawked the air on flimsy wings/ and plummeted to earth for meat./ They orbited
between the earth and stars/ and nodded in greeting/ when their orbits crossed.
Neighbours heard their squabbles/ frequently./ The travelling woman called on Saturdays/
religiously./ They ate the bread of life together/ occasionally,/ made calm-eyed children/
accidentally/ and nurtured them/ instinctively./ At night, together but apart/ they dreamed and
sighed. When clay was thrown down on them/ and the old priest intoned for them/ great
crowds wept for them/ knowing/ how much they loved each other/unknowingly.
LET THE STUDENT BEWARE
TRUTH
I show you nature through my eyes/ but you must cast away my truths,/ unless your own
experience/ should drift with mine/ as grappled boats, lost/ in the ghostly fog/ which scientists
call truth.
You must reach and trap the fog/ in baby's hands. Call it your truth./ But, if you dare to chink
your hands,/ be quick to look ! Some truths/ can last no longer than the dew at noon/ nor than
the lightning bolt/ that streaks to earth in June.
The thought of truth as absolute/ provokes me to irate invective !/ The nearest thing to
objective truth/ is the death of the unconceived./ The fool who knows she is a fool is not./ The
sage who thinks he is a sage is not.
BEWARE
Like digging moles, your eager minds/ probed for slugs of knowledge hidden/ in the humus of
half truths./ Your search is tonic to our jaded souls./ You drank my rehashed notes/ as if your

thirst could not be slaked/ and bolted my cliched words,/ then licked with relish from my
fingertips/ small crumbs of my truths./ You stomached them in your spring-bound books,/ to
ruminate on, quietly/ pelleting your truth.
I loved you then for I'm a student too !/ Beware !
THEN WHAT?
It
starts
in the heart,
seeps to the groin,
the awful need to be oneone with wife, with friends,
with life, the simple need to be
just one, a unity,
completeness,
the opposite
of lonely zero.
In
the head
the cynic jeers,
at the idiot's need.
Soul-lost in a lover's core,
at the precious moment of surrender,
or the farewells of a party,
or the climax of hard work,
he whispers the devil's anthem:
Is that all?
I must return
to my dark now,
to myself.
Then what?
QUESTIONS
1. One of the following statements is not correct. Indicate the incorrect statement: (a)
Yang relates to the hollow organs/Channels (LI, ST, SI, BL, TH, GB)
(b) Yin relates to dorsal, external, superior and facial areas
(c) In male development, it is normal to pass through Yin to Yang to Yin phases
(d) Perfect balance of Yin and Yang exists at the equinoxes (March and September).
(e) Maximum Yin exists at the winter solstice
2. One of the following statements is not correct. Indicate the incorrect statement: (a)
Sleeping over "the cross-point" of underground streams can cause chronic disease.
(b) The surface electrical potentials of plants and animals increase at full moon and at peak
sunspot activity.
(c) The vital energy (Qi) in a human is determined at birth and can not be increased after that.

(d) In Xu (deficiency) Syndromes, body resistance is relatively weak, and the dis-ease has
usually gained the interior and is more serious.
(e) In Shi (excess) Syndromes, body resistance (anti-pathogenic defence systems) are
relatively normal and the cause of dis-ease is usually external.
3. One of the following statements is not correct. Indicate the incorrect statement: (a) AP
can be used alone, or with other therapies, to enhance the adaptive responses
(b) Einstein's equation (E = m.c squared) has an analogy: Yang (function, energy) and Yin
(mass, substance) are interchangeable
(c) Human emotions rarely cause physical/organic disease
(d) The health and function of the organs are interdependent
(e) Chronic disease seldom arises from a single cause
4. One of the following statements is not correct. Indicate the incorrect statement: (a)
The least important cause for high mortality with E. Coli/Salmonella may be underlying
deficiency of trace-elements (Cu, Se, I).
(b) Climatic changes can cause disease
(c) Qi interacts with genetic influences and non-specific resistance to trauma, poisons and disease.
(d) Excess Yang weakens Yin. Deficient Yin allows excess of Yang. In both cases there is a
relative net excess of Yang ("Hot" Syndrome).
(e) Excess Yin weakens Yang. Deficient Yang allows excess of Yin. In both cases, there is a
relative net excess of Yin ("Cold" Syndrome).
5. One of the following is more Yang than Yin. Indicate the Yang one: (a) cold
(b) above
(c) winter
(d) female
(e) ventral
6. Geopathological effects on the body are due to (indicate the correct one): (a) mineraldeficiency
(b) sun-spots
(c) moon-phase
(d) atmospheric-electricity
(e) distortions in earth magnetic field
7. Which came first: the hen or the egg ? Indicate the most likely Chinese answer: (a) the
hen
(b) the egg
(c) it does not matter because each is an aspect of the other
(d) springtime
(e) the nest

1=b

2=c

3=c

4=a

5=b

6=e

7=c

ACUPUNCTURE EFFECTS ON THE BODY'S DEFENCE SYSTEMS AND

CONDITIONS RESPONSIVE TO ACUPUNCTURE
This paper was written in 1980. For an update, see "ACUPUNCTURE FOR IMMUNEMEDIATED DISORDERS", attached.
INTRODUCTION
Acupuncture (AP) is best known for its effects in controlling pain, its value in treating alcohol
and narcotic addiction and in the induction of surgical analgesia in humans and animals . It is
less well known that AP has great therapeutic value in a wide variety of human and animal
diseases. These effects are well established in clinical practice. Modern textbooks and journals
of AP list hundreds of clinical conditions which respond (partially or completely) to AP
therapy.
Some of the therapeutic effects of AP have been studied experimentally in animals and
humans. In this talk we will discuss the effects of AP in stimulating the defence systems of the
body. These effects are directly involved in the therapeutic value of AP in humans and
animals.
THE DEFENCE SYSTEMS OF THE BODY
Defence systems have two basic components: (a) recognition of the attack, its nature, locality
and extent, and (b) activation of mechanisms to counter the attack and to repair the damage
which has been done. Important defence systems of the body include the following:
a. the immune system (specific and non-specific immunity);
b. the phagocytic system (white cells and reticulo-endothelial systems) and lymphoid
tissues; c. the inflammatory reaction;
d. the thermoregulatory system;
e. the recognition and control of pain and muscle spasm;
f. the sensing of damaged tissue and its controlled regeneration.
The autonomic nervous system (and its reflexes) controls to a large degree these defence
systems in the body. The neuroendocrine system also allows the organism to adapt to changes
in the internal and external environment. The PRIMITIVE SYSTEM of Becker (see the paper
on Holistic concepts of health and disease) is also involved in the sensing and regeneration of
damaged tissue, such as wounds, fractures, burns, etc.
Occasionally the defence systems develop defects which cause them to react to self rather
than non-self. Examples of self-destruction include auto-immune diseases and autoinflammation. Other examples are failure to recognise pain (due to congenital neurological
defect or stress/excitement) with consequent risk of severe injury. One of the causal factors in
cancer is uncontrolled tissue regeneration or failure of the immune system to recognise and
destroy aberrant cells.
The immune system, which normally serves a useful protective function, occasionally creates
problems by causing reactions to allergens which gain entry to the body by inhalation,
ingestion or by skin contact.

AP IN THE TREATMENT OF INFECTIONS

AP textbooks and journals list many human infections which may be helped by AP
stimulation. Treatment is aimed at the main symptoms of the infection (such as fever,
headache, vomiting, diarrhoea, pain, colic, jaundice, paralysis, etc) and at the major regions
involved (such as the liver, lungs, intestine, upper limbs, etc).
Clinical infections in humans which may be helped by AP include:

Bacterial (typhoid, paratyphoid, cholera, bacillary dysentery, brucellosis, venereal

disease, tuberculosis).
Viral (Virus B encephalitis, poliomyelitis, viral hepatitis, influenza, Heres Zoster).
Protozoal (Malaria, schistosomiasis, filariasis, amoebic dysentery).
Fungal (Tinea pedis).
Post-operative infection.

Clinical infections in animals: Animal AP, even in China, is much less well developed than
human AP. Traditional Chinese Medicine (TCM) also relies very heavily on the use of
HERBAL Medicine, especially in the treatment of animal diseases. Thus, in veterinary
practice, AP as a therapy to help fight clinical infections appears to be limited (at this time) to
the treatment of enteric infections (such as E. coli) in pigs and dogs, uterine infections in
cows and bitches, udder infections in cows, and a few other infections.
As will be seen later, the use of AP in experimental infections and in the treatment of many
clinical and experimental conditions in animals suggests that it may have wide applications in
animal infections.
Experimental infections: Animals have been infected with bacillary dysentery, poliomyelitis
virus, trypanosomiasis and Erlich Ascites Tumour virus. In each of these conditions AP had
complete or partial effect in combatting the infection.
Further details of the antibiotic/antimicrobial effects of AP are given in Appendix 2.
AP IN THE TREATMENT OF INFLAMMATION
Inflammation is the normal defence reaction to local injury, infection, necrosis, allergy or
other local irritation. Thus, inflammation is a desirable reaction and one does not try to treat
inflammation per se, but to help the inflammatory response and to speed up its successful
resolution. Where possible, the cause of the inflammation should be diagnosed, removed
and/or treated also. In practice, many inflammations arise from non-specific or unidentified
causes. In these cases, orthodox treatment consists of analgesic, anti-inflammatory, antibiotic
drugs + penetrating agents and physical therapy, used in an empirical manner.
AP is a highly effective means of treating clinical inflammatory conditions in humans and
animals. The needles usually are used on local points (points near the inflamed organ or area),
plus some needles on distant points on meridians passing through the affected organ or area.
When they arise, associated symptoms (such as fever, cough, headache, back pain, etc) are
treated by needling the relevant points for these symptoms.
Human inflammatory conditions responsive to AP in clinical practice include:

Ear, nose, throat, eye, mouth (otitis, rhinitis, sinusitis, tonsillitis, pharyngitis,
opthalmitis, conjunctivitis, stomatitis, gingivitis, glossitis
Respiratory tract (tracheitis, bronchitis, pneumonia)
Gastrointestinal tract (gastritis, duodenitis, gastroduodenal ulcer, enteritis,
appendicitis, colitis, proctitis)
Liver, gallbladder, pancreas, peritoneum (inflammation,pain, colic etc)
Urinary tract (nephritis, cystitis, urethritis)
Genital tract (oophoritis, salpingitis, metritis, cervicitis, and cervical erosion,
vaginitis, orchitis, prostatitis)
Muscle-skeletal (myositis, bursitis, tenosynovitis, arthritis) Cardiovascular
(thromboangiitis, varicose ulcers, myocardial infarct and myositis)
Lymphatic (lymphadenitis, lymphangitis)
Skin and subcutaneous tissue (eczema, dermatitis, acne, furunculosis)
Nervous tissue (neuritis, encephalitis)

Inflammatory conditions in animals which respond clinically to AP are basically similar to

those in humans. However, as mentioned in the previous section, AP in animals has not been
used as extensively as in humans. Veterinary AP literature mentions clinical success with
inflammation in similar regions to those in humans. Examples are:

gingivitis, stomatitis, rhinitis

bronchitis, pneumonia
gastritis, enteritis,
hepatitis, cholecystitis, pancreatitis, peritonitis
nephritis, cystitis, metritis, pyometra
myositis, tenosynovitis, arthritis, laminitis
eczema, lick granuloma
mastitis, encephalitis

Klide and Kung's textbook and the books of Westermayer and Brunner list many more
inflammatory conditions which are said to respond clinically to AP (see Appendix 1 of this
paper).
The conditions listed above refer to uncontrolled clinical observation in humans and animals.
It could be argued that such observations do not prove that AP has anti-inflammatory effects.
However, there is direct evidence from experimental work with animals which shows that AP
has powerful effects on the inflammatory response.
Experimental inflammation

Bacterial peritonitis was produced in rabbits and other laboratory animals. AP greatly
reduced the volume of inflammatory exudate produced and the exudate became
(bacteriologically) sterile in a much shorter time in treated animals than in the control
animals.
Inflammatory granuloma was produced on the skin of the back in rats. After 8 days
of treatment by AP or moxa at ST36 (TsuSanLi), treated rats produced 3.5 ml effusate,
as compared with 7.0 ml in control rats.
Turpentine injection in rabbits caused severe inflammation. AP treatment increased
local circulation and lymph drainage and had strong effects in resolving the
inflammation.

Perforated gastric or duodenal ulcers were produced in rabbits. AP enhanced

peritoneal activity (speed of adhesion and speed of resorption of effusate) and was
effective in alleviating the clinical signs.
Myocardial infarct, necrosis and cardiopathy was produced in dogs and rabbits by
arterial ligation. AP at PC06 (NeiKuan) improved coronary circulation, reduced the
size of the infarct and the subsequent necrosis.

These experiments were conducted by Chinese workers but other experiments in animals also
confirm that AP has anti-inflammatory effects. One of the most obvious uses of AP for its
anti-inflammatory effects is in surgical (operative) cases. AP analgesia or AP therapy postsurgery causes a marked reduction in the incidence of post-operative complications (wound
sepsis, slow healing, intestinal atony etc). Wound healing in acupunctured animals is fast and
clean. The points used are similar to those used in AP analgesia for the surgical area (see
paper on AP Analgesia) but points LI04 (HoKu), LI11 (ChuChih), GV14 (TaChui) and ST36
are especially effective in controlling wound infection and fever.
AP IN THE TREATMENT OF FEVER
Clinical fever: AP is used to reduce fever in many specific and non-specific conditions in
humans. For this purpose, the points most often used are LI04, LI11 and GV14. For instance,
these points are used to reduce fever in influenza, poliomyelitis, malaria, typhoid, cholera etc
and in post-operative sepsis. The same points are used in non-specific fevers.
Experimental fever was induced in rabbits by injection of typhoid vaccine. Needling of
points ST36 and GV14 consistently reduced body temperature in the experimental rabbits but
normal temperatures were not reached. However, repeated needling at these points reduced
the duration of the fever as compared with the duration in control rabbits. Other Chinese
experiments also confirmed the anti-febrile effects of AP in monkeys with experimental
bacillary dysentery. In clinical veterinary practice, needling of points ST36; GV14; LI04;
LI11 is recommended to help reduce fever in many specific and non-specific cases.
AP EFFECTS ON ANTIBODY LEVELS
Papers presented at the AP symposium at Beijing (1979) noted strong effects of AP in
stimulating the immune response in humans and animals (6). Needling TienShu (ST25) and
ShangChuHsu (ST37) increased immunoglobulins and specific antibody levels in blood of
rabbits and monkeys experimentally infected with bacillary dysentery and in naturallyoccurring cases in humans. In clinical cases of human malaria, AP increases serum
complement levels.
Injection of specific antigen into many species of experimental animals (rats, guinea pigs,
rabbits, monkeys) has been used to examine the antibody response to AP. The main points
which enhance antibody production are LI04; HsuanChung (GB39) penetrating to San Yin
Chiao (SP06); ST36. In these experiments, AP caused a faster rise in antibody level, a higher
plateau and longer persistence of antibody than in the inoculated but non- acupunctured
animals.
AP EFFECTS ON PHAGOCYTES, RETICULO-ENDOTHELIAL SYSTEM AND
LYMPHOID TISSUE

Under experimental conditions in humans, needling LI11 caused neutrophilia (leucocytosis),

whereas needling a placebo point had no effect. In clinical medicine, LI11 (sometimes with as
LI04, GV14 and ST36) is frequently used in infections and in other conditions in which
activation of the neutrophils and reticulo-endothelial system is required. It is hardly
coincidence that these effects are stimulated by the same points which activate the antibody
system and that these points are valuable in the therapy of infections in humans.
Similarly, in animals, points such as LI4, LI11, ST36 and GV14, cause leucocytosis and
increase phagocytosis in experimental studies, as well as in clinical infections. For example,
AP at LI11 caused leucocytosis in rabbits whereas placebo points did not produce this effect.
Similarly, when plasma from rabbits needled at LI11 was injected into control rabbits, they
also developed leucocytosis, whereas plasma from control rabbits injected into other controls
caused a leucopenia. The release of a humoral leucocytic factor has been shown by other
studies. It was also shown that this effect of AP was inhibited by nerve section above the point
or by local anaesthesia of the point before needling. This demonstrates that the input signal to
the hypothalamus is transmitted via the peripheral sensory nerve.
Japanese workers challenged rabbits and rats with bovine serum albumin. ST36 and PangGu
(new points on the limbs) were needled. Marked histological changes occurred in the lymph
nodes of the acupunctured limb (enlargement of the lymph sinuses, haemorrhage, increase in
mast cells and degranulation. A rapid increase in plasma cells occurred in 48 hours). It could
be argued that these changes were of an inflammatory nature rather than an immune response.
However, the other data of the trial indicated definite immune enhancement of antibody
production and lymphocytopenia.
AP also caused release of a humoral bactericidal factor. In experimental bacillary dysentery in
rabbits and monkeys, AP at ST25 and ST37 increased the bactericidal activity of plasma by
50% after 30 minutes and by 70% after 3 hours. In these experiments, the phagocytic activity
of the reticulo-endothelial system of the liver increased 46% after 6 days and 63% after 12
days of AP. The treated animals ceased to excrete the bacilli in faeces in 4-5 days, whereas
control animals (untreated by AP) were still excreting bacilli after 21 days. All the symptoms
(fever, abdominal pain, tenesmus, bowel frequency etc)were eliminated by AP. In 800 clinical
cases of bacillary dysentery in humans, AP alone, given 1-3 times daily for 5-10 days was
effective therapy in 90% of patients. The symptoms were controlled and the organisms were
eliminated from the faeces.
EFFECTS OF AP ON TISSUE DAMAGE CAUSED BY X-RAYS
Rats exposed to X-rays developed anaemia and leucopenia. Needling at LI04, GB39 and SP06
caused the red cell count, haemoglobin level and while cell count to recover faster than in
control rats which received the same dose of X-ray. AP has been used clinically in humans to
assist recovery from nuclear exposure. Apart from its effects in haematology, nuclear
exposure also damages the immune response in humans and animals. The immunostimulant
effects of AP may be helpful to patients suffering from the effects of nuclear radiation, such as
that used in cancer therapy.
AP IN THE TREATMENT OF ALLERGIES

AP in human clinical allergies: AP is used to treat many human allergies, including allergies
caused by inhalation, oral intake and skin contact. These conditions include asthma, hay fever,
allergic rhinitis, food allergies, diarrhoea, contact allergies, allergic conjunctivitis etc.
The most important points for treatment in asthma include FeiShu (BL13) and GV14 but
other points are sometimes added, including HsinShu (BL15), KeShu (BL17), TingChuan
(Asthma point) and HaiLao (a new point). In hay fever and allergic rhinitis, the main points
are LI04 and YingHsiang (LI20) but other points, such as LI11 and Yin Tang (Z 03, between
the eyebrows) are also used.
In treating human allergies, the selection of the points is based mainly on the location of the
symptom or lesions. For instance, in asthma, the main points are chosen for their action on the
lung. In rhinitis the points are chosen for their action on the nose and upper respiratory tract.
Thus, in treating a food allergy in which the main symptom was nausea and vomiting, the
main points would be aimed at the stomach (ChungWan (CV12); ST36, PC06). If the main
symptom was biliousness and dizziness with headache, the main points would be aimed at the
liver and gallbladder ((TaiChung (LV03); FengChih (GB20) with possibly ST36 added for its
gastric effect).
A course of AP can often succeed in desensitising patients to their allergens, despite continued
exposure to them. Examples are hay fever, migraine headache and food allergies.
AP in clinical allergies in animals: There are few reports of the use of AP in specific clinical
allergies in animals. However, it might be tried in fog fever in cattle and in bronchospasm in
horses (similar to asthma) and in non-specific dermatitis, and pruritus in small animals. Also
many symptoms of allergies (bloat, vomiting, diarrhoea, etc) in animals are known to respond
to AP, aimed at the organ, region or symptom involved.
Experimental allergy in animals: Allergic-encephalomyelitis was induced in guinea pigs by
injections of an encephalogenic antigen. Needling certain points (LI11; ST36) enhanced the
immune response and exaggerated the allergic response. On the other hand, needling
ChihShih (BL52) prevented the allergic response. The antiallergic effect may have been due
to release of ACTH and corticosteroids. BL52 has effects on the kidney and adrenal.
AP AND ENDOCRINE RESPONSES
In the paper on AP analgesia, the role of the hypothalamus and endorphin release is discussed
more fully. AP stimuli are carried via the peripheral sensory nerves and sympathetic trunks to
the hypothalamus. Hypothalamic activation with subsequent activation of the pituitary, may
release ACTH, MSH, TSH, gondatropins, pancreatic (insulin) tropins etc depending on which
nuclei in the hypothalamus have been stimulated. This, in turn, depends on which AP points
have been stimulated. Release of these hormones may cause release of corticosteroids,
adrenalin, thyroid hormones, oestrogen, progesterone, oxytocin, prolactin, relaxin, insulin,
etc.
Clinical endocrine disorders in humans: AP is used to treat many human endocrine
disorders. If there are sufficient endocrine cells which can be activated by the trophic and/or
neural stimuli, the results can be very good. However, in chronic or severe cases (especially
where hormone substitution therapy has been given for a long time and has suppressed the
body's ability to produce its own hormones), the results are not so good.

Examples of endocrine conditions responsive to AP include: mild goitre, mild hormonal

infertility (due to oestrogen-prostaglandin-progesterone imbalance), post-parturient agalactia
(prolactin, oxytocin), uterine atony at parturition (oxytocin); cervical non-dilation at
parturition (ringwomb); recurrent abortion; menopausal syndromes. ln early or mild cases of
diabetes mellitus, AP at SP06; LV13 (ChangMen); BL20 (PiShu) can be very effective in
controlling blood sugar and in treating pancreatitis. In diabetes insipidus, due to deficiency of
the antidiuretic hormone, needling at BL23 (Shen Shu), BL28 (PangKuangShu); GB25
(ChingMen) can help.
Clinical endocrine disorders in animals: Similar conditions in animals have been helped
(reproductive disorders; parturition disorders; agalactia; pseudopregnancy; polyuria; hormonal
alopecia in castrated cats). However, as in other areas of veterinary AP, documentation of
these effects in very scarce.
The evidence from clinical use in humans and animals suggests that some of the therapeutic
effects of AP are mediated by the endocrine system.
OTHER CONDITIONS RESPONSIVE TO AP THERAPY
Earlier sections discussed many therapeutic effects of AP. These include leucocytosis,
increased activity of the phagocytic, lymphoid and reticulo-endothelial systems, release of a
leucocytotic factor and a bactericidal factor into plasma, enhanced antibody production,
antifebrile, anti-inflammatory and anti-infectious effects. These effects help to explain the
therapeutic value of AP in fighting infection, resolving inflammation and reducing fever in
humans and animals. Increased haematological stimulation and immunostimulation also help
to explain the effect of AP in damage caused by exposure to nuclear radiation. These effects
are stimulated only by certain points.
Other points have immunosuppressant effects and help patients during the allergic reaction.
Still others act by releasing various hormones in mild endocrine disorders.
Other applications of AP in humans and animals include: pain, poor circulation, smooth
muscle dysfunction, tissue damage and bleeding, paralysis, paresis and miscellaneous.
a. PAIN
Pain due to trauma, inflammation, ischaemia, muscle spasm, arthritis and other peripheral
causes, can be helped, if not fully controlled, by AP.
Pain conditions in humans which respond in varying degrees to AP are: headache,
toothache, eye pain, earache, neck pain; colic; pain in gastric, duodenal or colonic ulcer;
backache, sciatica; pain in the muscles and joints, phantom limb pain, angina pectoris,
narcotic withdrawal pain. One of the main uses of AP in human patients is in the control of
chronic peripheral pain. However, pain of central origin does not respond well.
AP is also of astonishing value in treating acute traumatic pain (fractures, dislocations, pulled
muscles, contusions, abrasions, etc). For this purpose, the most important point is
YangLingChuan (GB34). GB34 is usually combined with a local point for the region involved.

AP is also of great value in treating post-operative pain (and other complications, such as
inappetance, nausea, ileus and urine retention) in humans. For this purpose the main points
used are the same as in AP analgesia for the region (see paper on AP analgesia). Points to
assist the function of the stomach, large intestine, kidney and bladder are added, as needed.
Pain conditions in animals which respond to AP include: Lameness due to muscular
rheumatism, muscle spasm, myositis; arthritis; spinal trauma and mild cases of intervertebral
disc protrusion; laminitis, tendinitis, periostitis and trauma; abdominal colic (gastrointestinal,
hepatic, renal, cystic, uterine, etc).
Post-operative pain in animals: Although AP is seldom used specifically for this purpose in
animals, those which have been operated upon under AP analgesia have far fewer
complications and heal faster than those operated upon under conventional anaesthetics.
Post-operative complications in animals: after surgery, AP can be used to obtain pain relief
and to help restore normal physiological function, as in humans.
b. POOR BLOOD CIRCULATION
Many human clinical conditions are caused by poor blood circulation. Coronary heart disease
(CHD) and angina pectoris are greatly helped by frequent needling of PC06. Experimental
reduction of coronary blood supply in dogs was used as a model of human CHD. AP at PC06
improved coronary/myocardial circulation, reduced the size of the subsequent infarct and
assisted the healing of the damaged muscle.
Muscular aches and pains, "pins and needles" (peripheral paraesthesia) or ulcers, etc in
humans are frequently caused by poor blood circulation. AP is effective in many of these
conditions.
Human indigestion and hyperacidity may be associated with poor circulation in the
gastrointestinal tract. AP is very effective in these conditions. Two important points are ST36
and PC06; others include CV12 and BL21. Under experimental conditions in laboratory
animals, stimulation of ST36 and PC06 improves mesenteric and gastrointestinal circulation
and delays or prevents the onset of experimental ulcers, or assists in their resolution.
Similarly, gastrointestinal hyper- or hypo-motility is corrected by needling these points.
Poor circulation in the brain, such as in senile human arteriosclerosis, may cause many
problems. AP of points which act on brain function helps to alleviate these problems. Under
experimental conditions in animals, AP at JenChung (GV26) greatly improves brain microcirculation. GV26 is the emergency point par excellence in shock, collapse, coma, heatstroke,
convulsions and anaesthetic apnoea in humans and animals. Similarly, nausea and fainting in
humans are quickly corrected by needling or massaging GV26. However, other points also
help nausea + dizziness. These include PC06; ST36; GB20; CV12.
By its effect on the autonomic nervous system (see below) AP has powerful effects on blood
circulation in most vascular areas. The points for specific regions are similar to those for pain
or other problems of those regions.
c. SMOOTH MUSCLE DYSFUNCTION

Human conditions very often involve spasm of smooth muscle. Examples are pain in angina
pectoris; biliary, renal, uterine and gastrointestinal colic; peripheral circulatory upsets; asthma
etc. Factors which relieve smooth muscle spasm greatly reduce or eliminate the symptoms.
AP of the correct points produces this result. Also, in obstruction of ducts (such as the bile
duct and ureter), smooth muscle spasm not only causes pain but also prevents the obstruction
from being expelled. AP often allows calculi to pass out of the gallbladder, bile duct, ureter or
bladder by inducing relaxation of the smooth muscle and by increasing the fluid pressure
proximal to the calculus. In children, ascaris worms in the bile duct often have been expelled
after AP and even expulsion from the gut has been claimed. Many studies have shown that
needling the correct points has marked effects on smooth muscle contractability, bile flow,
peristalsis and gastrointestinal secretion.
Smooth muscle spasm in animals: The antispasmodic effects of AP are of use in treating
colics and digestive upsets. They are also of use in treating bronchospasm.
In dystocia, relative oversize of the foetus and uterine atony are often present. Kothbauer and
Westermayer used AP routinely in bovine dystocia. They found that pelvic relaxation occurred
within 10 minutes of AP and the birth was greatly helped by this. Westermayer treated more
than 200 cases of prolapsed uterus in cows by AP of the lumbosacral region. The uterus was
easily put back in position and straining by the cow seldom occurred, making the procedure
simple and very fast. Also in retention of the foetal membranes or in metritis + pyometra (in
which uterine atony is involved) AP may help the condition.
d. TISSUE DAMAGE AND BLEEDING
These conditions often follow trauma. Other factors also cause tissue damage, for instance
liver and kidney damage in many toxic conditions; heart and brain damage in circulatory
disorders; muscle damage in Vitamin E and selenium deficiency etc. The effects of AP in
traumatic pain has been mentioned earlier. However, AP also assists the recovery of damaged
tissue, if tissue regeneration is possible. For instance, the skin and liver have marked
regenerative capacity and AP stimulates this effect, by improving local circulation and its antiinflammatory and anti- infectious effects.
Muscular injury in humans and animals is also greatly helped by AP. The best points are the
tender spots (AHSHI points, trigger points) in the damaged muscles and the AP points which
control the damaged area.
Where subcutaneous or intramuscular bleeding and oedema result from trauma, AP helps in
the resorption of the fluid and in the resolution of the swelling.
Where tissue damage is severe (as in extensive burns or trauma) the main approach should be
to control shock, haemorrhage, fracture and infection by conventional means. AP may be used
later to relieve pain and to assist tissue healing.
AP cannot stimulate tissue regeneration if the tissues are incapable of regenerating, such as in
severe neural, spinal, cardiac, pulmonary or renal damage. However, many cases of severe
lameness in humans and animals are (wrongly) attributed to severe lesions in joints or in the
spine, including prolapsed inter-vertebral discs. Many of these patients can be greatly helped
by AP, but the lesion (other than soft tissue swelling, oedema etc) remains unaffected by the
treatment. This suggests that many cases of such lameness are not due to the lesion, but to

reflex muscle spasm triggered initially by the lesion. The clinical effects of AP in these cases
are due to their effects on pain and muscle spasm.
e. PARALYSIS, PARESIS
These conditions may arise in humans and animals from nerve damage at central, spinal or
peripheral level. For example, human cerebral haemorrhage, thrombosis, encephalitis, spinal
injury or peripheral nerve injury may cause paralysis of one or more regions or functions. We
are taught that if the nuclei of motor neurons are damaged, the neurons cannot regenerate and
that paralysis due to neural necrosis is irreversible. However, we also know (1) that many
cases of paralysis occur from axon damage, (2) that functional damage to the nervous system
(poor micro-circulation) may cause paralysis, and (3) that considerable plasticity exists in the
nervous system, i.e. that some neural circuits can be re- programmed to adopt new functions.
These facts explain a reasonably high success rate of AP in treating conditions such as central,
spinal and peripheral- nerve paralysis in humans. I would strongly recommend that any of you
who have friends or relatives who suffer from recent paralysis should consult with a
competent medical acupuncturist. AP combined with conventional therapy can be very helpful
in many of these cases.
Animals usually suffer paralysis from trauma or arthritis, involving the vertebral column or
trauma to peripheral nerves. AP is very effective therapy for many of these cases but many
sessions may be required and physical manipulation may also be required. (Paralysis from
central causes, metabolic upsets or poisoning is not in discussion here). Paralysis associated
with prolapsed intervertebral disc may also respond to AP. As in the treatment of pain, AP
does not alter the physical lesion (dislocation, arthritis, spondylitis, disc prolapse etc) but
function is often restored despite the persistence of the lesion. This indicates that these cases
of paralysis may be functional or due to oedema or poor blood supply to the nerve tracts. The
antiinflammatory, antioedematous and pro-circulatory effects of AP may explain the clinical
recovery in these cases.
f. MISCELLANEOUS CONDITIONS
The list of conditions which can be helped by AP runs to hundreds. Some respond very well,
others have less satisfactory results, or require many sessions. In general, AP has therapeutic
effects on all the major systems of the body in humans (nervous system, the 5 senses;
endocrine system; respiratory, cardiovascular, digestive, reproductive, urinary,
musculoskeletal systems and skin). It also influences all the main body regions (and their
parts) and organs, including the head, neck, upper limb, thorax, abdomen, spine and lower
limb. Recent reports from Hospitals in Sweden and Taipei suggest that AP has powerful
effects in treating spastic paralysis and cerebral palsy in children.
No one textbook of AP lists all the conditions amenable to therapy, but a study of many textbooks and journals will demonstrate the wide range of clinical uses (for details, see references
1 to 7 at end).
Veterinary AP therapy is not as well developed as human AP, but a wide range of clinical
conditions (involving all the main physiological systems and all the body regions, their parts
and organs) may be helped. The main limiting factor is often the economic one. AP therapy
generally requires more time per session and more sessions to be effective, especially in
chronic cases. Time is money to a busy veterinarian and to the client. It is often decided that

the cost of treatment would not be justified on economic grounds because of the relatively
small cash value of the animal. However, in the case of family pets, racing animals (dogs,
horses) and valuable breeding stock, the economic considerations are less important.
Appendix 1 lists miscellaneous conditions in animals which can be helped by AP. For further
details on AP in the activation of the defence systems, see References 6, 10, 11, 12 at the end
of this paper.
CONCLUSIONS
AP at specific points activates the defence system of humans and animals via reflex neural
effects, autonomic effects, neuroendocrine, endocrine and humoral effects. Sensory input to
the hypothalamus is most important in these effects. Other mechanisms, such as the Primitive
Nervous System of Becker, may be involved in the slow healing processes.
In general, if activation of the defence systems of the body can affect the clinical condition or
if tissue regeneration is possible, AP is indicated as a possible therapy alone or in combination
with other therapies.
AP has wide therapeutic effects in infection, inflammation, fever, allergy, endocrine disorders
and many other clinical conditions. AP is not a panacea; it should be seen as an aid to
conventional therapy and not as a complete alternative to it.
AP may be the treatment of choice in some cases (for instance anaesthetic apnoea, muscular
lameness). In other cases, AP combines well with other therapies (i.e. with antibiotics in
mastitis, with glucose infusion + corticosteroids in bovine ketosis). AP is useless, or of very
little use in cases in which the adaptive response is disabled (for instance in terminal
malignant cancer, severe spinal damage, the later stages of liver or renal fibrosis). In these
cases other therapies are required but these may be of little use also.
APPENDIX 1
EXAMPLES OF ANIMAL DISORDERS WHICH MAY BE HELPED BY AP
This list is not complete. It is extracted from the veterinary AP textbooks by Brunner,
Gilchrist, Klide and Kung and Westermayer. (See references).
GENERAL CONDITIONS: Emergencies, poisoning, intoxication, toxaemia, hog cholera,
distemper in dogs; agalactia, mastitis, udder oedema; fevers, chills; general weakness, lack of
energy; exhaustion, over-exertion, dullness; polyhidrosis, insect bites; tranquillizer effect; to
calm after a race; to tonify before a race; haemorrhage after uterine contraction; pain; to
stimulate immunity; allergy; stress.
MUSCULOSKELETAL DISORDERS: Lameness, pain, sprain, trauma to muscles, joints,
bones, tendons; muscle pain, trauma, atrophy, rheumatism, tired muscles, "tying-up",
myositis, myotonia, muscle spasms; arthropathy, arthritis, joint pain, strain, trauma, luxation;
bone trauma, periostitis, osteomalacia, rickets; ring-bone, sidebone; tendon disorders, pain;
bowed tendons; tendonitis, tenosynovitis; tendovaginitis; bursitis.

DISORDERS OF HEAD REGION: Nervous system: encephalitis, encephalomyelitis,

encephaloedema; cerebral accidents, cerebral anaemia, cerebral hyperaemia; stroke; mental
disorders; convulsions, epilepsy, chorea, ataxia, dizziness, unconsciousness; paralysis,
wobblers, tetanus. Eyes: cataract, keratitis, pannus, ophthalmia; ocular microfilariasis; excess
tears; conjunctivitis, eyelids swollen. Ears: certain types of deafness; ear paralysis. Face:
facial swelling; trigeminal neuralgia; facial paralysis.
DISORDERS OF THE NECK: pain, sprain, rheumatism, muscle spasm, arthritis,
subluxation, myositis of m. sternobrachiocephalicus.
DISORDERS OF FORELIMBS: General: pain, sprain, rheumatism, trauma, arthritis,
lameness, paralysis, weakness and oedema of the forelimbs. Shoulder: pain, sprain, luxation,
trauma, rheumatism, arthritis, lameness; shoulder m. atrophy; scapular and suprascapular n.
Paralysis. Arm: pain, rheumatism; biceps brachii m. strained; muscle pain. Elbow: pain,
sprain, trauma, luxation, rheumatism, arthritis. Forearm: radial, ulnar and medial m. paralysis;
muscle pain, rheumatism. Carpus: pain, sprain, luxation, arthritis, trauma, swelling, synovitis.
Metacarpus: pain etc; flexor and extensor tendon disorders; bucked shins. Fetlock: arthritis,
luxation, trauma, contusion, oedema; unable to flex fetlock. Digit: pain etc. Hoof: disorders
laminitis, bulb of heel pain and inflammation; navicular disease.
DISORDERS OF THORAX: General: pain, spasm, colic, oedema, pleuritis, diaphragmspasm. Cardiovascular and haematological: heart disorders, arrythmia; circulatory disorders;
arterial and blood pressure disorder; anaemia; leucopenia; ascites, oedema; shock, collapse,
syncope, heatstroke. Respiratory: nose disorders, rhinitis, rhinorrhoea, purulent sinusitis,
epistaxis; pharyngitis, laryngitis, tracheitis; lung disorders; bronchitis, pneumonia, lung
oedema, congestion; lung haemorrhage; emphysema; allergies; coughs, colds, 'flu, asthma,
wheezing, not enough wind; respiratory viruses; pleuritis.
DISORDERS OF BACK AND ABDOMEN: General: pain, spasm, colic, oedema, ascites;
abdominal disorders; peritonitis, adnexitis; liver diseases, hepatitis, cholecystitis, icterus;
ketosis and fatty liver, diabetes mellitus, pancreatitis. Mouth and digestive system: stomatitis,
salivation, glossitis, tongue ulcer, swelling, lips swollen, trismus, masseter spasm; disorders of
the jaws; chewing difficulty; pharyngitis, parotitis, pharyngeal paralysis, oesophageal
paralysis; inappetance, anorexia. Gastric: dilation, atony, bloat, gastritis, vomiting,
hyperacidity. Intestinal: enteritis, colitis, spasm, colic. Gastrointestinal: bloat, allergies; spasm,
colic, gastroenteritis, diarrhoea, dysentery, blood in faeces, constipation, hog cholera. Rectum:
paralysis, prolapse. Reproductive tract: infertility, sterility, nymphomania, prolonged oestrus,
anoestrus, pseudopregnancy, dysmenorrhoea; ovarian dysfunction, oophoritis, cystic ovary;
salpingitis; metritis, pyometra, dystocia (to relax pelvis and assist birth); uterine prolapse (to
assist reposition); vaginal prolapse, vaginitis; male impotence, depressed libido, penile
paralysis; orchitis, scrotal oedema. Urinary tract: incontinence, dysuria, difficult urination,
anuria, urine retention, haematuria. Kidney, ureter, bladder and urethra: nephritis; ureter
spasm; cystitis, bladder retention spasm; urethritis. Pelvic area: sacroiliac strain, luxation; to
relax pelvis in obstetrics. Lumbosacral area: pain, rheumatism, stiffness, myositis,
spondylosis, arthritis, nerve paralysis, paresis, posterior paralysis.
SPINAL DISORDERS: Pain, spasm, rheumatism, stiffness, myositis, lameness, etc in the
spinal or paravertebral area from neck to tail. Vertebral disorders: arthritis, luxation, mild disc
prolapse; spinal trauma; spinal paresis and paralysis, torticollis, wobbler syndrome.

HIND LIMB DISORDERS: Hindquarter: rheumatism, pain, spasm of rump muscles;

paralysis of the tail and hindquarters; Hindlimb: rheumatism, myositis, pain, spasm, lameness,
arthritis, motor malfunction, weakness, paralysis; hind limb oedema. Hip: pain, rheumatism,
spasm, lameness, arthritis, dysplasia; sciatic nerve paralysis, femoral nerve paralysis, myositis
of semimembranosus and biceps femoris m. Stifle (Knee): pain, rheumatism, arthritis; patellar
luxation; stifle locked; pain in region of tibia, fibula; tibial, fibular m. paralysis. Hock (tarsus):
swelling, pain, hypertrophy, spavin, arthritis; pain, inflammation and swelling of Achilles'
tendon. Metatarsus: pain, bucked shins, arthritis, flexor tendon disorders. Fetlock: oedema,
pain, arthritis, luxation, trauma, inability to flex. Digit and hoof: pain, laminitis, panaritium,
phlegmon, pododermatitis, heel and bulb of heel pain.
SKIN DISORDERS: allergy, urticaria, pruritus, trauma, eczema, dermatitis.
APPENDIX 2
EXPERIMENTAL TRYPANOSOMIASIS: Mice were infected experimentally with
Trypanosoma evasi. Some of the mice received water injections at GV14, ST36 + AiKen (a
point behind the second metatarsophalyngeal joint, at the inner side of the plantar surface).
Others remained as infected, untreated controls. AP significantly prolonged survival time of
infected mice. All control mice died. Some of the treated mice lived (Lin et al 1976, Chinese
Med. J. (Taiwan), 23, 152-157).
EXPERIMENTAL ERLICH ASCITES TUMOUR was induced in mice by inoculation
with tumour cells. Some of the mice were needled at the same points as above. AP
significantly prolonged the survival time of treated mice as compared with controls but all
mice died eventually (Lee and Lin, 1975. Chinese Medical J. (Taiwan) 22, 167-171).
EXPERIMENTAL POLIOMYELITIS was induced by virus injection in rhesus monkeys.
Ligation of certain points enhanced nerve fibre regeneration and the formation of
neuromuscular plaques in paralysed muscle. It also increased cholinesterase in the large motor
neurons in the ventral horn or the spinal cord, increased the number of dendrites and synapses
in the segment, increased the conduction velocity in motor nerves and increased metatarsal
perspiration (Anon 1979 a, p. 517).
CLINICAL HUMAN POLIOMYELITIS: AP or injection of the relevant points gave
valuable therapeutic results in 360 cases. In patients treated in the acute (febrile) phase,
improvement occurred in 88% and 52% recovered. In patients treated in the first month of
illness, the response rate was 48%, as compared with 31% and 18% respectively in those
treated within 6 months and after 6 months of onset respectively (Anon 1979a, p.76).
CLINICAL VIRAL HEPATITIS was treated in 280 cases by manual or electro-AP of
relevant points. Treatment was effective in 90% of cases in eliminating the symptoms (fever,
jaundice, gastrointestinal upset, pain etc) and in restoring health in less than 3 weeks. (Anon
1979a, p. 41 and 43).
CLINICAL BACTERIAL ENTERITIS IN PIGLETS: E. coli enteritis in piglets was
treated by needling certain points or by spiramycin. Some scouring piglets were left as
untreated controls. AP once daily gave a highly effective clinical response in 2-5 days, as
good as, or better than, the response to spiramycin (Anon 1977a, p265-). The results are
summarised below.

Trial 1
Treatment

No. % cured 5th day

Points used

Acupuncture

18

88

GV03, GV01, YuTang, ShanKen

Spiramycin

18

83

none

Control

18

44

none
Trial 2

Treatment

No.

% cured 5th day

Points used

Acupuncture

20

85

GV01, GV03, YuTang

Control

20

none

Acupuncture

20

95

GV01, BL20, ST36

Control

20

none

Acupuncture

20

100

BL20, ShanKen, TiMen

Spiramycin

20

100

none

YuTang : 0.5 tsun on either side of midline of hard palate, 1 tsun behind incisors
ShanKen: midline, just above snout (GV25)
TiMen : just above bulb of heels
INFERTILITY IN COWS: AP at YungChi gave excellent results. YungChi is 5 fingerwidths on either side of the spine, between lumbar vertebrae 5-6.
FURTHER READING MATERIAL
AP textbooks and Symposium Proceedings are available from Acumedic, 103 Camden High
Street, London, UK.
1. American Journal of AP (1973-), Quarterly Journal.
2. Scandinavian Journal of AP and Electrotherapy, from Pekka Pontinen, 4-B-77
Pikkusaarenkuja, Tampere, Finland.
3. Anonymous (1993) Academy of Traditional Medicine, Beijing. Essentials of Chinese
AP. English version. Foreign Languages Press, Beijing 432pp.
4. Anonymous (1977a) United States Dept. Health translation of official Chinese (1970)
manual. A barefoot doctor's manual. Running Press, 38 South 19th St., Philadelphia,
Pennsylvania, USA 948pp.
5. Anonymous (l977b) Basic AP: a scientific interpretation and application. English
version. Chinese AP Research Foundation, Box 84-223, Taipei, Taiwan, Republic of China
313pp.
6. Anonymous (1979b) AP, Moxibustion and AP anaesthesia. Proceedings of the Beijing
1979 Symposium, parts 1-5. Foreign Languages Press, Beijing. 534 abstracts, 517pp.
7. Anonymous (1979b) The treatment of 100 common diseases by new AP. Medicine and
Health Publishing Co., Hong Kong 89pp.
8. Brunner, F. (l980) Akupunktur der Kleintiere. WBV Biologisch Med. Verlag, Ipweg 5,
D7060 Schorndorf, Germany 309pp.

 8a. Gilchrist, D. (1981) Manual of AP for small animals. PO Box 303, Redcliffe,
Queensland 4020, Australia 79pp.
9. Klide, A.M. and Kung, S.H. (1977). Veterinary AP. University of Pennsylvania Press,
Philadelphia, Pennsylvania USA 297pp.
10. Lin, J.H. and Rogers, P.A.M. (1980). AP effects on the body's defence system: a
veterinary review. Veterinary Bulletin (August issue), 50, 633-640.
11. O'Connor, J. and Bensky, D. (1975) Summary of research on the effects of AP.
American Journal of Chinese Medicine, 3, 377-394.
12. Rogers, P.A.M. and Bossy, J. (1981) Activation of the defence systems of the body in
animals and man by AP and moxibustion: additional evidence from the Peking (1979)
Symposium: AP Research Quarterly (Taiwan), 5, 47-54.
13. Westermayer, E. (1978) AP in horses. Health Science Press, Devon, UK and WBV
Biologisch Med. Verlag, D7060 Schorndorf, Germany 90pp.
14. Westermayer, E. (1978) Atlas of AP for cattle. WBV Biologisch Med. Verlag, D7060
Schorndorf, Germany 60pp.
15. Rogers, P.A.M. (1990) AP for immune-mediated disorders. Chapter 14 of text on
Veterinary AP. Lippincott Publishers, USA, in press.

ACUPUNCTURE FOR IMMUNE-MEDIATED DISORDERS

See also the earlier review "Acupuncture effects on the body's defence systems and
conditions responsive to acupuncture" (Rogers 1980)
SUMMARY
Acupuncture (AP) activates the defence systems . It influences specific and nonspecific
cellular and humoral immunity; activates cell division, including blood-, reticulo-endothelialand traumatised- cells; activates leucocytosis, microbicidal activity, antibodies, globulin,
complement and interferon. It modulates hypothalamic-pituitary control of the autonomic and
neuroendocrine systems, especially microcirculation, response of smooth and striated muscle
and local and general thermoregulation.
Applications of AP include inflammation; trauma; tissue healing; burns; ulcers; indolent
wounds; ischaemia; necrosis; gangrene; infections; post-infection sequelae; fever; autoimmune disease; allergy; anaphylaxis and shock; treatment or prevention of side effects from
or sequelae to cerebrovascular disease (CVD), coronary heart disease (CHD), general
anaesthetics, parturition, surgery, cytotoxic chemotherapy and ionizing radiation. AP may
inhibit neoplastic cells.
Immunostimulant points include LI04,11; ST36; GB39; SP06; GV14; BL11,20,23-28; CV12.
Some, such as BL52 are immunosuppressive. Antifebrile points include GV14 and ST36.
Reactive reflex SHU, MU and Earpoints are useful in organic diseases. In immunomediated
diseases, some or all of those points can be used with other points, especially local points and
points for the major symptoms and/or points for the affected body part, area, function or
organ.
INTRODUCTION
"Control of infectious diseases has depended on the use of vaccines and antibiotics, isolation
and embargo, test and slaughter programmes. These strategies have failed to eradicate the
major infectious diseases of livestock" (1). "Bacterial infections of the mare's uterus have the
same incidence as they had before penicillin was discovered and the economic importance of
endometritis is increasing with the increase in value of horses" (2).
Micro-organisms and other pests preceded the evolution of higher species and will exist long
after their extinction. For optimum chance of survival, higher forms must learn to co-exist
with lower. Adaptation is the key.
Acupuncture (AP) has antiinflammatory, antibacterial, antiviral effects. It enhances humoral
and cellular immunity and has antiallergic effects. Earlier papers on the effects of AP on
immunity were reviewed (3-9). Trelles et al (10) reviewed low power laser therapy (LLLT).
The stimulus elicited analgesia, vasodilation, antiinflammatory and antioedematous effects,
biostimulatory effects, cell proliferation, cicatrisation and tissue regeneration (wounds, burns,
ulcers of skin and portio uteri, herpes lesions, urethritis, haemorrhoids, sinusitis, bone

fractures and osteomyelitis, arthritis, muscle injury, neuralgia, alopecia areata) and local
immune responses.
This Chapter summarises papers published mainly since 1980. The papers were published in
medical journals, or in journals not usually read by orthodox health professionals. Most of the
abstracts are from the American Journal of AP and the Scandinavian Journal of AP and
Electrotherapy. Most of the reviews listed above are excluded. Readers are referred to those
reviews.
EFFECTS OF AP ON THE IMMUNE SYSTEM AND CLINICAL USES
AP, Electro-AP (EAP) or moxa enhanced the recovery of red and white cell counts (RCC
and WCC) to normal or near-normal values in many conditions (11), including experimental
radiation sickness (13-17), experimental Vibrio cholerae sensitivity (18). AP post-op in
humans enhanced WCC, neutrophil phagocytosis, lymphocyte counts, and bactericidal
activity (19). Low Level Laser Therapy (LLLT) increased phagocytosis in chronic wounds in
horses (20), improved immune functions and remedied anaemia in children (21).
Homoeostatic effects of AP are more obvious when abnormalities exist first (14). AP in
patients on long-term cortisone therapy for spastic bronchitis, restored granulocyte migration
to almost normal values (22). LLLT decreased the numbers and caused marked degranulation
of mast cells in irradiated tissues (23). EAP or moxa enhanced the activity of the reticuloendothelial system (24,25) but if used too often, adaptation reduced the effect (26-28).
Narcotic medication inhibits local immune response (29). AP or moxa enhanced cellular
immunity (29-31), increased lymphocyte proliferation/count (30,32), lymphocyte
transformation (LT) (31,33-35), T-cell numbers (36), serum globulins (34), T-cell staining
by alpha naphthyl acetate esterase (ANAE) (37,38) and E-rosette formation (29,31,38).
AP increased Natural Killer (NK) -cell activity (32). AP increased suppressor/cytotoxic Tcells, E-rosette positive T-cells and Leu 7+NK cells. Leu 11+NK cells decreased (39).
SPECIFIC AND NON-SPECIFIC ANTIBODIES, GLOBULIN, COMPLEMENT,
INTERFERON
Globulins and antibodies: AP, LLLT or moxa increased SIgA in the small intestine in mice
sensitised against Vibrio cholerae (18), Igs, specific antibodies and faecal IgA in bacillary
dysentery (40), plasma IgM in chronic pelvic inflammation (41), beta and gamma globulins
and A/G ratio in dogs with g/i helminthiasis (42) and antibody formation in wounded horses
(20). AP improved non-specific immunity and regulated hyperactivity of the non-specific
immune system in asthmatic and normal subjects (43). AP, LLLT and moxa improved immune
parameters in systemic lupus erythematosus (44). Plasma cAMP was low in early malaria,
indicating that metabolites of Plasmodia inhibit immune responses. As AP may cure malaria,
its actions are thought to involve activation of the immune system and its symptomatic effects
(45). AP or moxa increased complement in acute bacillary dysentery (40) and in scleroderma
and asthma (46). Moxa increased complement in rabbits (47). AP increased circulating
interferon in humans. Stimulation of interferon production may have clinical uses in viral
infections and in other diseases (48).
PRE-, PER- AND POST- OPERATIVE INDICATIONS FOR AP: General anaesthesia
suppresses antibody response (49) and other immune functions. It markedly reduces
lymphocyte blastogenesis, which is not influenced by AP analgesia (50). Reflex analgesia by
AP, EAP or TENS enhances immune response (see above) and leaves autonomic functions,

including those of the foetus, intact (51,52). Effective methods of pre-, per- and post- op
management, if they have immunostimulant effects, would be in the best interests of the
patient and would reduce the need for potent drugs (opiates, barbiturates, diazepam, epidurals,
gastric sedatives etc) and depress vital functions less (53,54).
Shock, anxiety, anorexia, nausea, vomiting etc are common pre-op. Some patients are
hypersensitive to drugs. Pain, shock, abdominal spasm, anxiety, anorexia, wound infection,
adhesions, scar TPs, intestinal adhesion, ileus, nausea, vomiting, apnoea, dyspnoea, retention
of sputum, laryngitis, decreased renal filtration rate, urinary retention, peripheral ischaemia,
pressure ischaemia etc are common post-op. AP pre- and/or post- op can prevent or treat most
of those complications. Combination of per- and post-op EAP reduces the demand for post-op
analgesic drugs and patients become self-caring more quickly (55,56). In particular, Patterson
(53) cited data which showed that the incidence of post-op sepsis was 3% in patients under
AP analgesia or electro-analgesia, as compared with 17% under general anaesthetics.
AP, EAP or acupressure at PC06 was more effective in preventing pre- or post- op nausea
and vomiting than cyclazine and metoclopramide in patients undergoing surgery (57-59).
When given during operation under drug anaesthesia, EAP (5 minutes at 10 Hz) was not
effective (60). Nausea and vomiting due to passing a laryngoscope can be prevented in 80%
of patients by heavy acupressure on LI04 (61,62). Atropine or conventional anticholinergic
agents produce side effects, including dry mouth, blurred vision, dizziness and tachycardia.
AP can replace anticholinergics, with few or no side effects, to facilitate gastroscopy or a
barium meal (63-67).
AP, EAP or LLLT are useful per-operative analgesics in: high-risk patients (68);
coordination of uterine contraction in labour (69,70); Caesarian section (71); gynaecological
operations (31) and in hysterectomy. Post-op analgesia persists for 3-4 hours (54).
EAP combined with epidural (55), local or general anaesthesia for surgery reduces the
amount of anaesthetic drugs needed (71) and confers neurovegetative protection from the
effects of surgical trauma (72). Post-op recovery of spontaneous breathing, consciousness
(56), and autonomic function is faster and the immune system is less depressed after
combined anaesthesia than after drug anaesthesia without AP (68,73,74).
Similar analgesic and neurovegetative effects occur with post-op use of EAP and TENS (75).
AP or EAP post-op stimulates fast recovery of liver function (69) and reduces hallucinations
on emerging from ketamine anaesthesia (76). EAP and TENS post-op gave better analgesia
than i/v meperidine but EAP analgesia lasted longer than TENS analgesia and increased with
repetition of treatment (77). EAP post-op halved the use of pethidine (78). In post-op wound
infection, blood vessels near the HuatoJiaJi points become engorged, usually in the scapular
or inter-scapular area in the case of infected wounds of the upper limbs or face and in the
lumbar area in the case of the lower limbs. One paravertebral needling, to release a few drops
of blood from engorged vessels on the back, cured most cases (79).
AP was better than laser-AP or narcotic management of post-op infected wounds as regards
analgesia, speed of healing and hospital stay (29). EAP reduced post-op intestinal adhesions
(80). EAP or AP rapidly cured urinary retention post-op and in paraparetic cases (81-83) or
retention postpartum or post-obstetrical surgery (84). AP restored urinary function in
100% of cases of retention or incontinence due to laceration and spondylosis of sacral
vertebrae (85).

AP was effective in 96% of ileus/obstipation cases. Most cases emptied the bowel within 1
hour (86).
TRAUMA, TISSUE HEALING, BURNS, ULCERS, FISTULAS, INDOLENT
WOUNDS: The success and use of plastic surgery, tissue replantation can be improved by
increasing local blood circulation, phagocytosis and inflammatory reaction and/or preventing
arterial spasm, thrombosis, blood sludging or clotting. Topical leeches (87), nitroglycerin, AP,
EAP and LLLT enhance flap/graft survival (88-90).
Time to obtain pain relief and to resolve swelling in bone fracture and time to eliminate other
symptoms and to heal the fracture was less than usual with EAP (91). EAP, Electrostimulation
(ES) or LLLT greatly enhanced the rate of healing and strength of repair of wounds (92-94)
and infected wounds and burns (95) and local antibiotics did not improve the success (96).
Brown et al (11) stated that AP stimulation gave a longer rise in ipsilateral skin temperature
(vasodilation) than stimulation of "non-points". AP or EAP via needles around the edge of
trophic ulcers, including post-phlebitis ulcers, cured 100% (97). AP cured thromboangitis
obliterans (98). AP, with anticoagulant therapy (heparin), cured thrombophlebitis (99).
LLLT cured chronic wounds in horses (20). TENS or LLLT cured wounds, fistulas and
peripheral circulatory disorders including ischaemia, ulcers, gangrene (10,100-103);
chronic leprous ulcers (104). The healing rate was the same as in TENS treatment of other
types of ulcer (neuropathy, atherosclerosis, varicose veins, thrombophlebitis, decubitus etc).
Marked, prolonged vasodilation follows non-segmental TENS, probably due to release of
vasoactive intestinal polypeptide (VIP), endorphin and serotonin (104). AP cured 92% of anal
fissures. Pain and bleeding improved or stopped after the first session in 82% (105). Moxa
needle (warming effect) was better than EAP or simple AP in re-establishing peripheral
circulation in frostbite of the fingers (106).
INFLAMMATION, LOCALISED AND ORGANIC INFECTION: EAP inhibited
experimental inflammation. EAP into the site gave the greatest antiinflammatory effect
(107-109). AP suppressed histamine-mediated increase in vascular permeability and reduced
exudation in burns (110).
AP or LLLT cured and prevented acute conjunctivitis (111), cured maxillary sinusitis
(112,113). The results were better than with antibiotics. EAP is a first-choice method of
preventing repeated attacks of chronic tonsillitis with fever (114). Earpoint AP was effective
in treating tracheitis in infants (115) and was as good as medication in pyogenic otitis media
(116). LLLT cured most acute cases (117). Fire needling, with a medicinal fuse, cured 100%
of tubercular cervical lymphadenitis (118). AP cured 80% of Tinea capitis cases (119). EAP
cured 46% and improved 42% of Tinea pedis cases. Fungal culture from the site was
negative after AP (120). AP cured or markedly improved 46% and improved 50% of Scrofula
cases (121). AP needling to bleed viral warts cured 97% within 3 months (122).
GASTROINTESTINAL DISORDERS: Stomach: AP at ST36 increased gastric motility
(123) and amplitude, decreased the frequency of gastric contraction (124), increased serum
gastrin (125) and decreased basal and vagally-mediated gastric acid secretion (126,127). EAP
at BL20 increased the frequency and amplitude of contraction. Naloxone did not abolish the
effect but vagotomy or atropine did (128). AP or EAP at ST36, BL21, PC06 increased gastric
secretion of bicarbonate and sodium in dogs. Gastric acidity decreased (129,130). The AP
effect was blocked by local anaesthesia of the AP points or by use of atropine. The AP effect
is mediated by somatovisceral reflexes, via blockade of histamine H2- or cholinergic-

receptors in gastric mucosa (126,128-130). AP-injection at BL18, BL21, ST36 was effective
in atrophic gastritis (131). AP or EAP was effective in treating experimental gastric ulcer
in rats (132,133), peptic ulceration in foals (134) and in clinical gastroduodenal ulcer in
humans (126,135,136), even those which had relapsed after completion of conventional
therapies (137). AP, moxa, magnetic-, electro-magnetic- or laser-AP were effective in 1-3 days
in infantile enteritis, often in cases which had failed to respond to medication (138-142) and
AP was effective in diarrhoea in diabetic neuropathy (143). AP was as good as antibiotic
therapy in treating piglet diarrhoea usually associated with E. coli and coronavirus (144146). LLLT at GV01 was effective in lamb dysentery (403). AP or AP + moxa was effective
in dysentery (34,147), which had not responded to medication (37), increased intestinal
microcirculation in 15 minutes and reduced hyperperistalsis and borborygmus after 15-30
minutes (148). AP or LLLT was effective in acute appendicitis (149,150). AP at GV01,
BL35, BL57, GV20 cured 100 % of types 1 and 2 and 77 % of type 3 prolapsed rectum in
children (151). AP, EAP, moxa and herbs are effective in curing hepatopathy (152) and
hepatitis, including acute viral icteric hepatitis (153,154,155,156,157,158,159). AP and EAP
aided normalisation of the pathological increase of 5-HT metabolism and decrease of DA
content of the brain in CCl4 toxicity (160) and helped to prevent and cure pathology in CCl4
toxicity. The AP effect was mediated by endogenous opiates (161,162). AP at GB-related
points increases intra-GB pressure up to 26 times. This helps expulsion of stones or ascarides
from the bile duct (163). AP, EAP, acupressure are effective in cholecystitis, cholelithiasis
and biliary ascariasis (136,163-176).
REPRODUCTIVE DISORDERS: AP-type stimuli influence reproductive organs and
functions, including release of LH, FSH, progesterone and oestradiol (177-179). It can
activate or inhibit uterine and cervical contraction in humans and animals and can increase
local microcirculation and immunity. AP can be used to prevent threatened abortion (180);
to correct foetal malposition (181,182); to induce labour in women; to cure morning
sickness (183,184); vaginitis/leucorrhea (185); dysmenorrhoea (186-190). AP cured vulvar
ulceration (191), vulvar leukoplakia (192) and hysteromyoma without the need for surgery
(193). It cured female infertility/sterility (amenorrhoea, anovulation, polycystic ovarian
disease (POCD), functional metrorrhagia) (178,179,194,195); pelvic inflammatory disease
(PID) (41,196-198). The results were better than in similar cases treated by antibiotics (199).
Endometritis always follows mating in mares but healthy mares clear the uterus within 48-72
hours. Poor contractility, imbalance of lymphatic/ circulatory/uterine secretion (build-up of
secretions) and inability to clear the debris through the cervix are important in the aetiology
uterine infection (200). AP was effective in repeat-breeder mares (201). Laser on the clitoris
was effective in anoestrus in cows (404). Others claim success with AP in treating infertility
(anoestrus, cystic ovary, and repeat breeder) in other species (cows, bitches, sows).
AP can treat impotence, poor libido, infertility and prostatitis in men (143,202-209).
Similar claims are made for stud animals.
MAMMARY DISORDERS: AP, moxa, point bleeding and massage was effective within a
few days in acute mastitis, breast abscess and breast carbuncle in women (210-214). AP
cured mammary fibrocystic disease in women within 3 weeks and can be used in the
differential diagnosis of fibrocystic disease from mammary carcinoma (215). AP was effective
in mammary hyperplasia (216-217); proliferative mastosis (painful breast tumour, not
specified if inflammatory or neoplastic) (218); primary agalactia and hypogalactia (219221). There are claims that AP is effective in mastitis and agalactia in animals. Because of

different anatomy/nerve supply, points for mammary disorders in animals are different to
those in women.
URINARY DISORDERS: AP is effective in nephritis, cystitis, urethritis, urolithiasis and
disorders of diuresis and micturition. BL23, GB25 and KI01 are especially effective for
kidney function. AP at KI01 in dogs reduced diuresis (KI function). AP at BL23 blocks the
effect of KI01 and adjusts diuresis (222). AP at BL23 markedly increased diuresis (urine, Na
and Cl excretion) in men (223). AP was effective in limiting proteinuria and curing nephritis
in HgCl2 toxicity in mice (162). AP was effective in renal colic, urolithiasis. Pain is
controlled in minutes and stones are often passed in hours or days (136,224-229). The effects
of AP on renal function and ureteral peristalsis can be seen with intravenous pyelography
(230). BL28,32; CV03 and SP06 are very effective for bladder function and irritable
bladder. The effects of AP on bladder function involve supra-spinal reflexes (83,231,232). AP
is effective in cystitis, dysuria, urgency, frequency (233). In monkeys with unstable bladder,
AP at SP06 had similar effects to atropine - it reduced or eliminated inappropriate bladder
contractions but left normal voiding sequences intact. AP gave fast relief of unstable bladder
and function normalised after repeated sessions (234). AP cured "neurogenic" bladder,
(incontinence/retention) as in distal symmetrical polyneuropathy (143,235) and in enuresis
(21,236,237).
SYSTEMIC OR GENERALISED INFECTIONS: AP activates immune reactions and
controls the main symptoms in viral, protozoal, bacterial and fungal infectious diseases in
humans and animals. It has a role in these conditions, if only as a support-therapy. AP cures
the main signs and symptoms of viral diseases and has antiviral effects via the immune
responses. Chronic Epstein-Barr Virus (CEBV) syndrome, also called Chronic Fatigue
Syndrome (CFS), is caused by a herpes-type virus that causes an infectious mononucleosis.
There is no effective medical treatment but AP at the immunostimulant points plus points for
the main symptoms is helpful. AP cured mumps within 1-5 sessions (238); early cases of
Herpes Zoster (shingles) within 2-7 days, with no post-herpetic sequelae (30,239). Pain
eased within minutes of the first session. In chronic cases (more than 3 months old), the dorsal
root ganglia may be scarred and prognosis to AP is poor. The most effective points are SI03
and the "Loo Point" (between BL62 and GB40 (240). AP cured or nearly cured 78% of
infantile acute infectious multiple radiculitis. There were no deaths and no sequelae. The
results were better than in cases treated without AP (241). AP improved 53% of infectious
multiple neuritis, classified as a flaccidity syndrome in TCM (242). Saline injection twice/
day for 7 days at BL13 cured 90% of cases of lobar pneumonia, as compared with an 84%
cure rate by penicillin and streptomycin (243). LLLT at Earpoint Lung in mice infected with
influenza virus completely inhibited virus replication in lung cells but Earpoint
Hypothalamus had no effect (244). Very good results were obtained by AP in AIDS and ARC
victims in treating fatigue, depression, general malaise, dyspnoea, sinusitis, night sweat,
diarrhoea, lymphadenitis, neurological disorders and pain, as in Kaposi's sarcoma. AP may
prevent development of opportunistic infection but it was not successful in treating severe
anaemia, which required blood transfusions if the PCV fell <22%, nor did AP prevent the
appearance of new Kaposi's sarcoma lesions (245). Results improve when Chinese herbs are
used (246).
AP treated and prevented symptoms of malaria if given 2 hours before the expected attack
(45,247) and was far better therapy than decocted Herba Artemisiae Chinghao (Chinese herb
with antidysenteric effect) but was less effective than nitroquine (248). AP cured 90% of cases
of thrombocythaemia following splenectomy in schistosomiasis (249).

AP in gastroenteritis, dysentery, cholera etc has been discussed. EAP at PC06 and LU06 in
lung TB cured or improved the haemoptysis (250). Local ES via saline-soa-ked gauze
wrapped around the digits and tibia, plus naproxin cured infectious polyarthrosis in parrots
which had failed to respond to medication (251).
POST-INFECTION SEQUELAE: The prognosis for successful AP treatment of postherpetic neuralgia was good in younger patients, with more recent pain of lower intensity,
but was bad in older patients with severe pain of long duration (252). Carbamacepine or
carbamacepine plus AP-injection was used in Post-Distemper Epileptiform Seizures
(PDES) and Idiopathic Epilepsy (IE) in dogs. AP cured early IE and enhanced the curative
effects of carbamacepine in IE. Neither was effective in PDES, probably because of
irreversible brain damage in PDES (253). AP was very effective in 63-89% of post-polio
paralysis (254-257).
THERMOREGULATION, FEVER: Fever points include GV13,14,20; LI04,11; ST36 and
Earpoints ShenMen, JiaoGuan, Lung, Ear Apex (258-260).
ALLERGY, HYPERSENSITIVITY: AP was successful in allergies, including
cardiovascular (migraine), respiratory (asthma, rhinitis, hayfever), digestive (colitis, enteritis,
ulceration) and cutaneous (eczema, itch).
SKIN ALLERGY: Bilaterality of signs or symptoms indicates brain or spinal mediation.
SI03 and the "Loo Point", alone or combined with Source and GV Points, can help in such
cases (Herpes Zoster, neurodermatitis, eczema, psoriasis, pityriasis rosea, dyshidrosis of
hands and feet, diffuse granuloma annulare) (240,261). Segmental AP inhibited histamineinduced pruritus. Extra-segmental AP had no effect. The results suggested that AP could be
effective in pruritic conditions (262-263). Uraemic pruritus is difficult to treat medically but
EAP or laser-AP was successful (264). AP was much better than herbs and western drug
therapy in treating acne (265). AP, L-phenylalanine or DPA enhanced immune response, as
assessed by enhanced delayed type hypersensitivity to di-nitrofluorobenzene in mice (266).
AP was effective in pruritus vulvae (267). Scleroderma is very difficult to cure by
conventional methods. AP of the lesion and AP point injection with herbal extracts improved
97% of cases (33). AP and EAP are preferable to conventional methods of treating focal
scleroderma (268).
RESPIRATORY ALLERGY: More than 60 papers on AP in chronic obstructive
pulmonary disease (COPD) in the previous 10 years were reviewed (269). 70-97% of
>18,400 cases were cured or improved. AP and moxa increased immunity to infections,
decreased allergic reaction and regulated the ANS. AP (270-272), EAP (273), injection-AP
(274), plum-blossom AP and cupping (275), laser-AP (276), moxa followed by application of
a mixture of Ginseng, gentian violet and white mustard powder (277) and catgut embedding
(278) improved 53-90 of COPD cases. Best results were in mild cases of bronchitis and
bronchial asthma. Steroid dependent cases improved less. Success was associated with shorter
hospitalisation, improved subjective symptoms, general well-being, improved respiratory
function, oxygen cost, ease of breathing and walking distance, increased sputum secretion,
normalised serum immunoglobulins and cessation of medication or decreased use of some or
all previously required drugs (steroids, mucolytics, antibiotics, amino-xanthines, betaagonists, sedatives, aerosols and nebulisers) except in attacks of dyspnoea or lung infections.
AP (187, 279-283), thermal-AP (284), AP + moxa + cupping (285), Earpoint-AP (283), LLLT
(286), "Festering" or scarring moxa (moxa over garlic- or ginger- juice) (287-289) improved

65-100% of bronchial asthmatics. AP with warming moxa was more effective than AP with
cupping (290). The therapeutic effect of AP in asthma may be by reflex and humoral effects
(279). Others also confirmed that AP was beneficial in asthma (291,292). In children with
exercise-induced asthma, AP and sham-AP attenuated exercise-induced asthma but real AP
was more effective (293,294). Salbutamol spray was less effective after real AP, as there was
less bronchoconstriction at the end of challenge (293). AP, EAP or cesium chloride plasters
were effective in resistant allergic rhinitis (283,295-298).
AUTO-IMMUNE DISEASE: AP and moxa decreased steroid use and improved the
symptoms and signs of Systemic Lupus Erythematosus (44,299). Symptoms and signs of
rheumatoid arthritis were alleviated by AP (300), AP plus cupping (301), semi-permanent
needle, point injection, gold beads or magnets (302-304), festering moxa (305,306) and
dietary change. The lesions and pruritus of psoriasis were helped by AP, catgut embedding
(307) and dietary change.
Signs and symptoms of multiple sclerosis can be controlled by AP, EAP (308-311) and
dietary change, especially removal of wheat products.
Signs and symptoms (exophthalmos, palpitations, nervousness etc) in auto-immune
hyperthyroidism (Hashimoto's thyroiditis) can be helped by AP (312-314), point injection
(315), moxa (316) and LLLT (286,317,318).
EMERGENCIES, ANAPHYLAXIS, SHOCK: Emergencies include shock (traumatic-,
haemorrhagic-, endotoxic-, toxic- and anaphylactic-); convulsions, coma, unconsciousness or
collapse from many other causes; CVD, CHD, heatstroke, drowning, poisoning etc. Points for
revival include GV26 and KI01. GV26 (or KI01) with PC06 is useful in coma or
unconsciousness with cardiac failure. AP, EAP and LLLT was effective in anaphylactic
shock (319-321); in experimental haemorrhagic shock (322-324) and protected against
damage to myocardial cells (325). The antishock effect of AP, EAP, TENS, moxa or
electrocautery at GV26 is via sympathicomimetic cardiovascular responses (326-330). AP at
GV26 reversed anaesthetic shock and apnoea within 10-30 seconds (331-336). In
circulatory collapse with cardiac arrest, the success rate was 43% but stimulation had to be
continued for up to 10 minutes (331). In histamine-induced shock, moxa at CV04 increased
cardiac output, peripheral resistance, mean BP, renal plasma flow, glomerular filtration rate,
urine flow and excretion of Na, Cl and K ions (337). AP at PC06 and the Four Pass points was
successful in treating convulsions (187).
CVD, CEREBRAL PALSY, PARALYSIS: In the acute stage of CVD, AP can help to save
life and to reduce sequelae. Points include GV26, whose stimulation causes an immediate and
marked increase in brain and cerebral pia mater perfusion (322), similar to that following
increase of carbon dioxide, but greater than that following 100% oxygen, in the inspired air
(338). EAP at ST09 (over the carotid plexus) or AP at GB34, LI04,11 had similar effects to
GV26 (338-340).
Signs and symptoms of acute or recent CVD were cured or improved in 50-95% of cases by
AP (341-348), AP plus point injection (349) or EAP (350). Early AP treatment gave better
results.
CVD sequelae: Loss of motor or sensory power after CVD may be due to clot persistence,
oedema and vasospasm. After the vascular rupture has sealed and BP has stabilised, great

improvement may be obtained by methods which (a) increase cerebral oxygenation (local
vasodilation and removal of oedema) and (b) increase fibrinolysis. AP can give both of these
effects.
When the patient is stabilised, to prevent or treat sequelae, points include Scalp points (351),
Meridian points and New Points. Points are chosen according to the signs and symptoms and
can be combined with distant points, such as SI03 and the "Loo point" (midway between
BL62 and GB40) and points on the affected nerve trunk (261). Points are often used on the
"good" limb or on the diagonal of the affected limb. The SHU points of the main channels are
useful.
Improving cerebral oxygenation post-CVD: AP relieves spasm in cerebral vessels and
increases circulation by improving the elasticity of vessels, improving cardiac pumping
capacity and promoting formation of collateral circulation (341). AP or EAP is 56-96%
effective, even in cases 6-12 months old (308,328,352-356). Best results were in cases less
than 3-6 months old. AP plus moxa is used in weak or fatigued patients (355).
Improving fibrinolysis post-CVD: Blood clotting time is reduced in many cerebral
thrombosis cases. AP, EAP, LLLT and moxa reduced blood viscosity, decreased fibrinogen
and increased clotting time and cerebral arterial flow (357-360).
CVD due to cerebral-arteriosclerosis, infarct: Clinical signs and symptoms in such cases
are often reversible. Many such cases have kidney or bladder problems. When these are
treated successfully, cerebral functions improve. (Kidney and bladder problems may be the
cause of the cerebral signs and symptoms). Headaches may be caused by pelvic, gonadal,
vesical or renal problems. Somatic pathology may cause spinal and central signs which
resemble arteriosclerosis (361). AP is 60-98% effective in improving organ function in
patients diagnosed as infarcted or arteriosclerotic (362-364).
As part of a multiple-modality treatment in cerebral trauma, concussion, AP helped to
normalise vegetovascular function (365) and improved 72% of cases (366).
Sequelae of cerebral birth injury include blindness, deafness, paralysis and muscle spasms.
AP at BL01,02; ST02; LV03; LI04; GB20,37 cured 100% of children with cortical blindness
(367). Brain-damaged children were helped by acupressure (368) and Scalp EAP helped 94%
of cerebral palsy cases (356).
Points for spinal disorders (disc disease, spondylitis, paralysis from oedema or bleeding in
the cord etc) include Trigger Points (TPs), local points, key points such as: BL40 and GB34
for lumbar spine (369); GV14, BL40 for thoracic spine; SI03, ST38 for cervical spine. SI03
and the "Loo Point" alone or with other points (especially GV points and Source points) has
been up to 90% successful for diseases of all parts of the spinal cord, including pain;
paraesthesia; tremors; paralysis in polio or trauma (261).
ONCOLOGY, CANCER THERAPY, CHEMOTHERAPY AND RADIATION
SICKNESS: Immunocompetence is decreased in cancer (370-372). Chemo- and radiotherapy may depress it still further (373). Therapy which enhances local or general immune
response or influence local microclimate may influence metabolism in neoplastic tissue.
Direct application of heat, cold, ionizing radiation or chemicals to cancerous tissue changes its
micro-environment. Electrothermal needling of transplantable carcinoma in mice cured 50-

88% and 70-90% of tumours regressed (374). Direct current applied to cancerous tissue
shows promise (375). Aberrant cells are killed selectively (cytotoxic effect) or replication is
halted. Local lysis, change of local ionic composition, peripheral micro-thrombosis, reduced
fuel- or blood- supply to the cancer and activation of humoral and local cellular immune
responses (chemotaxis, phagocytosis etc) may be involved. AP, LLLT, moxa and herbs have a
role as a primary or secondary therapy in cancer (376-379). AP increased immune
responses (370,372,376,380,381), normalised ERFC and counteracted the immunosuppressive
effect of radiotherapy (372,373). Laser-AP promoted immune responses and gave direct and
indirect results in cancer therapy (382). Microwave-AP was more effective that chemotherapy.
It had marked therapeutic effect on leucopenia resulting from radio-therapy (381). AP helps
differential diagnosis of cancer (383). AP, EAP, point injection, TENS etc can give
analgesia in patients with cancer pain (384-389), even when physiotherapy, conventional
analgesia, radiation- and chemo-therapy give little or no relief (390,391) or when narcotic
analgesia causes undesirable side effects (386,387,391,392). They can also control secondary
symptoms (384,392). AP analgesia was used successfully to facilitate radiosurgical therapy
of cancer (insertion of radium needles in neoplasms of the oral cavity). Post-op analgesia
lasted 24-48 hours. Local tissue healing was enhanced (393). Side-effects of cancer therapy
(oncosurgery, cytotoxic anticancer drugs, radio-sensitizing drugs and ionizing radiation) may
be so severe as to hinder the patient's treatment (394). The side-effects can be treated or
prevented by AP, EAP, moxa or LLLT therapy (31,246,394-399). Radiation sickness can be
treated or prevented successfully by AP, EAP and moxa (12-16,400, 401).
The following is an example of new claims from Chinese sources: 2% cesium chloride cream
was applied to the AP points. The plaster was renewed every 2-3 days. The method was used
in >2500 cases, including pain, trauma, chronic rhinitis, asthmatic bronchitis, enuresis and
primary hypertension. It gave results similar to those of AP and therapeutic effects usually
appeared in 15-30 minutes when the correct points were treated (296). Similar success was
reported in 70 cases of pain and skin diseases when lithium chloride cream was applied to AP
points or to the lesion, or when cream with 20% urea was applied to painful areas or skin
lesions and in 80 cases of anal fissures or colic due to intestinal fissure when suppositories
containing 100 mg urea were used (188). Oral or rectal lithium was effective in menometrorrhagia, acute dysentery, rectitis, colitis, anal fissure, haemorrhoids, constipation, mild
precordial pain, colic due to intestinal adhesion, bipolar affective disorders, granulopenia,
shoulder pain but had no effect in backpain and acute cystitis. Lithium, cesium and urea are
acetyl choline esterase (AChE) activators. Their clinical effects may be mediated by the
biphasic AChE-activation system. AP Channels and Points may be an interconnecting network
of tissue rich in AChE isoenzymes and receptors and clinical effects of AP are mediated by
that system (188, 402).
REFERENCES
CODES FOR AP AND LASER JOURNALS IN ENGLISH

AETRIJ Acupuncture & Electro-Therapy Research International Journal

AJA American Journal of Acupuncture
AJCM American Journal of Chinese Medicine
ARQ Acupuncture Research Quarterly (Taiwan)
CME&W Comparative Medicine East & West
CMJ Chinese Medical Journal
LS&M Laser Surgery & Medicine

SJA&ET Scandinavian Journal of Acupuncture & Electrotherapy

CODES FOR AP JOURNALS IN CHINESE AND JAPANESE

CAP&M Chinese Acupuncture & Moxibustion

CJIT&WM Chinese Journal of Integrated Traditional & Western Medicine
JJSAP&M Journal of the Japan Society of Acupuncture & Moxibustion
JTCM Journal of Traditional Chinese Medicine

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41.Zhang YH et al. Treatment of 71 cases of chronic pelvic inflamm- ation by moxa

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44.Feng SF et al. Treatment of systemic lupus erythematosus by AP. Abstract AJA
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52.Liu YT et al. Neonatal neuro-behaviourial responses after AP and general
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53.Patterson M. Addictions can be cured. Lion Publishers, Berkhamsted, U.K. 1975.
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55.Ma LH et al. Clinical observation of 57 cases of hysterectomy using combined AP
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60.Dundee JW et al. Influence of intraoperative AP and droperidol on postoperative
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62.Deng DH et al. Observations on combatting nausea by finger pressure on LI04.
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63.Han et al 1981 64. Hou YZ et al. AP anaesthesia as a premedication for peroral

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65.Shen JQ et al. The use of AP analgesia in fibergastroscopy. Abstract AJA 1986;
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66.Chu H, Zhao SZ, Huang YJ. Application of AP during gastroscopy with a fiberoptic
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72.Markelova VF et al. Reaction of the pituitary-adrenal system to surgical
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75.Zolnikov SM, Ponomarenko TP. Reflex therapy in the post-operative period.
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76.Ceccherelli F et al. Influence of AP on post-operative complications following
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78.Christensen A et al. EAP and post-operative pain. Abstract AJA 1989; 17:269, ex
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86.Shi XM. Clinical observation on 50 cases of obstipation treated by AP. Abstract
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87.Anon. Leeches to enhance reimplant survival in humans. Cable TV, New York City,
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100.Pontinen P. Low frequency TNS in peripheral vascular disease. SJA&ET 1986;
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110.Sin YM. AP and thermal injury. AJA 1984; 12:133-138.
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112.Pothmann R, Yeh HL. Effects of treatment with antibiotics, laser and AP on

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113.Eichner H, Kampig G, Wimmer M. AP in acute sinusitis maxillaris in children and
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119.Zhong YS. 60 cases of tinea capitis treated by AP. Abstract AJA 1987; 15:80, ex
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120.Song JH. Foot Tinea treated by AP at Yu Zhen. Abstract AJA 1985; 13:380, ex
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125.Wu YX et al. Effect of AP at ST36 and test meal on gastrin level in healthy
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126.Sodipo JO, Falaiye JM. AP and peptic ulcer studies. Proceedings of the
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127.Li YY et al. Effect of AP on gastric acid secretion. Abstract AJA 1988; 16:275, ex
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128.Jiang YG et al. Effect of EAP on gastric motility in rats. Abstract AJA 1987;
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129.Zhou L, Chey WY. Subcutaneous EAP causes non-parietal cell secretion of the
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130.Lu Z, Chey WY. EAP stimulates non-parietal cell secretion of the stomach in
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131.Qian ZS et al. Point injection for chronic atrophic gastritis. Abstract AJA 1988;
16:378, ex CAP&M 1988; 8 (Apr):1-3.
132.Dai S, Low WD, Ng CK, Ogle CW. Some preliminary findings on the effect of AP
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134.Rogers PAM. Suspect peptic ulcer in two foals: AP therapy successful. AJA 1988;
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135.Kajdos V. Effective AP therapy for duodenal and gastric ulcers. AJA 1977; 5:277279.
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138.Li XT. AP treatment of 102 cases of infantile diarrhoea at GV01 and ST36.
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139.Wu DM. Clinical observation of 100 cases of infantile diarrhoea treated by AP.
Abstract AJA 1985; 13:170-172, ex CAP&M 1984; 4 (Oct):14.
140.Dai QS. Diarrhoea in infants treated by AP. Abstract AJA 1985; 13:376 ex
CAP&M 1985; 5 (Jun):14-15.
141.He JZ. Infantile diarrhoea treated with new AP therapy. Abstract AJA 1986;
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143.Danciu A, Danciu E. The preference of AP treatment in autonomic diabetic
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144.Liu SI, Chai MJ, Cheng DK. A study on AP therapy on white scours of piglets.
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145.Lin JH, Lo YY, Shu NS, Wang JS, Lai TM, Kung SC, Chan WW. Control of preweaning diarrhoea in piglets by AP and herbal medicine. Personal Communication,
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146.Hwang YC, Jenkins EM. Effect of AP on induced enteropathic E. coli diarrhoea in
young pigs. American Journal of Veterinary Research 1988; 49:1641-1643.
147.Gao GX. Clinical observation of 192 cases of acute bacillary dysentery treated by
AP. Abstract AJA 1983; 11:70, ex CAP&M 1982; 2 (Aug):6-7.
148.Hua YB et al. Effect of AP on intestinal function in acute bacillary dysentery.
Abstract AJA 1982; 10:373, ex CAP&M 1982; 2 (Jun):11-13.
149.Tang H. He-Ne laser irradiation of AP points in treatment of 50 cases of acute
appendicitis. Abstract AJA 1982; 10:180, ex JTCM 1981; 1/1:43-44.
150.Fan YK, Zhang CC. 20 years AP in 461 acute appendicitis cases. Abstract AJA
1984; 12;86, ex CMJ 1983; 96:491-494.
151.Jin AD. Treatment of 67 cases of child XU-type prolapsed rectum by AP and
moxa. Abstract AJA 1986; 14:180-181, ex CAP&M 1985; 5 (Dec):7-8.
152.Igari T et al. Effect of AP and moxa for chronic liver disorders. Abstract AJA
1983; 11:376, ex JJSAP&M 1982; 32:34-39.
153.Jin 1983 ..... re AP/hepatitis.
154.Gao GX et al. Clinical observation of 55 cases of acute viral hepatitis treated by
AP. Abstract AJA 1983; 11:272, ex CAP&M 1983; 3 (Apr):14-16.
155.Zhao JM. Acute jaundice hepatitis treated by AP. Abstract AJA 1985; 13:372-374,
ex CAP&M 1985; 5 (Jun):4-6.
156.Zhao JM. Clinical observation and treatment by AP of 194 cases of chronic
hepatitis. Abstract AJA 1983; 11:272, ex CAP&M 1983; 3 (Apr):14-16.
157.Ros LM. AP treatment for hepatitis. Abstract AJA 1989; 17:85 ex 4th International
Congress of Chinese Medicine, University College San Francisco 1988; July 29-31.

158.Shen HP, Hu GS, Sha WJ. Clinical study of moxibustion treatment of Hashimoto's
thyroiditis and type B chronic hepatitis. Abstract AJA 1989; 17:86, ex 4th International
Congress of Chinese Medicine, University College San Francisco 1988; July 29-31.
159.Tao MZ et al. Preliminary clinical and experimental observation on asymptomatic
carriers of antihepatitis B surface antigen. Abstract AJA 1988; 16:181, ex CAP&M
1988; 8 (Feb):28-31.
160.Wang YJ, Zhang WN. Effects of EAP on regional changes of monoamine
neurotransmitters in brain of rat with carbon tetrachloride-induced liver injury.
Abstract AJA 1983; 11:282-283, ex JTCM 1982; 2 (Dec):261-265.
161.Watari N. Protective effect of AP for mouse liver injury caused by administration
of carbon tetrachloride. Abstract AJA 1983; 11:79, ex JJSAP&M 1982; 31:315-322.
162.Watari N et al. Morphological study of the protective and curative effects of AP in
experimental CCl4 hepatitis, alloxan diabetes and HgCl2 nephritis. Abstract AJA
1984; 12:381-382, ex JJSAP&M 1983; 33:125-133.
163.Wu JQ et al. Study on "Massage to activate the Meridian" technique in the
treatment of cholecystolithiasis. Abstract AJA 1989; 17:270, ex CJIT&WM 1989;
9:141-143.
164.Song ZL. AP treatment of biliary ascariasis. Abstract AJA 1982; 10:173, ex
CAP&M 1981; 1 (Oct):15-16.
165.Zhang SY et al. Bile excretion produced by AP stimulation of different points.
Abstract AJA 1983; 11:372, ex CAP&M 1983; 3 (Jun):17-19.
166.Zhang SD et al. Observation on 150 cases of gallstones treated by pressing
Auricular points. Abstract AJA 1986; 14:177, ex CAP&M 1985; 5 (Dec);4-6.
167.Deng DY et al. Ear AP in treatment of hepatolithiasis. Abstract AJA 1986; 14:274
ex CAP&M 1986; 6 (Apr):3-5.
168.Dong SR et al. Clinical analysis of therapeutic efficiency in 365 cases of
cholelithiasis treated by pressure over Earpoints. Abstract AJA 1986; 14:273, ex JTCM
1986; 6 (Mar):1-5.
169.Heinzl MWR. When there is gallbladder trouble. AJA 1986; 14:83-84 (letter).
170.Sun JZ et al. Biliary ascariasis treated by penetrating points LI20 through to ST 2.
Abstract AJA 1986: 14:272, ex CAP&M 1986; 6 (Apr):13-14.
171.Tian SX. Relation between pressing SI11 and infection and stones in the biliary
tract. Abstract AJA 1987; 15:79, ex CAP&M 1986; 6 (Aug):20-21.
172.Zhang YP. AP treatment of 150 cases of acute cholecystitis: clinical results.
Abstract AJA 1987; 15:66, ex CAP&M 1986; 6 (Aug):5-6.
173.Gong CM, Kong QL. Observation with realtime ultrasound on gallbladder
contractive effects with EAP of Earpoint GB (Erdan point). Abstract AJA 1988;
16:181, ex CJIT&WM 1987; 7:273-274.
174.Li ZY et al. Observation of 114 cases of cholelithiasis treated by auricular plaster
therapy. Abstract AJA 1988; 16:79, ex CAP&M 1987; 7 (Oct):23.
175.Mo TW. et al Observation of 70 cases of biliary ascariasis treated by AP. Abstract
AJA 1987; 15:84, ex CAP&M 1987; 7 (Oct):13-14.
176.Wang YX. Observation on the effect of treatment by Earpoint pressure on 303
cases of biliary stones. Abstract AJA 1989; 17:273, ex CAP&M 1989; 9/1:8.
177.Aso T et al. Influence of AP on plasma levels of LH, FSH, progesterone and
oestradiol in normally ovulating women. Abstract AJA 1987; 15:76, ex Rivista Italiana
di Medicina Orientale 1986; 7:57-63.
178.Yu J, Huang WY, Zheng HM. EAP induced ovulation and changes in skin
temperature of the hand. Abstract AJA 1987; 15:276-277, ex CJIT&WM 1986; 6:720722.

179.Yu J et al. Changes in serum FSH, LH and ovarian follicular growth during EAP
for induction of ovulation. Abstract AJA 1989; 17:269-270, ex CJIT&WM 1989;
9:199-202.
180.Woronzova GM, Undrizov K. AP for prevention of premature births in women
with a high risk of abortion. Abstract AJA 1987; 15:269, ex Deutsche Zeitschrift fur
Akupunktur 1987; 30:8-11.
181.Anon. Direct moxa at BL67 to correct foetal malposition. Abstract AJA 1982;
10:176, ex CAP&M 1981; 1 (Dec):17-19.
182.Ding AH et al. Laser-AP in converting breech presentations. Abstract AJA 1986;
14:380, ex LS&M 1986; 6:208 (Meeting Abstract).
183.Zhao RJ. Morning sickness in pregnancy treated by AP. Abstract AJA 1985;
13:180, ex CAP&M 1985; 5 (Feb):10-11.
184.Dundee JW, Ghaly RG. AP researchers concede they never opened a book. AJA
1989; 17:280 (Letter).
185.Flaws B. Leucorrhea and vaginitis: their differential diagnosis and treatment. AJA
1986; 14:305-315.
186.Steinberger A. Treatment of dysmenorrhoea by AP. Abstract AJA 1982; 10:282, ex
AJCM 1982; 9:57-60.
187.Fang JQ et al. Clinical applications of PC06. Abstract AJA 1984; 12:372, ex
CAP&M 1984; 4 (Jun):23-24.
188.Zhen L. AP-like effects of AChE-activators administered via the alimentary tract.
AJA 1985; 13:43-49.
189.Helms JM. AP for the management of primary dysmenorrhoea. Abstract AJA
1987; 15:170, ex Obstetrics and Gynaecology 1987; 69:51-56.
190.Wang XM. Observations of the therapeutic effects of AP and moxa in 100 cases of
dysmenorrhoea. Abstract AJA 1987; 15:383, ex JTCM 1987; 7 (Jan):15-17.
191.Shen QH, Zheng K. Treatment of vulvar dystrophy mainly with electro- thermoAP. Abstract AJA 1988; 16:285, ex CJIT&WM 1988; 8:27-28.
192.Bai YL et al. The therapeutic effect of electrothermal-AP on 172 cases of
nutritional leucoplakia vulvae. Abstract AJA 1988; 16:181, ex CAP&M 1988; 8
(Feb):20-21.
193.Wang L. Hysteromyoma treated by AP. Abstract AJA 1986; 14:174, ex CAP&M
1986; 6 (Feb):27.
194.Gerhard I, Postneek F. Auricular AP as a possible treatment for female sterility.
Abstract AJA 1988; 16:373, ex Geburtsh. Fr., 1988; 48:165-171.
195.Liu WC et al. AP treatment of functional uterine bleeding: clinical observation of
30 cases. Abstract AJA 1988; 16:270, ex JTCM 1988; 8 (Mar):31-33.
196.Wang LQ. Short-term therapeutic effects in 60 cases of chronic pelvic
inflammation treated by He-Ne laser. Abstract AJA 1983; 11:182, ex CAP&M 1983; 3
(Feb):40.
197.Wu XQ et al. Observations on the effect of He-Ne laser AP radiation in chronic
pelvic inflammation. Abstract AJA 1986; 14:372, ex CAP&M 1986; 6 (Jun):23-24.
198.Wu XQ et al. Observations on the effect of He-Ne laser AP radiation in chronic
pelvic inflammation. Abstract AJA 1988; 16:280, ex JTCM 1987; 7 (Dec):263.
199.Wang XM. Therapeutic effect of EAP with moxa in 95 cases of chronic pelvic
inflammatory disease. Abstract AJA 1989; 17:275-276, ex JTCM 1989; 9/1:21-24.
200.Allen WE, Pycock JF. Current views on the pathogenesis of bacterial endometritis
in mares. Veterinary Record 1989; 125:298-301.

201.Tominaga T. Therapeutic effect of AP on reproductive disorders and lameness in

horses. Abstract AJA 1987; 15:282, ex Bulletin of the Japanese Society of Veterinary
Acupuncture & Moxibustion 1985; 4:2-4.
202.Riegler R, Fischl F, Bunzel B, Neumark J. Correlation between psycho- logical
changes and improvement of spermiogram following AP. Urology (A) 1984; 23:329333.
203.Fischl F. Does AP influence sperm quality in subfertile men ? Abstract AJA 1984;
12:368, ex Deutsche Zeitschr. fur Akupunktur 1984; 27:53-56.
204.Fischl F. Does AP influence sperm quality in subfertile men ? Abstract AJA 1986;
14:170 ex Singapore Journal of Obstetrics and Gynaecology 1985; 16:151-155.
205.Zhang JS. Male infertility treated by AP: a report of 248 cases. Abstract AJA
1987; 15:279-280, ex CAP&M 1987; 7 (Feb):3-4.
207.Xu BR et al. AP treatment of 80 cases of chronic prostatitis. Abstract AJA 1987;
15:281, ex CAP&M 1987; 7 (Apr):19-20.
208.Jiang YL. Clinical observation on 250 cases of impotence treated by AP at
Yangwei and procaine block at GV01. Abstract AJA 1988; 16:374, ex CAP&M 1988;
8 (Apr):28-29.
209.Li ZM, Ye CG. Treating impotence with TCM coordinated by AP and moxa.
Abstract AJA 1988; 16:384, ex JTCM 1988; 8 (Jun):121-122.
210.Xu ZX et al. Treatment of 1000 cases of acute mastitis by AP point bleeding.
Abstract AJA 1982; 10:186-187, ex CAP&M 1981; 1 (Dec):5-6.
211.Xiong XN. Moxa of CV17 and massage of SI11 in 47 cases of acute mastitis.
Abstract AJA 1983; 11:78, ex JTCM 1982; 2 (Jun):109-110.
212.Xie BH. Acute mastitis treated with AP and bleeding on the forearm: report of 124
cases. Abstract AJA 1987; 15:61, ex CAP&M 1986; 6, (Aug), 7-8.
213.Gao DK et al. Efficacy of AP at GB21 in 393 cases of acute mastitis. Abstract
AJA 1986; 14:276, ex JTCM 1986; 6 (Mar):19-20.
214.Liang ZP. Thirty-two cases of acute mastitis treated with AP, moxa and cupping.
Abstract AJA 1988; 16:284, ex JTCM 1988; 8 (Mar):15-18.
215.Chen GS. AP treatment of breast fibrocystic disease. Abstract AJA 1982; 10:272
ex International Conference on World Medicine, New York 1982; March 19-28
(Meeting Abstract).
216.Guo CJ et al. AP treatment of mammary hyperplasia. Abstract AJA 1982; 10:368,
ex CAP&M 1982; 2 (Jun):1-3.
217.Hou SK. Effect of freezing-warming AP in 90 cases of mammary hyperplasia.
Abstract AJA 1985; 13:181, ex CAP&M 1984; 4 (Oct):15-16.
218.Yuan S et al. Therapeutic effect of microwave AP on 53 cases of prol- iferative
mastosis. Abstract AJA 1988; 16:283, ex JTCM 1988; 8 (Mar):23-24.
219.Fava A, Bongliovanni A, Frassodati P. AP treatment of hypogalactia. AJA 1982;
10:333-339.
220.Fava A, Bonazzi del Poggetto C. AP treatment of hypogalactia: a seven- year
experience. Abstract AJA 1989, 17, 83, ex 4th International Congress of Chinese
Medicine, University College San Francisco 1988; July 29-31.
221.Yao CX. AP treatment for agalactia. Abstract AJA 1988; 16:373, ex JTCM 1988; 8
(Jun):127-128.
222.Strauss S. AP inhibition of a lasix-induced diuresis: a somatovisceral reflex. AJA
1981; 9:169-172.
223.Suzuki Y et al. The curative effects of AP in hypertension. Abstract AJA 1984;
12:384-385, ex JJSAP&M 1984; 33:260-265.

224.Zhao YM et al. Urinary calculi treated mainly by AP. Abstract AJA 1982; 10:174,
ex CAP&M 1981; 1 (Dec):10-12.
225.Zhu ZY. Treatment of urolithiasis by AP point injection. Abstract AJA 1984;
12:86, ex CAP&M 1983; 3 (Oct):1-3.
226.Zhen KQ. Acute abdominal colic treated by AP at low-resistance points on the
limbs. Abstract AJA 1984; 12:368, ex CAP&M 1984; 4 (Aug): backcover and p. 45.
227.Hosni R et al. Comparative effects of AP, paravertebral block and medical
treatment in the management of acute renal colic. Abstract AJA 1987; 15:173, ex paper
to the International Medical Acupuncture Conference, London 1986; May 4-6.
228.Jang YY. Urolithiasis treated by AP and Chinese herbs. Abstract AJA 1987;
15:379, ex CAP&M 1987; 7 (Feb):5-6.
229.Zhang XT. Clinical observation of 50 cases of renal colic treated by wrist-ankle
AP. Abstract AJA 1988; 16:76, ex CAP&M 1987; 7 (Oct):16-17.
230.Zhen YC et al. Ureteral peristalsis caused by AP at SP06 and BL60. Abstract AJA
1982; 10:182, ex CAP&M 1981;1 (Dec):35-37.
231.Wu DZ et al. The effect of AP on posterior hypothalamic and medullary
micturition centres and related function of the urinary bladder. Abstract AJA 1983;
11:84, ex CAP&M 1982; 2 (Oct):15-19.
232.Zhang ZX et al. Effect of AP on the midbrain micturition centre and related
function of the urinary bladder. Abstract AJA 1986; 14:172, ex CAP&M 1985; 5
(Dec):31-34.
233.Chang PL. Urodynamic studies on AP for women with frequency, urgency and
dysuria, Abstract AJA 1989; 17:75, ex Journal of Urology 1988; 140:563-566.
234.Stoller ML et al. Efficacy of AP in reversing unstable bladder in pig-tailed
monkeys. Abstract AJA 1987; 15:276, ex Journal of Urology 1987; 137:104A
(Meeting Abstract).
235.Mori H et al. Clinical studies on the effects of AP and TENS on the neurogenic
bladder. Abstract AJA 1983; 11:374, ex JJSAP&M 1982; 32:40-46.
236.Ionescu-Tirgoviste C, Rodica V, Ionescu C, Tomescu M. The treatment of enuresis
by AP. AJA 1983; 11:119-124.
237.Huo JS. Treatment of 11 cases of chronic enuresis by AP and massage. Abstract
AJA 1989; 17:183, ex JTCM 1988; 8 (Sep):195-196.
238.Song GY. 1000 cases of mumps treated with ear needling on Pingjian point (MAT2). Abstract AJA 1989; 17:272, ex JTCM 1989; 9/1:14.
239.Yang HJ. Herpes zoster treated by injection of medicine into AP points. AJA 1986;
14:276, ex CAP&M 1986; 6 (Apr):11-12.
240.Loo CW. Symptoms associated with impaired transmission of nerve impulses to
different muscle areas and their treatment with AP. AJA 1985; 13:319-330.
241.Zhao L et al. Infantile acute infectious multiple radiculitis treated by AP in
combination with point injection with ATP. Abstract AJA 1983; 11:382, ex CAP&M
1983; 3 (Jun):7-8.
242.Zheng KS et al. AP treatment of 24 cases of infectious multiple neuritis. Abstract
AJA 1986; 14:270-272, ex JTCM 1986; 6 (Mar):29-30.
243.Zhang SL et al. Lobar pneumonia treated by AP point injection with physiological
saline. Abstract AJA 1984; 12:81, ex CAP&M 1983; 3 (Dec):11-12.
244.Zalessky VN et al. Laser AP in experimental influenza in mice. Abstract AJA
1988; 16:278, ex LS&M 1988; 8:177.
245.Rabinowitz N. AP and the AIDS epidemic: reflections on the treatment of 200
patients in 4 years. AJA 1987; 15:35-42.

246.Smith MO. AIDS: Results of Chinese medical treatment show frequent symptom
relief and some apparent long-term remissions. AJA 1988; 16:105-112.
247.Wang ZQ. AP treatment of 45 malaria cases. Abstract AJA 1987; 15:66, ex
CAP&M 1986; 6 (Oct):18.
248.Xiao SQ et al. Clinical and experimental research on AP treatment of tertian
malaria. Abstract AJA 1984: 12:74, ex CAP&M 1983; 3 (Aug):1-4.
249.Wang CJ et al. Schistosomiasis and thrombocythaemia after splenectomy treated
by AP. Abstract AJA 1983: 11:81, ex CAP&M 1982; 2 (Dec):15-16.
250.Meng XY. Therapeutic effects of EAP on haemoptysis of pulmonary TB. Abstract
AJA 1986; 14:178, ex CAP&M 1986; 6 (Feb):9-11.
251.Lopez BG, Lopez BR, Sumano HL. Acute infectious polyarthrosis in red- fringed
parrots treated with electrostimulation. School Mexico City. Personal Communication
1987.
252.Dung HC. AP for the treatment of post-herpetic neuralgia. AJA 1987; 15:5-14.
253.Sumano HL, Ocampo LC, Gonzalez MV. Evaluation of the effect of AP and
carbamacepine in treating idiopathic epilepsy and distemper-produced epileptiform
convulsions in dogs. Rev. Veterinaria Mexico, 1987; 18:27-31.
254.Ren SZ. AP treatment for sequelae of poliomyelitis. Abstract AJA 1982; 10:173,
ex CAP&M 1981; 1 (Aug):38-39.
255.Wang QD. Infantile paralysis treated by AP on points from the three joints.
Abstract AJA 1986; 14:174-175, ex CAP&M 1985; 5 (Dec):15-16.
256.Zhao L et al. Infantile paralysis treated by embedded needle AP therapy. Abstract
AJA 1985; 13:176-177, ex CAP&M 1985; 5 (Feb):1-3.
257.Qin NT et al. Infantile paralysis treated by AP and moxa. Abstract AJA 1987;
15:76, ex CAP&M 1986; 6 (Dec):1-3.
258.Lin MT et al. AP at LI04 and LI11 induces hypothermia and analgesia in normal
adults. Abstract AJA 1982; 10:278, ex AJCM 1981; 9:74-83.
259.Zhao SH. Infant fever treated by Ear-AP therapy. Abstract AJA 1986; 14:72, ex
CAP&M 1985; 5 (Aug):13-14.
260.Yang JZ. Fever accompanied with infantile convulsion treated with AP: report of
40 cases. AJA 15; 1987:278, ex CAP&M 1987; 7 (Apr):15-16.
261.Loo CW. Dramatic response of illnesses of spinal cord origin treated with SI03
and the "Loo Point". AJA 1988; 16:205-216.
262.Belgrade MJ, Solomon LM, Lichter EAP. Effect of AP on experimentallyinduced itch. Abstract AJA 1984; 12:276, ex Acta Derm. Venereol. 1984; 64:129-133.
263.Lundeberg T et al. Effect of AP on experimentally induced itch. Abstract AJA
1988; 16:275, ex British Journal of Dermatology 1987; 117:771-777.
264.Shapiro RS, Stockard HE, Sckank A. Uraemic pruritus successfully controlled
with AP. Abstract AJA 1988; 16:385, ex Dialysis 1988; 17:180-183 and AJA 1986;
14:235-242.
265.Xia YQ et al. Bloodletting therapy for acne. Abstract AJA 1983; 11:68, ex
CAP&M 1982; 2 (Jun):9-10.
266.Shimura N et al. Enhancement of immune responsiveness by AP and
diphenylalanine. Abstract AJA 1983; 11:381 ex Journal of Dental Research 1983;
62:669 (Meeting Paper Abstract).
267.Huang WY et al. Therapeutic effects in 56 cases of pruritus vulvae treated by AP.
Abstract AJA 1985; 13:384, ex CAP&M 1985; 5 (Jun):7-9.
268.Lyrenas S et al. AP and EAP in the treatment of focal scleroderma. Abstract AJA
1988; 16:269, ex Gynaecol. Obstetr. Invest. 1987; 24:217-224.

269.Tian CH et al. AP therapy for chronic bronchitis. Abstract AJA 1982; 10:173, ex
CAP&M 1981; 1 (Dec):37-41.
270.Sliwinski J, Matusiewcz R. Effect of AP on the clinical state of patients suffering
from chronic spastic bronchitis and undergoing long-term treatment with
corticosteroids. Abstract AJA 1986; 14:76, ex AETRIJ 1984; 9, 203-205.
271.Jobst K, Chen JH, McPherson K, Arrowsmith J, Brown V, Ethimiou J, Fletcher
HJ, Maciocia G, Mole P, Shifrin K, Lane DJ. Controlled trial of AP for disabling
breathlessness. Lancet 1986; Dec. 20/27:1416-1418.
272.Jobst KA, Chen JH, Lane DJ. Traditional Chinese AP for chronic disabling
breathlessness. Thorax 1987; 42:223 (Meeting abstract).
273.Shang F et al. Clinical observation of 1493 cases of chronic bronchitis treated
with EAP at GV points. Abstract AJA 1989; 17:180, ex CAP&M 1988; 8 (Oct):7-9.
274.Sun CJ. Treatment of 100 cases of bronchitis by AP point blocking. Abstract AJA
1987; 15:83, ex CAP&M 1986; 6 (Dec):4.
275.Tsibuliak VN, Silber EAP. Combination of superficial AP with thoracic vacuum
massage in the treatment of chronic obstructive pulmonary disease. SJA&ET 1989;
4:88-94.
276.Jackeviciute GI. Laser AP in bronchial asthma and chronic bronchitis. SJA&ET
1989; 4:98 (Abstract).
277.Liu YB et al. Moxibustion and herb medicine used in treating 482 cases of
bronchitis. Abstract AJA 1987; 15:280, ex CAP&M 1987; 7 (Feb):7-8.
278.Wen MS. Observation of 310 cases with bronchitis and asthma treated by suture
embedding therapy. Abstract AJA 1987; 15:79, ex CAP&M 1987; 7 (Oct):5-6.
279.Feng GT et al. Mechanism of asthma remission by AP at LU10. Abstract AJA
1986; 14:278 ex CAP&M 1986; 6 (Apr):27-28.
280.Takishima T, Mue S, Tamura G, Ishihara T, Watanabe K. Bronchodilating effect of
AP in patients with acute asthma. Annals of Allergy 1982; 48:44-49.
281.Batra YK, Chari P, Singh H. AP in corticosteroid-dependant asthmatics. AJA
1986; 14:261-264.
282.Kachan AT, Nezabudkin SN, Fedoseev GB, Gamayunov KP. Reflex therapy for
patients with respiratory allergy. SJA&ET 1989; 4:51-65.
283.Portnov FG. Latest achievements in electropuncture. SJA&ET 1989; 4:78-84.
284.Guan 1987 .... re thermal AP/bronchitis.
285.He J, Ma R, Zhu L, Wang Z. Immediate relief and improved pulmonary functional
changes in asthma symptom-complex treated by needle warming moxa. Abstract AJA
1989; 17:176-178, ex JTCM 1988; 8 (Sep):164-166.
286.Yang FS. Research into laser AP. Abstract AJA 1987; 15:280-281, ex LS&M
1987; 7:77-78 (Meeting paper abstract).
287.Anon. Effect of "Festering Moxa Therapy" on 985 cases of bronchial asthma.
Abstract AJA 1982; 10:184, ex CAP&M 1981; 1 (Aug):15-18.
288.Zi ZM et al. Therapeutic effects on 182 cases of asthma treated by scarring moxa.
Abstract AJA 1983; 11:84, ex CAP&M 1982; 2 (Oct):13-14.
289.Li XQ et al. Analysis of cyclic nucleotides system in the mechanism of "festering
Moxa Therapy" on bronchial asthma. Abstract AJA 1987; 15:62, ex CAP&M 1986; 6
(Dec):33-35.
290.Ding YD et al. Relieving asthma by AP at BL12, BL13 and GV14. Abstract AJA
1984; 12:83, ex CAP&M 1983; 3 (Oct):7-8.
291.Wagner U, Gotz M. Airway obstruction can be attenuated by AP. Abstract AJA
1988; 16:269, ex Pediatr. Pulm. 1988; 4:107.

292.Mitchell P, Wells JE. AP for chronic asthma: a controlled trial with six months
follow-up. AJA 1989; 17:5-13.
293.Fung KP et al. AP and exercise induced asthma. Abstract AJA 1986; 14:269, ex
Pediatric Research 1986; 20:472A (Meeting Paper Abstract).
294.Kam PF et al. Attenuation of exercise-induced asthma by AP. Abstract AJA 1987;
15:172, ex The Lancet 1986; Dec. 20/27:1419-1422.
295.Kropej H. Influence of AP on rhinopathic vasomotoria: a sympathetic reaction.
Abstract AJA 1984; 12:280-282, ex Deutsche Zeitschrift fur Akupunktur 1984;
27:...-....
296.Zhen L. AP-like effects of cesium salts acting on AP meridian points. AJA 1984;
12:351-353.
297.Chari P, Biwas S, Mann SBS, Sehgal S, Mehra YN. AP therapy in allergic rhinitis.
Abstract AJA 1988; 16:143-147.
298.Lehmann V. The efficacy of AP and EAP in allergic rhinitis - a randomised,
controlled study. SJA&ET 1989; 4:54-55.
299.Minjares T. The use of AP, moxa and herbs in the treatment of Systemic Lupus
Erythematosus. AJA 1987; 15:180-181, ex paper to International Medical Acupuncture
Conference, London 1986; May 4-6.
300.Xi YJ et al. AP treatment of early rheumatoid arthritis. Abstract AJA 1987; 15:64,
ex JTCM 1986; 6 (No. 3):162-164.
301.Sun JD. Rheumatic arthritis treated with AP plus cupping. Abstract AJA 1987;
15:79, ex CAP&M 1986; 6 (Dec):7-8.
302.Jin PH. Rheumatoid arthritis treated by point injection of Chinese herbal
medication. Abstract AJA 1984; 12:84, ex CAP&M 1983; 3 (Dec):9-10.
303.Cheng Z. Rheumatoid arthritis treated by magnetic AP. Abstract AJA 1986; 14:75,
ex CAP&M 1985; 5 (Oct):5-7.
304.Shapiro RS. A dramatic therapeutic possibility in the management of rheumatoid
arthritis. AJA 1989; 17:211-214.
305.Luo SR, Zhu YW. Extending moxibustion in the treatment of rheumatoid
arthritis:a clinical observation of 65 cases. Abstract AJA 1988; 16:174, ex JTCM 1987;
7 (Sep):171-176.
306.Luo SR et al. Clinical observation of "long snake" moxibustion with garlic in the
treatment of rheumatoid arthritis. Abstract AJA 1988; 16:374, ex CAP&M 1988; 8
(Apr):8-11.
307.Sui BJ et al. Observation on effect on psoriasis of treatment with catgut
embedding method. Abstract AJA 1988; 16:381, ex CAP&M 1988; 8 (Apr):4-5.
308.Hoang D. AP therapy for paralysis due to stroke and multiple sclerosis. AJA 1981;
9:129-138.
309.Walker JB. Modulation of spasticity: prolonged suppression of a spinal reflex by
electrical stimulation. Science 1982; 216:203-204.
310.Smith MO, Rabinowitz N. AP treatment of multiple sclerosis: two detailed clinical
presentations. AJA 1986; 14:143-146.
311.Steinberger A. Specific irritability of AP points as an early symptom of multiple
sclerosis. Abstract AJA 1987; 15:179, ex AJCM 1986; 14:175-178.
312.Guo XZ et al. AP treatment of benign thyrocoele. Abstract AJA 1982; 10:368, ex
CAP&M 1982;, 2 (Jun):4-6.
313.Jin SB et al. AP treatment of thyropathy. Abstract AJA 1982; 10:272, ex CAP&M
1982; 2 (Feb):14-17.
314.He QS et al. Clinical effects of different AP methods on hyper- thyroidism.
Abstract AJA 1987; 15:68, ex CAP&M 1986; 6 (Oct):15-17.

315.Zhu HB. Clinical observation on treatment of 50 cases of endocrine exophthalmos

by acupoint injection. Abstract AJA 1988; 16:170 ex CAP&M 1987; 7 (Jun):7-8.
316.Hu GS et al. A clinical study of treating Hashimoto's thyroiditis by moxibustion.
Abstract AJA 1987; 15:77-78, ex JTCM 1987; 7 (Sep):181-184.
317.Ge TK et al. Treatment of exophthalmic hyperthyroidism by laser radiation at AP
points. Abstract AJA 1987; 15:82 ex CAP&M 1986; 6 (Jun):20-22.
318.Ge T et al. An approach to the mechanisms of laser AP in treatment of
exophthalmic hyperthyroidism. Abstract AJA 1988; 16:373 ex JTCM 1988; 8
(Jun):85-88.
319.Khoe WH. The use of AP in emergency cases. AJA 1976; 4:66.
320.Xu RZ et al. Observations on the curative effects on anaphylactic shock in mice
by laser, EAP and embedded needles on auriculo acupoints. In Second National
Symposium on AP and Moxibustion, Beijing. Foreign Languages Printing House
1984; 147.
321.Mu J. Influence of adrenergic antagonist and naloxone on the antiallergic shock
effect of EAP in mice. Abstract AJA 1986; 14:176, ex AETRIJ 1985; 10:163-167.
322.Liu JL et al. Effect of GV26 on the circulation system. Abstract AJA 1984; 12:76,
ex CAP&M 1983; 3 (Aug):44-47.
323.Liu JL et al. Effect of AP on catecholamine histochemistry in the adrenal medulla
of rabbits in haemorrhagic shock. Abstract AJA 1985; 13:172-174, ex CAP&M 1984;
4 (Oct):3-34.
324.Liu JL. Histochemical observation on the effect of AP at GV26 in the adrenal
cortex of rabbits in haemorrhagic shock. Abstract AJA 1986; 14:276, ex CAP&M
1986; 6 (Apr):33-35.
325.Xia YQ et al. AP effect on dehydrogenase in the myocardia of rabbits under
haemorrhagic shock. Abstract AJA 1986; 14:165, ex CAP&M 1986; 6 (Feb):41-43.
326.Lee DC, Lee MO, Clifford DH, Ichiyanagi K. Transcutaneous electrical
stimulation: comparison of cardiovascular effects at GV26 for 10 seconds and 10
minutes in dogs. AJA 1979; 7:215-222.
327.Lee DC, Lee MO, Clifford DH. Does beta endorphin modify the sympathomimetic effects of AP during anaesthesia in dogs ? AJA 1980; 8:215-222.
328.Anon. AP treatment of cardiovascular disease complicated by hyperlipid-aemia.
Abstract AJA 1983; 11:66, ex CAP&M 1982; 2 (Aug):10-11.
329.Baraskov GN, Staroverov AT. Effects of AP on the neuronal mechanism of
respiration. In: Theory and Practice of AP (3). Institute of Post- graduate Studies,
Leningrad 1984.
330.Wu YL et al. Relationship between central cholinergic activity and pressor effect
of EAP. 2. Under hypotension. Abstract AJA 1984; 12:383-384, ex CAP&M 1984; 4
(Jun):34-37.
331.Janssens L, Altman S, Rogers PAM. Respiratory and cardiac arrest under general
anaesthesia: treatment by AP of the nasal philtrum. Veterinary Record 1980; 105:273276.
332.Gonzalez BB, Sumano HL, Ocampo LC. Levels of acetylcholine in the medulla
oblongata of rats treated with Doxapram or AP at GV26. Rev. Veterinaria Mexico
1982; 13:119-124.
333.Davies A, Janse J, Reynolds GW. AP in the relief of respiratory arrest. New
Zealand Veterinary Journal 1984; 32:109-110.
334.Lin JH. AP demonstration in sows: resuscitation and reproductive disorders. ARQ
1985; 9:41-43.

335.Still J, Konrad J. The use of AP for resuscitation of animals. Veterinarni Medicina

1985; 30:493-500.
336.Still J. A comparison of the respiratory stimulant effects of AP at GV26 with
noradrenaline in thiopental-induced apnoea in dogs. SJA&ET 1988; 3:129-136.
337.Ho CC. Effects of moxibustion at CV04 on cardiovascular and renal responses to
histamine-induced shock. Abstract AJA 1987; 15:80, ex AJCM 1987; 15:77-82.
338.Chen GS, Erdmann W. Effects of AP on tissue oxygenation of the rat brain.
CME&W 1977; 5:147-154.
339.Jiang DS et al. Effect of AP on cerebral blood flow of cats with experimental
cerebral ischaemia. Abstract AJA 1984; 12:75, ex CJIT&WM 1983; 3:238-240.
340.Yurino M et al. Clinical effect of EAP on peripheral venous circulation. Abstract
AJA 1987; 15:376, ex Journal of the Japan Society of Acupuncture 1986; 36:172-177.
341.Qiu ML et al. Observation of changes in rheoencephalogram and haemorheology
in apoplexy patients before and after AP therapy. Abstract AJA 1984; 12:383, ex
CAP&M 1984; 4 (2):1-5.
342.Ma SQ et al. Warm moxa treatment for hypertension and cardiac disease. Abstract
AJA 1982; 10:187, ex CAP&M 1981; 1 (Dec):19-21.
343.Shi XM et al. Clinical analysis of 54 cases of cerebral haemorrhage treated by AP.
Abstract AJA 1985; 13:170, ex CAP&M 1984; 4 (Oct):11-13.
344.Sun ST et al. Cerebrovascular disease treated by AP. Abstract AJA 1984; 12:371,
ex CAP&M 1984; 4 (Aug):5-7.
345.Zhang Z et al. Hemiplegia treated by AP on points on the healthy side of the body.
Abstract AJA 1985; 13:176, ex CAP&M 1985; 5 (Feb):6-7.
346.Li DM et al. Clinical study on treatment of cerebral haemorrhage by needling
GV15 and GV16. Abstract AJA 1987; 15:88, ex CAP&M 1987; 7 (Jun):1-4.
347.Shan HR et al. Influence of GV15 and 16 on blood coagulation and fibrinolysis in
patients with brain haemorrhage. Abstract AJA 1988; 16:378, ex CAP&M 1988; 8,
(Apr), 39-41.
348.Li DM et al. Clinical observation on AP therapy for cerebral haem- orrhage.
Abstract AJA 1989; 17:274-275, ex JTCM 1989; 9 (1):9-13.
349.Liu XL et al. AP treatment of 55 cases of cerebral vascular disease and point
injection of Angelica Sinensis Compositus. Abstract AJA 1982; 10:272, ex CAP&M
1982; 2 (Feb):27-29.
350.Wu YX. Treatment of 32 cases of pseudobulbar palsy by EAP. Abstract AJA 1984;
12:386, ex CAP&M 1984; 4 (1):10-11.
351.Bao XY et al. Elementary introduction to treatment of cerebral apoplexy
(hemiplegia) with AP points on the head. Abstract AJA 1986; 14:275-276, ex CAP&M
1986; 6 (Apr):47-48.
352.Zhou YM et al. Hemiplegia and aphasia resulting from CVA treated by needling
cervical sympathetic nerve. Abstract AJA 1983; 11:76, ex CAP&M 1982; 2 (Dec):1719.
353.Xu BR et al. Therapeutic effects of AP in 262 cases of cerebral thrombosis.
Abstract AJA 1984; 12:85, ex CAP&M 1983; 3 (Dec):13-14.
354.Yu ZS et al. Special function head-AP points for treating hemiplegia. Abstract
AJA 1986; 14:75, ex CAP&M 1985; 5 (Aug):21-24.
355.Wang XM. Clinical AP treatment in 480 cases of hemiplegia. Abstract AJA 1987;
15:68, ex CAP&M 1986; 6 (Dec):5-6.
356.Chen DY. Treatment of cerebral paralysis and aphasia by scalp AP: Reports of 440
cases. Abstract AJA 1987; 15:283, ex CAP&M 1987; 7 (Apr):9-10.

357.Jiang YG et al. Moxa at ST36 and the effect on plasma fibrinogen and
fibrinopenia. Abstract AJA 1983; 11:77-78, ex CAP&M 1982; 2 (Dec):33-34.
358.Chen JF et al. AP effects in haemorheology of in-patients suffering from diabetes
mellitus. Abstract AJA 1986; 14:165, ex CAP&M 1986; 6 (Feb):5-8.
359.Nikolaev NA. Therapeutic effectiveness of laser and EAP in early cerebralcirculation insufficiency. Abstract AJA 1986; 14:179, ex Zh. Nevropatol. Psikhiatrii
1986; 86:60-64.
360.Ji N et al. A study on the mechanism of AP therapy in the treatment of sequelae of
cerebrovascular accident or cerebral injury. Abstract AJA 1987; 15:87, ex JTCM 1987;
7 (Sep):165-168.
361.Schuldt H. A frequently misleading diagnosis: cerebral sclerosis. AJA 1984;
12:157-159.
362.Qi LY. Cerebral infarction treated with AP: changes in hemorrheological indices.
Abstract AJA 1987; 15:272, ex CJIT&WM 1986; 6:730-733.
363.Qi LY et al. Effects of AP on serum HDL-C in cerebral infarction patients.
Abstract AJA 1989; 17:278, ex JTCM 1988; 8:161-163.
364.Jiang DQ et al. The effect of Head and Body AP on 169 cases of sequelae of
cerebrovascular disease. Abstract AJA 1989; 17:273-274, ex CAP&M 1989; 9 (1):1213.
365.Petelin LS, Goidenko VS, Biblana IM. The effects of AP in multiple- modality
treatment on some electrophysiological parameters in patients with mild acute craniocerebral trauma. Abstract AJA 1986; 14:78, ex Zhournal Nevropatol. Psikh. 1985;
85:1166-1171.
366.Wang XM. Sequela of cerebral concussion treated by AP. Abstract AJA 1986;
14:178, ex CAP&M 1985; 5 (Dec):13-14.
367.Liang XY. Cortical blindness treated by AP. Abstract AJA 1984; 12:375, ex
CAP&M 1984; 4 (Jun):13-14.
368.Wang ZP. Sequelae of cerebral birth injury in infants treated by acu- pressure.
Abstract AJA 1988; 16:284, ex JTCM 1988; 8 (Mar):19-22.
369.Janssens LA. AP treatment of experimental spinal cord trauma in the rat. SJA&ET
1989; 4:43-48.
370.Xie MY et al. Increasing immunity of nasopharyngeal carcinoma patients with AP.
Abstract AJA 1984, 12, 80, ex CAP&M 1983; 3 (Oct):5-6.
371.Kobayashi T, Kawakubo T, Maki M. Relationships between RyodoRaku
autonomic nervous patterns and immunological levels. AJA 1986; 14:23-28.
372.Xia YQ et al. Immunity reflex state in cancer patients treated by AP. Abstract AJA
1986; 14:277-278, ex CAP&M 1986; 6 (Apr):17-19.
373.Xia YQ et al. An approach to tumours treated by AP in combination with
radiotherapy or chemotherapy. Abstract AJA 1986; 14:269, ex JTCM 1986; 6
(Mar):23-26.
374.Tang XZ et al. Effect of local hyperthermia on transplantable mouse carcinoma by
using electroheating needle. Abstract AJA 1984; 12:378, ex CAP&M 1984; 4 (1):1620.
375.Nordenstrom W. Electrochemical treatment of cancer. Abstract AJA 1988; 16:376,
ex 4th International Congress of Chinese Medicine, University College San Francisco
1988; July 29-31.
376.Zhu RG et al. Triple combination of AP, moxa and Chinese herbs in treating
cancer of the oesophagus and stomach. Abstract AJA 1983; 11:85, ex CAP&M 1982; 2
(Aug):22-24.

377.Sternfeld M, Hod I, Yegana Y, Nun G, Livneh O. Bimodal effect of moxibustion

on mammary carcinoma transplanted in BALB/c mice. AJA 1988; 16:358-361.
378.Yung HC, Dou MH, Yu TH. Effect of irradiation and moxibustion on mice bearing
mammary sarcoma cells. Abstract AJA 1988; 16:374, ex 4th International Congress of
Chinese Medicine, University College San Francisco 1988; July 29-31.
379.Zhao WS. Report on AP treatment for 303 cases of oesophageal cancer. Abstract
AJA 1988; 16:182, ex CAP&M 1988; 8 (Feb):23-24.
380.Shimura N et al. Inhibition of mouse sarcoma-180 by AP and diphenyl- alanine.
Abstract AJA 1982; 10:381 ex Journal of Dental Research 1982; 61:598 (Meeting
Paper Abstract).
381.He CJ, Gong KH, Xu QZ. Effects of microwave-AP on the immunological
function of cancer patients. Abstract AJA 1987; 15:380, ex JTCM 1987; 7:(Mar).
382.Yang FS. Low power N-2 laser AP used in the treatment of 102 tumour cases and
animal experiments. Abstract AJA 16; 1988:280, ex LS&M 1988; 8:176.
383.Gui CM. X-ray barium meal examination of the upper digestive tract. Abstract
AJA 1985; 13:282, ex CAP&M 1985; 5 (Apr):14-15.
384.Kamei J et al. Evaluation on the indication of AP treatment for malignant
neoplasm pain. Abstract AJA 1984; 12:379, ex JJSAP&M 1984; 33:25-32.
385.Toshikazu T et al. Effect of AP anaesthesia for urological cancer pain. Abstract
AJA 1984; 12:376, ex JJSAP&M 1984; 33:285-292.
386.Filshie J, Redman D. AP for malignant pain problems. Abstract AJA 1986; 14:165
ex European Journal of Oncology 1985; 11:389-394.
387.Filshie J, Redman D. AP for malignant pain problems. Abstract AJA 1987;
15:170, ex paper to the International Medical Acupuncture Conference, London 1986;
May 4-6.
388.Pothmann R. TENS in children. Abstract AJA 1987; 15:283, ex paper to
International Medical Acupuncture Conference, London 1986; May 4-6.
389.Chen YF. AP and acu-point injection for cancer pain. Abstract AJA 1989; 17:180,
ex CAP&M 1988; 8 (Oct):30-31.
390.Rico RC, Trudnowski RJ. Studies with EAP. Abstract AJA 1983; 11:81-82, ex
Journal of Medicine 1982; 13:247-251.
391.Zalessky VN, Frolov G. Fibreoptic laser-AP for cancer pain relief. SJA&ET 1987;
2:105-106.
392.Van Benschoten MM. AP and TENS for pain control of terminal cancer. AJA
1983; 11:186-187 (Letter).
393.Mortellaro N et al. AP analgesia in radiosurgical treatment for oral cavity
neoplasia. Abstract AJA 1987; 15:167, ex paper to the International Medical
Acupuncture Conference, London 1986; May 4-6.
394.Dang WL. Reactions following laser therapy over AP points in patients
undergoing chemotherapy. Abstract AJA 1987; 15:280, ex LS&M 1987; 7:78 (Meeting
Abstract).
395.Zhen KY et al. Function of AP on toxic reactions to chemical anticarcinogens.
Abstract AJA 1984; 12:78, ex CAP&M 1983; 3 (Oct):17-19.
396.Moldovan C et al. EAP treatment for superior limb oedema, subordinate to radical
radiosurgical treatment in patients with mammary neoplasia. Abstract AJA 1987, 15,
175, ex paper to the International Medical Acupuncture Conference, London 1986;
May 4-6.
397.Dundee JW, Ghaly JW, Fitzpatrick KTJ, Lynch GA, Abram WP. AP to prevent
cisplatin-associated vomiting. The Lancet 1987; May 9:1083 and British Journal of
Anaesthesia 1987; 59:1322.

398.Dundee JW et al. AP prophylaxis of cancer chemotherapy-induced sickness.

Abstract AJA 1989; 17:278, ex Journal of the Royal Society of Medicine 1989;
82:268.
399.Zalessky VN, Nonko V, Baren L. Laserpuncture in the treatment of cancer
patients. SJA&ET 1989; 4:10-17.
400.Zhang ZH. Curative effects of AP in 44 cases of radioactive rectitis after treating
cervical cancer. Abstract AJA 1986; 14:375, ex CAP&M 1986; 6 (Jun):18-19.
401.Sin YM, Chan WS, Lee E. Beneficial effects of EAP on irradiated mice. AJA
1987; 15:239-244.
402.Zhang JQ et al. Effectiveness of AP therapy in 108 cases of gastroptosis. Abstract
AJA 1983; 11:75, ex CAP&M 1982; 2 (Aug):12-16.
403.Yu,C. (1983a) The effect of laser irradiation at GV01 on the treatment of
dysentery in young lambs. Chinese Journal of Veterinary Medicine, 9, 37-38.
404.Yu,C. (1983b) The effect of laser irradiation of the clitoris on oestrus, ovulation
and conception in cows. Chinese Journal of Veterinary Medicine, 9, 38-41.

QUESTIONS
Meridian codes: LU-LI / ST-SP / HT-SI / BL-KI / PC-TH / GB-LV
1. Indicate the best AP point to treat fever: (a) BL11
(b) GV03
(c) GV14
(d) ST40
(e) LV03
2. Indicate the best point (for use with local points) to treat acute traumatic pain: (a)
LI04
(b) ST25
(c) SP06
(d) LI11
(e) GB34
3. Five of the following six points are immunostimulant points, for instance to treat
cholera with fever. Indicate the point of least value: (a) SP09
(b) LI04
(c) LI11
(d) ST36
(e) ST25
(f) GV14
4. Indicate the condition least likely to respond to AP: (a) Paralysis due to drug overdose
(b) Paralysis due to motor neuron degeneration
(c) Paralysis due to disc disease with loss of deep pain sensation
(d) Paralysis due to traumatic peripheral neuritis
(e) Paralysis due to cerebral vasospasm
5. One of the following statements is not correct. Indicate the incorrect statement: (a)
Combination of per- and post-op EAP reduces the demand for post-op analgesic drugs and
patients become self-caring more quickly

(b) The incidence of post-op sepsis was much lower in patients under AP analgesia as
compared with those under general anaesthesia
(c) AP at PC06 was much less effective in preventing pre- or post- op nausea and vomiting
than cyclazine and metoclopramide in patients undergoing surgery
(d) Nausea and vomiting due to passing a laryngoscope can be prevented in 80% of patients
by heavy acupressure on LI04
(e) Atropine or anticholinergic agents produce side effects, including dry mouth, blurred
vision, dizziness and tachycardia. AP can replace anticholinergics, with few or no side effects,
to facilitate gastroscopy or a barium meal
6. One of the following statements is not correct. Indicate the incorrect statement: (a)
EAP combined with epidural, local or general anaesthesia for surgery reduces the amount of
anaesthetic drugs needed and confers neurovegetative protection from the effects of surgical
trauma
(b) Post-op recovery of breathing, consciousness and autonomic function is faster and the
immune system is less depressed after combined anaesthesia than after drug anaesthesia
without AP
(c) AP post-op stimulates fast recovery of liver function and reduces hallucinations on
emerging from ketamine anaesthesia
(d) Electro-AP post-op gave less effective analgesia than i/v meperidine
(e) Electro-AP post-op halved the use of pethidine
7. One of the following statements is not correct. Indicate the incorrect statement: (a) AP
was not effective in primary agalactia and hypogalactia
(b) AP was effective within a few days in acute mastitis, breast abscess and breast carbuncle
in women
(c) AP was effective in mammary fibrocystic disease in women within 3 weeks and can be
used in the differential diagnosis of fibrocystic disease from mammary carcinoma
(d) AP was effective in mammary hyperplasia and proliferative mastosis
(e) AP can be used to prevent threatened abortion, to correct foetal malposition, to induce
labour in women; to cure morning sickness, vaginitis/leucorrhea, dysmenorrhoea; to resolve
vulvar ulceration, vulvar leukoplakia and hysteromyoma without the need for surgery.
8. One of the following statements is not correct. Indicate the incorrect statement: (a) AP
cured female infertility/sterility (amenorrhoea, anovulation, polycystic ovarian disease,
functional metrorrhagia) and pelvic inflammatory disease
(b) The results of AP in pelvic inflammatory disease were not as good as antibiotic therapy in
similar cases
(c) Laser on the clitoris was effective in anoestrus in cows
(d) AP can treat impotence, poor libido, infertility and prostatitis in men
(e) Endometritis always follows mating in mares but healthy mares clear the uterus within 4872 hours
(9) One of the following statements is not correct. Indicate the incorrect statement: (a)
BL23, GB25 and KI01 are especially effective for kidney function and BL28,32; CV03 and
SP06 are very effective for bladder function
(b) AP was effective in limiting proteinuria and curing nephritis in HgCl2 toxicity in mice
(c) AP was effective in renal colic, urolithiasis. Pain was controlled in minutes and stones
were often passed in hours or days
(d) The effects of AP on renal function and ureteral peristalsis can be seen with intravenous

pyelography
(e) Although AP is effective in functional bladder problems (dysuria, urgency, frequency,
urine retention) it is not effective when bladder lesions are present (calculi, erosion, cystitis)
1=c2=e3=a4=b5=c6=d7=a8=b9=e

TRADITIONAL VERSUS MODERN ACUPUNCTURE

SUMMARY
Traditional Chinese Medicine (TCM) is based on ancient Chinese concepts of health and
disease, including the theories of Yin-Yang, Qi, Change, Five Phases, the Six Evils, oriental
diagnostic methods and the necessity for balance/control in all aspects of life. Some of these
concepts are considered irrelevant to western-trained professionals. Others are highly
relevant.
Acupuncture (AP) is part of TCM. It is based primarily on a knowledge of the location and
function of AP points . In western concepts, AP is based on a knowledge of the input/output
terminals of a two-way system of data transmission between superficial reflex (reactive)
points and the organs or parts which are related to these points via the neuro-endocrine
system.
AP diagnosis and therapy depend in part on TCM concepts. Mastery of traditional AP (TAP)
demands years of study under expert teachers. Most western professionals will not invest the
time and effort needed for that.
The basics of AP and Cookbook methods can be learned in 40-120 hours of concentrated
course-work and 6-12 months part-time home-study. That training (combined with western
medical knowledge) can produce excellent clinical results in properly selected cases.
Success with AP therapy demands a knowledge of medicine and basic AP. Those who have
not studied or will not study the basics of both systems delude themselves and their
clients/patients if they try to use AP in any but the simplest of cases. The more a clinician
knows of TCM and western medicine, the greater the probability of being able to select an
effective regime of therapy for the patient.
INTRODUCTION
The Guide to Professional Behaviour (page 22), issued by the Veterinary Council of Ireland in
April 1988, states:
"19. Meeting an unqualified person in consultation
By this is meant the meeting for the purpose of consultation, with an unqualified person such
as an acupuncturist, osteopath, bone setter, chiro-practitioner etc. Such a consultation is
unethical and would be construed as conduct disgraceful in a professional respect...".
On being found guilty of that charge, the penalty may be removal of the veterinarian's name
from the Veterinary Register of Ireland. He or she would be unable to practice veterinary
medicine legally in Ireland or in any other country which recognises the Irish veterinary
qualification.
Before and since the advent of western medicine, TCM and TAP have stood the test of time.
They serve more of the world's population than our medicine and it will not go away because
some westerners scoff at it. Among professionals and the public in the west, there is also
growing awareness that holistic medicine must involve the study of many modalities,

including western and eastern. Today, a small but slowly growing number of medical, dental,
physiotherapy and veterinary graduates in almost every country in the developed world use
acupuncture (AP) routinely. However, AP is practised at levels of proficiency ranging from
grossly incompetent (by professionally qualified people who may have attended an expensive
but worthless weekend AP crash-course) to highly skilled (by people fully trained in Classical
AP but deemed to be professionally "unqualified").
Orthodox colleagues of "professionally qualified" acupuncturists have mixed reaction to their
use of AP, ranging from encouragement, to disinterest (due to complacency with the status
quo or intellectual laziness), to honest scepticism (based on genuine criticism of the poor
standard of science/statistics behind many of the published claims for AP, or based on
ignorance of the body of solid research and clinical results from well conducted AP trials), to
antagonism (based on prejudice, if not malign intent in the face of knowledge that AP has a
useful role in medicine).
Three main factors limit the more widespread use of AP and allied methods in "western
medicine":

a. Scepticism and/or vested interest;

b. Refusal of orthodox practitioners to re-train and
c. The difficulties of organising AP training.
a. Scepticism and/or vested interest among the more influential members of the
professions inhibit active promotion of training, clinical trials and basic research in AP
by the professional associations and academic authorities. If they were to admit openly
that AP methods are effective, even in some human and animal diseases, the
implications for the establishment would be enormous. For example:
The public image of professorial/scientific authority would be weakened. Competent
AP teachers and clinicians would have to be found, selected and graded. Who would
be competent to select/grade them? Who would pay their salaries and how much?
Academic undergraduate curricula (already over-stretched) would have to be rescheduled to incorporate considerable time for AP at the expense of other coursework.
Research teams would have to recruit expert AP specialists and fund AP research in
the face of a multi-national, multi-million dollar drug industry which has a powerful
influence on funding of orthodox research, sponsorship of drug-related professional
seminars/conferences and junkets for cooperative practitioners.
The National Health, med/dental/vet hospitals, physiotherapy clinics and the general
professions would have to establish AP services.
How would the establishment treat AP practitioners unqualified to practice in the
orthodox professions and how would the latter react to attempts to control or ban
"unqualified" practice?

b. Refusal of orthodox practitioners to re-train: If post-graduate basic- to masterclass training were to be made available (even a voluntary basis, at the State's
expense) many professionals would probably opt out.
c. The difficulties of organising AP training: Most western countries have no
cohesive national approach to AP training, the minimum standard needed, whether
classical or simplified AP should be taught. There are many differences of opinion on
these questions within and between AP factions within the professions, and between
the "professionally qualified" and "unqualified" acupuncturists. Even if these
differences can be resolved, there is a chronic shortage of competent AP teachers.
This paper compares and contrasts aspects of the two main schools of AP: the Classical and
the Cookbook. It concludes that both systems have strengths and weaknesses and that the
minimum requirement is a working knowledge of the basic principles of AP theory and a
good knowledge of the main AP points. Neither the Traditional nor the Cookbook system
(alone or combined) is effective as a therapy for all types of disease. Therefore a complete
approach to professional therapy requires more than proficiency in AP.
The ideal for western societies is an orthodox professional training, combined with a mixture
of classical and modern AP, to say nothing of integration of other complementary therapies
(homoeopathy, manipulative therapy, etc). Ideals are difficult to attain. A good compromise
solution would:
a. allow graduates from bona fide AP Schools to continue to practice and
b. encourage Universities to provide highly practical, elective AP courses (including
the Cookbook method and short, basic instruction in Classical AP) at undergraduate
and postgraduate level.
Without such a compromise, acupuncturists (even those with recognised qualifications within
the medical and paramedical professions) are likely to remain "out in the cold" for the
foreseeable future in most western countries.
AP SYSTEMS
Historically AP developed from applications of Tibetan/Chinese thought. Today there are
many variants of AP. The two main ones are the Traditional (Classical) school and the Modern
(western-oriented school). The latter is based on a limited study of what westerners consider
to be the relevant classical principles, combined with Cookbook (prescription) AP and
western concepts of physiology and medicine. Both systems demand knowledge of the AP
points and Channels.
There were/are major differences (cultural, philosophical, political, sociological, economic
and environmental) between our world and that of the Chinese, ancient and modern.
Difficulties in communication, not least of which are language and conceptual differences
between eastern and western minds, can be traced to that fact. Even highly educated Chinese
scholars have difficulty in interpreting the meanings hidden in the ancient Chinese texts. The
ideograms and their context have subtleties of meaning which can be distorted or lost in
"technical" translations.

Conceptual differences are also barriers to understanding. Concepts of Yin-Yang, Five Phases,
the Emotional Causes of disease, the Six Evils, direction and flow of Qi (life energy), the Qi
body clock, pulse diagnosis etc have no parallel in western thought. The closest we can come
to them is by analogy and by some specific examples. But, in spite of years of exposure to
these concepts, many western students of AP still regard them as "foreign, Chinese or
traditional", e.g. "non-self", not part of "our" world-view. But, if we are to improve our
clinical results, we must be prepared to learn from other effective medical systems, including
TCM.
TRADITIONAL AP (TAP)
TAP is based on ancient Chinese concepts, which will be discussed:

1. AP Points and Channels

2. Qi and Yin-Yang
3. Change (Transformation, Rhythms, Cycles, Relativity, Balance)
4. Five Phase Theory
5. Concepts of ecology, Syndromes and causes of disease in TCM
6. Diagnosis in TCM
7. Therapy in TCM
8. AP methods
9. Methods of choosing effective AP Points

These concepts are discussed in more detail in other papers and in texts on TCM (Austin
1974; Connolly 1979; Kaptchuk 1983; Mann 1973; Porkert 1983; Wu Wei Ping 1973; van
Nghi 1971).
The western student who wants to make rapid progress in the study of TAP must "forget"
western ideas for a time. He or she must approach the study of AP as a child approaches a
wise teacher- in a spirit of openness, total ignorance, tranquillity and trust.
The teacher is there to teach and the student is there to learn. There is little value in
questioning each step of the lessons from a critical, analytical western viewpoint. From
western viewpoints there are no satisfactory answers to many valid questions. At best, such
questions impede the student's progress and, at worst, may discourage him or her from
continuing the study. Because of unsatisfactory answers, many western "scientific" research
workers reject the entire system, throwing the baby out with the bath water.
1. AP POINTS AND CHANNELS
AP POINTS
The diagnostic, therapeutic and preventative value of AP depends totally on a knowledge of
the AP points, the Channels and their functional and anatomical relationships with each other.
Characteristics of AP points There are two main types of AP points: (a) Ahshi points and (b)
codified AP points. Most AP points of type (b) are reactive electro-permeable points (REPP)
relative to nearby skin areas. Hyper-reactive AP points, whether of type (a) or (b) are
hypersensitive to pressure-palpation, electric current or heat. Hypo-reactive AP points, usually
type (b) only, are hypo-sensitive to pressure-palpation, electric current or heat.

a. Ahshi points Ahshi points are abnormally tender to palpation pressure. The patient may be
unaware of their presence until they are pressed. When Ahshi points are pressed, the human
patient usually grunts, groans, swears or jerks (AH = Ah! SHI = Yes !; Ahshi = "Ouch!"). In
animals, pressure on Ahshi points elicits definite defensive or aversive behaviour (movement,
dipping, swishing of the tail, attempts to kick or escape in horses; movement, bellowing or
attempts to kick in cattle; attempts to bite, howling, whining, attempts to escape in dogs).
Some Ahshi points are just painful locally, corresponding with "fibrositic nodules", "motor
points" and other irritable foci in muscle and fasciae.
These are not as important in therapy as those which are painful locally and refer pain to the
area in which the patient reports the clinical pain. The latter type of Ahshi points are the
Trigger Points (TPs) of "Western Medicine", as they trigger pain to the referred area of pain.
For instance, many headaches may be caused by TPs points in the trapezius, neck or temporal
muscles; shoulder pain may be due to TPs in the infraspinatus or supraspinatus muscles. (See
Travell and Simons 1984).
Ahshi points may occur anywhere in the body but are usually in muscle. Many (up to 70%)
occur at codified AP points but others occur at positions not codified in AP texts. They are
usually present in myofascial syndromes and are very useful in diagnosis and prognosis. In
the absence of signs of other pathology, they confirm that muscular spasm is the main
problem and that the prognosis is very good if they can be eliminated successfully.
Ahshi points may also occur in disorders of internal organs (especially at the Shu
(paravertebral reflex) and Mu (front alarm) points). For instance, in heart/pericardial disease,
pressure along T4,5,6 (BL14,15,16) or from under the xiphoid cartilage to a point between the
nipples (CV14-17) may be painful. These points are the Shu and Mu points for HT and PC
(see section (a) under MASTER POINTS below).
Apart from diagnostic value, Ahshi points have great therapeutic value. They are always
treated as part of AP therapy.
So far, it would appear that treatment of tender points (Ahshi, Shu and Mu points) is all that is
needed for successful AP therapy. Unfortunately, that is not sufficient. Point tenderness does
not always occur in clinical disease. In the absence of point tenderness, the therapist can not
begin to use the AP system unless he/she knows the position and uses of the codified AP
points.
b. Codified AP points
There are over 1000 codified AP points. Apart from the 361 classical Channel Points, there
are over 639 other points described in this century, mainly outside the Channels. These are the
"New", "Strange", "Hand", "Ear", "Foot", "Scalp", "Face", "Nose", "Red Doctor Zone" points
etc.
Each point has a Chinese name and an alpha-numeric code (e.g. ST36 is the 36th point on the
ST Channel). The Chinese name describes its function, location or other detail of use to those
who know the language, for example Tsu San Li (ST36) translates as Foot Three Li (3 Li = 1
mile), a point for tired legs and also 3 TSUN below the patella; Fei Shu (BL13) is the reflex
point for Lung; Hsin Shu (BL15) is the reflex point for the Heart etc). As few westerners
know Chinese, much valuable "automatic information" is hidden from them by not knowing

what the point name means. They must learn the points the hard way- by alphanumeric code
and functions, as most texts do not translate the point name for western readers.
Each AP point is described anatomically, in relation to easily visible or palpable body
landmarks; joints, tendons, body creases, intercostal spaces, vertebrae, umbilicus, xiphoid,
nipples, mouth, ear, eye etc. Some of the better texts also describe the location of the point in
relation to nearby blood vessels and nerves.
AP point location: The "body inch" or TSUN is the standard way of locating points in
relation to each other (See Anon 1980: "Essentials of Chinese AP"). The average TSUN in
humans is the width of the joint of phalanx 1-2 of the patient's index finger. 3 TSUN is
approximately the width of the patient's hand (thumb excluded) at the level of phalanges 1-2.
However, the length of the TSUN varies slightly with the part of the body being searched. The
body is divided into a number of TSUN between fixed landmarks:
Points on the Head and Neck are located as follows:

from anterior to posterior hairline (midline) is 12 TSUN

from anterior hairline to spine of C 7 (midline) is 15 TSUN
from anterior hairline to midpoint of eyebrows (midline) is 3 TSUN
from midpoint of eyebrows to spine of C 7 (midline) is 18 TSUN
from anterior hairline to cleft of chin (midline) is 10 TSUN
between the left and right mastoid processes is 9 TSUN
between the highest points of left and right cheekbone is 7 TSUN

Points on the Trunk are located as follows:

from left to right nipple (male) is 8 TSUN

from midline of spine to upper angle of scapula is 3 TSUN
from upper angle of axillary crease to free end of 11th rib is 12 TSUN
from xiphisternum to umbilicus is 8 TSUN
from umbilicus to upper edge of pubis is 5 TSUN
from xiphisternum to upper edge of pubis is 13 TSUN

Points on the Thoracic limb are located as follows:

from upper angle of anterior axillary crease to elbow crease is 9 TSUN
from elbow crease to distal wrist crease (medial or lateral) is 12 TSUN
Points on the Pelvic limb are located as follows:

from tip of great trochanter of femur to lateral edge of popliteal fossa is 19 TSUN
from lateral edge of popliteal crease to external malleolus of tibia is 16 TSUN
from upper edge of pubis to medial epicondyle of femur is 18 TSUN
from medial condyle of femur to medial malleolus of tibia is 13 TSUN.

Thus, point KI27 (2 TSUN from the midline, below the clavicle), can be located easily in a
child or in a huge man. The TSUN is a ratio system, as applicable in mice or elephants as it is
in humans.

AP POINT FUNCTIONS
Apart from functions specified for each point in standard texts, AP points also influence:
a. the Channel and associated functions of its Organ (e.g. points on the ST Channel
influence ST function and the stomach);
b. the Channel and areas anatomically close to it (e.g. ST points influence pain and
dysfunction along the superficial and deep paths of the ST Channel;
c. local tissue and functions (e.g. GB34 (on the lateral leg, in the notch between the
upper head of the fibula and the tibia) influences the knee, the upper lateral leg and its
structures and functions);
d. thoracic and abdominal points, including paravertebral points, influence organs
anatomically close to them.
For example, the GB Channel begins at the lateral canthus of the eye (GB01), travels upwards
and backwards over the head, down the neck dorsomedial to the mastoid process (GB20),
over the highest point of the trapezius (GB21), down the lateral thorax past the tip of the last
rib (GB25), behind the femoral trochanter (GB30), down the lateral thigh to the fibular-tibial
notch (GB34), down the lateral leg, to end on the 4th toe. GB34 (apart from functions
specified in the textbooks) influences GB function and disorders (cholecystitis, cholelithiasis
etc); pain and dysfunction along the course of the Channel from eye, to lateral headache, to
neck/shoulder area pain, to lateral thoracic/abdominal pain, to hip, lateral thigh, knee, lateral
leg, ankle, to 4th toe pain/sprain/paralysis etc.
Apart from specified and additional functions (above), certain points on the Channels are
more powerful than others, even for local effects. For instance, GB34 is more often used than
GB33 in knee problems, even though GB33 is near the knee. For other details, see the papers
on the "Choice of Points for Particular Conditions" and "The Study of Points and Channels").
MASTER POINTS
(See paper on "The Study of Points and Channels"). Each of the 12 main Channels has a
number of MASTER points, which are used in TAP:

a. Shu and Mu Points

b. Five Phase Points
c. Luo (Passage) Points
d. Yuan (Source), Xi (Cleft), Tonification, Sedation, Hour Points etc.

a. Shu and Mu Points

Each Channel-Organ System (COS) has a Shu and Mu point. These are reflex points
which may become spontaneously tender, or tender to palpation if the COS is
disturbed. Thus they have diagnostic uses. The Shu and Mu points has a powerful
therapeutic effect on affected organs and often are combined in those cases.
The Shu (Paravertebral reflex, Associated) points occur on the first line of the BL
Channel between vertebral spines T 3 and S 4. There are 18 pairs of Shu points, 12 of
which relate to the 12 main Channels. The Mu (Front Alarm) points occur on the
anterior or lateral thorax and abdomen. There are 12 points corresponding to the 12
main Channels. Six are in the CV line between CV03 and CV17 (BL, SI, TH, ST, HT,
PC) and six are bilateral (LU, LV, LI, GB, KI, SP).

Because of overlap in the spinal nerve supply to the organs, the Shu and Mu points are
not as organ-specific as TCM/TAP states. For example BL14 (paravertebral below the
spine of T4) and CV17 (midway between the nipples) are the Shu and Mu points for
the pericardium (PC). However, because of nerve overlap, disease of HT and LU
could also activate reflex sensitivity at those points. Therefore, Shu and Mu point
sensitivity is a guide but not a definitive indication as to the organ affected. Final
confirmation is based on other evidence from TCM or western tests.
Anyone who practices AP, even in its most simple forms, should know the Shu and
Mu points.
b. Five Phase Points
These transfer Qi between the Channels in the Five Phase Cycle (see section 4 below).
c. Luo Points
These transfer Qi between the Husband and Wife Channel within each Yin-Yang pair
within each Phase (see section 4 below).
d. Yuan (Source), Xi (Cleft), Tonification, Sedation, Hour Points etc. These are
discussed in the papers on the Study of AP.
Point types b, c, d (above) are powerful Energetic Points of AP. Their use needs a study of the
principles of TAP.
As a knowledge of point location and functions is essential to the use of AP, beginners may
feel daunted by the large number of points. Please take courage from the fact that most
western AP experts are familiar with as few as 50-150 points ! If beginners grasp the
principles of basic AP, they can consult AP textbooks for details of the less commonly used
points, as the need arises.
The Channel-Organ Systems (COSs) of AP
When the Chinese use the term Hsin (Heart, HT), Pi (Spleen-pancreas, SP), Fei (Lung, LU),
Shen (Kidney, KI), Kan (Liver, LV) etc, they imply much more than the physical organs
(heart, spleen-pancreas etc). They include the nature, structure and functions of the organs and
many other attributes, as well as the superficial, collateral and deep paths of the Channels.
Thus, it is better to think of the Twelve COSs (each with many specific attributes) rather than
to anatomical pathways or localised physical organs. The extended COS (Channel-Organ
System) concept is most important in diagnosis and therapy by TAP.
TAP is a system of Energetics and Correspondences. Classical practitioners are interested in
symptomatology, only in so far as it indicates WHICH COS(s) has/have energy (Qi)
imbalance. By correcting the Qi imbalances, all amenable symptoms and signs are expected to
regress rapidly. For example, Hsin (HT) is of the Fire Phase. It controls the heart, tongue and
psyche. Thus, neurasthenia, restlessness, insomnia, excitability, rapid speech, angina pectoris,
red complexion, dislike of summer weather or heat etc indicate a disorder in Fire, manifest in
a disturbance in Heart function. (In that case, ECG and heart muscle enzymes etc may be
normal but treatment of the HT Channel can eliminate most or all of the symptoms).
There are twelve main Channel-Organ Systems, which either begin or end on a finger or toe.
The superficial paths of the 12 main Channels have bilateral symmetry: Lung (LU); Large

Intestine (LI, colon); Stomach (ST); Spleen-Pancreas (SP); Heart (HT); Small Intestine (SI);
Bladder (BL); Kidney (KI); Pericardium (PC, Circulation-Sex, Heart Constrictor); Triple
Heater (TH, Endocrine, (Respiration, Digestion, Reproduction)); GallBladder (GB); Liver
(LV). The superficial paths of the Channels are longitudinal lines of low electrical resistance
(high conductivity) which connect AP points of similar function. The deep paths are planes of
low electrical resistance (high conductivity) which connect the superficial path to their related
organs.
Each Channel passes through an arm or leg, has a polarity (negative (Yin) or positive (Yang)),
belongs to one of the Five Phases and has a specific number of AP points:
Limb

ARM

LEG

ARM

LEG

ARM

LEG

Polarity

-+

+-

+-

-+

-+

+-

Meridian

LU LI ST SP HT SI BL KI HC TH

GB LV

Phase

Metal

Earth

Fire

Water

Fire

Wood

Number of points

11 20

45 21

9 19

67 27

9 23

44 14

The arm Yin Channels (LU, HT, PC) begin in their organs, become superficial on the chest
and end at the fingers;
The arm Yang Channels (LI, SI, TH) begin on the fingers and end on the face but send a deep
branch to their organs;
The leg Yang Channels (ST, BL, GB) begin near the eye and end on a toe but send a deep
branch to their organs;
The leg Yin Channels (SP, KI, LV) begin on a toe and end on the chest but send a deep
branch to their organs.
Channel circuits: In TAP, vital energy (Qi) flows in a specific daily circuit through the
Channel network and in a fixed time sequence. It circulates throughout the body, reaching all
parts and all organs. The Qi peaks in each COS at a fixed time each day. The peak times for
the Channels are:
+
+
+
+
+
+
LU LI ST SP HT SI BL KI PC TH GB LV LU
0400 0600 0800 1000 1200 1400 1600 1800 2000 2200 0000 0200
The daily Qi Cycle ends in LV at 0300h, the "dead hour of night". A new cycle begins in LU
at 0300h, peaks there at 0400h and passes to the LI at 0500h etc. In the daily Qi Cycle, LU is
the Son of LV (LU receives Qi from LV) and LU is the Mother of LI (LU feeds Qi to LI). LI
is the Son of LU and the Mother of ST etc.
Within each Phase, the Yin partner is the Wife and the Yang partner the Husband, e.g. in Metal
(LU, LI), LU is the Wife of LI; LI is the Husband of LU. This pairing is important in
Energetic AP, as Qi can be shunted from Husband to Wife (or vice-versa) via the Luo
(Passage) point of the Deficient partner. This shunt (via Luo of Deficient partner) is also used
in balancing disturbed Qi in the Five Phase Cycle (see below). Also, the pairings indicate that
LU points can be used in LI diseases and vice-versa.

In addition to the 12 main Channels, there are Eight Mai (Vessels or Extra Channels). These
intersect with some of the main Channels and act as Qi reservoirs for them. The Eight Mai
are: Du Mai (Governing Vessel, (GV), in the dorsal midline, 28 points); Ren Mai (Conception
Vessel, (CV), in the ventral midline, 24 points) ; Chong Mai; Dai Mai; Yang Chiao Mai; Yin
Chiao Mai; Yang Wei Mai; Yin Wei Mai. There are 361 AP points on the 14 Channels (the 12
main Channels + GV + CV).
2. QI AND YIN-YANG (DUALITY)
Qi is the general Chinese name for energy. Qi is immaterial and is neither created nor
destroyed; it just changes form. Qi and substance interchange. Every thing in the universe,
organic/inorganic, material/solid, immaterial/intangible, hot/cold depends on, or is a
manifestation of Qi. Life and death, health and disease, growth and senility, composition and
decomposition is caused by changes in the proportions and types of Yin and Yang Qi.
There are many types and expressions of Qi, creative and destructive. Qi can manifest in Yin
and Yang forms, in the Five Phases, in a flower, the wind, a laugh and in empty space,
nothingness.
Yin-Yang: Thousands of years before the Bible spoke of Good and Evil, the Chinese
developed the concepts of duality and relativity. To them, nothing was absolute, but was a
mixture of opposing forces, Yin (the passive or negative force) and Yang (the active or
positive force).
"Yin and Yang are the source of creation and the cause of destruction of all things": Chinese
concepts of Yin and Yang were essential, fundamental parts of this world view. The Yin-Yang
principle refers to opposites. Everything in creation has its opposite number. Yin-Yang
referred to female/male, below/above, Earth/heaven, passive/active, front/back, dark/bright,
etc.
This concept of Yin-Yang was applied to everything in life: art, politics, philosophy, medicine,
architecture, etc. Everything in nature can be characterised by its proportions of Yin and Yang
Qi.
In medicine, Yin-Yang referred to hypo/hyper states, solid organs/hollow organs, female
genitalia/male genitalia etc. Chronic dis-eases were Yin, acute dis-eases were Yang, etc. Table
1 shows some other examples of Yin-Yang.
TABLE 1. Examples of Yin-Yang (states of relative opposition)
Yin

Water

Ice

Cold

Female

Passiv
Dark
e

Material Solid

Yang

Fire

Steam

Hot

Male

Active Bright

Immateri
Gas
al

Yin

Slow

Centripeta Precipitatio
Winter
l
n

Night

Downwar
Inner
ds

Yang

Fast

Centrifuga Evaporatio Summer

Day

Upwards Outer

Yin

Solid organs
Below
LU SP HT KI
waist
PC LV CV

Dorsal

Medial

Lower

Yang

Hollow organs
Above
LI ST SI BL
waist
TH GB GV

Ventral

Lateral

Upper

Acute

Hot

Yin
Inhibitio
Relaxation
n
Hypo(Xu,
Deficient
)
Chronic
Cold
Moon
HyperContractio
(Shi,
n
Excess )

Yang

Excitation

Yin

Parasympathet
Diastole
ic

Flaccid

Conservati Black
ve
hole

Yang

Sympathetic

Erect

Radical

Systole

Sun

Big
bang

3. CHANGE (transformation, rhythms, cycles, relativity, balance)

Change: Everything in existence must change in a ceaseless cycle of anabolism (building up)
and catabolism (breaking down). Change reverses to the original state, in time. Nothing is
permanent. Everything changes.
All great civilizations were aware of the rhythms and cycles in nature:

a. the seasonal cycle

b. the lunar and tidal cycle
c. the mating-birth-growth-death cycle
d. the sexual (menstrual and male) cycles.

We have the activity/rest, the day/night cycles, sunspot cycles, political cycles. Internal
(diurnal) cycles include the cardiac cycle (systole/diastole), the respiratory cycle

(inspiration/expiration), the hormone secretion cycle (tropins/inhibitors) etc. All of life and
nature follows cyclic patterns.
The Wheel symbolises change/transformation in a cycle of endless and beginningless
revolution. The Monad, symbolises the Yin-Yang, and within the Yin is some Yang and viceversa. Diagram of the Wheel and Monad:
EVERYTHING CHANGES

THE MONAD

Yang

Yin

JOY

WHEEL

SORROW

Yin
Yang

VALLEY
NOTHING CHANGES

MOUNTAIN <=====>
ROCK <=========> SAND
BIRTH <========>

DEATH
DISEASE

HEALTH <=======>

Yin and Yang are opposite, essential but complementary parts of the same whole. Yin (dark
area) changes to Yang (bright area) and Yang changes to Yin in a changing, yet changeless
cycle. Thus, mountains become flat land and flat land becomes mountains. Rock becomes
sand and sand becomes rock. Thus, tears and laughter are opposite yet essential parts of the
same whole. Birth/death, day/night, potency/impotence, fertility/sterility, joy/sorrow are the
lot of nature.
Yin-Yang concepts imply continuous Change, movement and transformation. Nothing is
static. Day must become night. Change occurs because of the interplay of Yang Qi and Yin Qi.
Winter becomes Summer as Yin Qi weakens and Yang Qi strengthens. Summer becomes
Winter because of a reverse change. Thus Winter must become Summer when Yin reaches its

LIMIT (mid-winter solstice) and transforms into Yang. Summer must become Winter when
Yang reaches its LIMIT (Mid-summer solstice) and transforms into Yin.
Different Syndromes are categorised into Yin and Yang types. For example, chronic diarrhoea,
with cold extremities and abdomen is Yin Syndrome and an acute febrile disease with raging
thirst is a Yang Syndrome. But Yin disease can become Yang and vice-versa.
The change from Yin to Yang to Yin has many other analogies: In childhood, the male (Yang)
may have predominantly Yin characteristics (soprano voice, no body hair, tendency to cry if
hurt etc). Between puberty and old age, the Yang characteristics develop and the Yin
characteristics decay. In old age, the male may revert to predominantly Yin characteristics
again (quav-ering voice, breast enlargement etc). The opposite may occur in female (Yin)
from childhood (tomboy = Yang characteristics) to fertile womanhood (Yin) to postmenopausal old age (many Yang characteristics).
Substance (Yin) transforms into function (Yang) and function transforms into substance. In
the most profound sense, in the midst of frenetic change, nothing changes. Energy is merely
transferred elsewhere in the total system.
RELATIVITY: Nothing is created or destroyed, it only changes form. Structure/mass (Yin)
and blueprint/energy (Yang) transmute. That is all. The concept predated Einstein's equation
(e = mc2) by thousands of years.
There was no "Instant of Creation" in which "Something" was created from "Nothing". Nor
can there be an "Instant of Annihilation", in which "Something" can become "Nothing".
Nothing is absolute and all things must exist in relation to each other. Yin and Yang are
RELATIVE states. The head is Yang relative to the chest (Yin), but the chest is Yang relative
to the feet (Yin) and is Yin relative to the back (Yang). The front and inside are Yin, the back
and outside are Yang etc. But the outside can become the inside (the neural tube becoming the
brain and spinal cord) and the inside (emotions, organs) can become externalised (see
correspondences in the paper on the Five Phases).
A man is predominantly Yang (aggressive, strong, phallus etc) but may have some Yin
characteristics also (gentleness, laziness, compassion, sensitiv-ity). A woman is predominantly
Yin (pacifying, gentle, compassionate, sensitive) but may have some Yang characteristics also
(creativity, perseverance, courage, extroversion etc). In the family there must also be Yin and
Yang. If both Husband and Wife are Yang (active, bossy) there are family arguments, and if
both are Yin (passive, inactive the marriage will be dull, apathetic and uncreative. Either way,
the lack of balance (antagonism between Yin and Yang) leads to poor family life. If the YinYang balance is maintained, the marriage (unity) can be very stable.
BALANCE: The totally balanced system has equal amounts or Yin and Yang. Yin and Yang
are necessary for the other (interdependence) yet each opposes the other (inter-opposition).
Balance or equilibrium is maintained by the mutual antagonism, yet mutual dependence of
opposing forces. For example, for life to exist (as we know it on our planet) we need a
balance of sunlight and darkness. If there was perpetual sunlight or perpetual darkness, life on
the planet would cease.

Yin or Yang can not exist in isolation. If there is no day, there is no night. If there is no
excitation, there is no inhibition. The balance of Yin-Yang is a dynamic, changing state. There
is seldom exact balance, with equal amounts of Yin and Yang. For instance in Summer,
daylight exceeds darkness (Yang is predominant) but in Winter, darkness exceeds daylight
(Yin is predominant). Equal amounts of Yin and Yang (night/day occurs only at the equinoxes
(March 2lst and September 23rd). The limits of Yin and Yang are seen, for example at the
Winter solstice (December 2lst) when Yin is maximal (relative to Yang) and Summer solstice
(June 2lst) when Yang is maximal. This transformation of Yin to Yang and Yang to Yin is a
natural, universal phenomenon. It is natural for Yin to predominate at certain times and Yang
to predominate at other times, in dynamic cycles. Allowing for the transformation of energy
within the system, the overall state is one of balance.
The concept of balance is very important in Oriental philosophy, including TCM/TAP
concepts of health and disease. The balanced body has a time for work and a time for rest
(physical and mental). Deficient (depleted) energy must be conserved or renewed; Excessive
energy must be drained or released.
Overactivity or underactivity in any facet of life causes Qi imbalance. Too much work
(overexertion) or underactivity (laziness); too much sexual activity (loss of KI Qi) or inability
to release sexual energy in some constructive way (frustration); overindulgence in food or
drink, or undernutrition etc can have adverse effects. For example, too much sex (Water) can
weaken the Water organs (KI, BL), resulting in lumbago, sciatica (controlled by BL, KI
Channels), as well as throwing strain on HT, PC (heart, circulation) via the Ko Cycle
(Deficient Water allows Excess Fire (HT, PC)). Inability to release sexual energy can cause
Excess Qi in KI, causing Deficient HT Qi (Excess Water Qi causes Deficient Fire). Apart
from cardiac problems and hypertension, this may cause, frustration, lack of drive, spirit and
mental energy).
Balance also extends to food: too much (or too little) bitter food (Fire), sweet food (Earth),
acrid/pungent food (Metal), salty food (Water) or sour food (Wood) can damage the
corresponding COS in the Five Phase Cycle (see next section). Balance of the taste and food
types helps to maintain good health. Over-cooking of food can destroy some of the good Qi in
food. Under-cooking of food can cause indigestion or food-poisoning.
Similarly, the emotions are associated with the Five Phases (see section 5c). Control of the
emotions to maintain a good balance is important.
4. FIVE PHASE THEORY
As well as a binary classification (Yin-Yang), the Chinese classified natural phenomena into
five archetypes, translated as the Five Phases, once called the Five Elements. The word
"Phase" is more appropriate, as it signifies that the five classifications are relative and it infers
the idea of change between the phases. The Five Phases are Fire type, Earth type, Metal type,
Water type and Wood type. The Five Phases stand together as a mutually nourishing
(anabolic) and controlling (catabolic) whole, as in the diagram (below):
The outer clockwise circle ( ---> ) is the Sheng, creative or nourishing cycle. Things of a Fire
nature nourish ( --> ) things of an Earth nature in the Sheng Cycle: Fire --> Earth --> Metal
--> Water --> Wood --> Fire. In the Sheng Cycle, Fire is the Mother on Earth; Metal is the Son
of Earth.

THE SHENG AND KO CYCLE OF THE FIVE PHASES

Fire

Wood

Earth

Water

Metal

The inner clockwise star ( > ) is the Ko, controlling cycle. Things of a Fire nature control or
weaken ( X ) things of a Metal nature in the Ko Cycle: Fire X Metal X Wood X Earth X Water
X Fire.
Each Phase also contains Yin and Yang attributes or correspondences (see paper on the Five
Phases). Each Phase also relates to a specific Yin-Yang pair of COSs and Fire relates to 4
COSs (HT, SI, PC, TH). For instance Wood Yin relates to Liver and Wood Yang relates to
Gallbladder function, as in the diagram (below).
The Yin-Yang pairs in each Phase are called Husband-Wife pairs. For instance ST (Yang) is
the Husband of SP (Yin). Each Channel has a special AP point (the Luo (Passage) point). The
Luo points are used to shunt Qi between Husband and Wife.
Each Phase also has relationships to a specific season, food, emotion, sound, body tissue,
secretion etc. (See details in the paper on the Five Phases). Any imbalance of Qi in the Five
Phase system can affect the balance in the whole system. For instance, Deficient KI (Water)
Qi can cause Deficient LV Qi (the Mother can not feed the Son in the Sheng Cycle), or it can
cause Excess HT (Fire) Qi (via the Ko Cycle, Deficient Water allows Excess Fire). Excess KI
Qi would have the opposite effect.
Five Phase Theory has very practical use in TAP therapy. For instance, if there is a Qi
Deficiency in one Channel and an Excess in another, the Qi can be balanced very easily by
needling special points (selected from the Five Phase Points and/or the Luo (Passage) points).
Each Channel has a special point which relates to each Phase (5 x 12 points = Sixty Phase
Points). These points are used to shunt Qi between the Phases.

One stimulates the appropriate TAP point on the Deficient Channel (always the Deficient
Channel!) to draw the Excess Qi directly into it (or indirectly via other Channels), thereby
balancing the whole system.
In the Five Phase relationships (below), the Yang organs (SI, TH, ST, LI, BL, GB) are those
on the outside of the diagram and the Yin organs (HT, PC, SP, LU, KI, LV) on the inside.
CHANNEL RELATIONSHIPS VIA THE SHENG AND KO CYCLES

SI

TH

HT

PC

Fire
GB

ST
LV

SP
Wood

Water
KI
BL

Earth

Metal
LU
LI

Five Phase Theory teaches that disorder in any one COS can directly or indirectly cause
disorder in any other COS via Sheng, Ko or other energetic transfer routes. It is essential to
the understanding of disease interactions in TCM and in the selection of the primary sites of
disease.
It also teaches that if the primary disorder is corrected, the secondary disorders may selfcorrect rapidly.
A detailed study of Five Phase relationships and the uses of the Phase and Luo Points is
essential to the therapeutic use of energetic TAP. The system can give dramatic clinical results

in complex Syndromes but few western acupuncturists have the patience to study the system
properly.
5. CONCEPTS of ECOLOGY, SYNDROMES and CAUSES of DISEASE in TCM
TCM teaches that Nature (all of creation, macrocosm and microcosm) is a unity which
reflects the interplay of Qi, Yin-Yang, the Five Phases, the material and the immaterial. As
we are wed to Nature, we feel Her claws or Her caress. And if we ravish Nature, or sow black
seed at the time of white seed-sowing, or work against Her changeless Laws, we plant a
bastard harvest, which we will reap. And we will weep alone, groan long in the hell of a Manmade night.
Health is a relative state. Optimal adaptation to prevailing circumstances (and the ability to
adapt to new ones, if needed) are important factors in health. Healthy people adapted to living
high up in the Andes mountains may have Packed Cell Volumes which would indicate serious
dehydration or disease in people living in, say, Belgium. Adaptation to internal changes are
also important. What may be healthy sport for a strong young man may kill a weak old man.
Many factors regarded by TCM to be involved in health are discussed below but TCM was
also aware of acute causes of illhealth: trauma/wounds; undernutrition, genetic influences.
(Modern Chinese medicine also recognises many other causes, as in western concepts: stress,
toxicities, infection, parasitism, nutrient imbalances and deficiencies, metabolic and hormonal
imbalances, senility etc).
Health depends on self-control: Chinese/Japanese parents dote on children, but their
children are programmed very early in life to develop a high degree of self-discipline. This
helps them to develop self-control of body and mind, which is perfected further in adulthood,
to a degree which puts many westerners to shame. Mastery of the self was also part of the
training and lifestyle of the oriental monks, who were said to be very healthy and resilient.
The secret of good health is to strive for physical and mental control and to live in balance
with Nature and with the Laws of Nature.
As part of Nature, the human or animal organism is influenced by Natural Laws, forces and
energies. We dance or writhe to Nature's rhythmic tune. Conversely, the activities of the
organism influences Nature for good or ill. Today's specific problems of environmental
pollution (production and preservation of food to be eaten out of season by the use of
chemical preservatives; dumping of toxic metals and chemicals, nuclear waste; the ozone
hole/greenhouse effect etc) may not have been foreseen by the ancients but the global
philosophy of Yin-Yang would have predicted them- we are creators and destroyers, a
mixture of good and evil. A more recent law of physics can be adapted and extended to apply
to biological systems: "To every action, in due time, there is an equal and opposite reaction".
We decorate, or foul, our den, which, in time, empowers, or overpowers, us.
Avoidance of attack is the first law of self-defence. This implies that self-training to heighten
one's awareness, perception and intuition have a prime defensive role. Strength (Qi) and skill
(physical and mental) to deflect or minimise an unavoidable attack is the second law of selfdefence. Rapid adaptation to prevailing circumstances is the key to survival.

Adaptation implies the ability to respond optimally to challenge. Clean air, exercise of mind,
good food and a fit mind-body helps to develop Qi and to direct it when and where it is
needed.
a. Qi IN RELATION TO DISEASE
Qi (the vital force and defence energy of the body and mind) comes from different sources:
Ancestral Qi (genetic energy), Qi from Heaven (the energy of life) and from earth (vital
energy from air, food). Healthy lung and gastrointestinal function are vital to balanced Qi.
Deep breathing exercises (imagining the air being drawn down as far as the pelvis) and
visualisation of Qi streaming through the Channel system (in the correct direction of Qi flow,
and in time with deep, slow breathing) are part of TAI Qi and Qi KUNG exercise systems
which are used to counter stress and attain physical/mental wellbeing.
Health and disease are determined by the amount and balance of Qi in the organism. The
healthy body/mind has a perfect balance of Qi which can circulate freely in the body through
the Channel network, the collateral Channels, the deep Channels and the organs. Adepts can
direct Qi (by conscious or subconscious control) to circulate to those parts which may need
extra Wei (Defensive) Qi. In the body, upset Qi (Excess of Yin or Yang, Deficiency of Yin
or Yang etc) is the cause and result of disease.
If the Wei (Defensive) Qi is weak, disease can invade from outside (see 4b below). Body Qi
can also take many forms: Qi of Kidneys, Qi of life (semen) etc. Blockage of Qi flow,
whether caused by trauma, scar tissue or other causes) is followed by functional or organic
disease of the affected COS.
b. INTERACTION BETWEEN ENVIRONMENT AND THE ORGANISM
"Man (the organism) stands between Heaven and Earth". This ancient teaching infers the
external environment (extra-terrestrial and terrestrial energy) can influence us and that we can
influence the heavens and earth. Natural environmental forces (Qi) include magnetism,
gravity, electromagnetic fields, solar, lunar and planetary influences etc. Others include
geophysical/geopathological fields, as known to the practitioners of Feng Shui (Chinese
diviners, who would shun the valley where no bird sings). We must cope with seasonal
changes, which can predispose to their own Syndromes, or types of disease. To dress and
work outdoors in the depths of winter as if it were the middle of summer (or vice-versa) can
seriously imbalance Qi and cause disease. The wise one wears thick skins in snow, fine silk in
sun.
In Yin-time live a Yin-type life; in Yang-time, Yang.
THE SIX EVILS
TCM recognises six climatic causes of disease: Heat, Summer-Heat; Damp, Dryness, Cold
and Wind.
Each one of the Six Evils (type of perverse energy which attacks the body from the Exterior)
has a preference for a specific COS in the Five Phase Cycle:
Perverse Energy Heat, Summer-Heat Damp Dryness Cold Wind

Phase attacked Fire Earth Metal Water Wood

Yin SYSTEM attacked HT, PC SP LU KI LV
Yang SYSTEM attacked SI, TH ST LI BL GB
These "devils" gain access to the body via the skin-holes (the AP points). Pathogenic Qi can
reach the Interior of the body via the superficial and deep course of the Channels in two
ways:
a. if, relative to the force of the attack, the Wei Qi is weak (unable to deflect the acute attack),
or
b. if the condition is not treated successfully (by increasing Wei Qi using TCM/TAP at that
stage).
Once the inner organs are invaded, the condition is serious and may become chronic, lifethreatening and difficult to treat.
Apart from the preferred organ, other organs and functions can be attacked, using routes in the
Five Phase Cycle (Sheng and Ko and reverse-Ko routes). For example, Summer-Heat can
attack HT-PC (heatstroke, circulatory collapse, heart attack), the mind (febrile hallucination,
heatstroke) and also the SI (summer gastroenteritis). Wind can attack LV, the eyes, GB, the
muscles and the mind (anger, jealousy) etc and can also counter-attack LU (via a reverse Ko
route: Wood (LV) is controlled by Metal (LU)).
Treatment at that stage aims to increase the adaptive reactions of the primary organ attacked
and the general resistance of the body in an attempt to expel the invader. (Treatment can
include induction of vomition, purgation, diuresis, sweating etc if the invader can be expelled
by these routes).
c. THE ROLE OF THE EMOTIONS IN DISEASE
Each of the Five Phases is associated with specific emotions. Balance of the emotions is
important, as imbalance in any one of them can imbalance the Qi, to weaken the
corresponding COS:

Phase

Emotion

Sound expressed

HT Fire

Pleasure/Joy/Excitement

Laughter

SP Earth Anxiety/Obsession/Meditation Singing/Whistling

LU Metal Grief/Sorrow/Melancholia

Weeping

KI Water Fear/Fright

Sighing/Moaning

LV Wood Wrath/anger

Shouting/Screaming

For example, too much excitement/pleasure/joy can weaken the HT COS (angina, heart
attack etc) and one of the signs of HT disorder is too much laughter/excitability. Too much
anxiety (obsession) can weaken the SP COS and one of the signs of SP disorder is a tendency
to obsession and sing (to oneself) a lot. Similarly for the other organs (LU, KI, LV).
Psychosomatic disease: The Chinese were among the first people to note an association
between the emotions/psyche and disease. They were aware of the importance of
psychosomatic disease before the time of Christ. Similarly, in imbalance of a Channel, the
appropriate emotions can be fostered and used in the Ko Cycle to redress the imbalance. For
instance, in grief (Deficient Metal), stimulation of laughter/joy, pleasure can reduce grief and
strengthen LU via the Ko Cycle (Fire controls Metal). Fear (Deficient KI) can be helped by
stimulating meditation, singing, or whistling (Earth controls Water).
DISEASE CLASSIFICATION BY THE EIGHT PRINCIPLES (the EIGHT TYPES)
The Eight Principles classify disease by 4 categories:
a. Yin or Yang
b. Hot or Cold
c. Shi (Excess) or Xu (Deficiency)
d. External or Internal.
a. Yin and Yang Syndromes
Balance of Yin and Yang Qi is the normal state. Disease is classified according to its
disturbance of Yin and Yang Qi. However, Yin organs may have Yin or Yang diseases (and
Yang organs likewise). If Yin or Yang (or both) deviate from the normal level, a state of
relative Excess (Shi) or Deficiency (Xu) exists.

Yin type
Yang type*
Hypo-withdrawn ,inhibited,
Activity
Hyper-, excited, fidgety
quiet
Body and limbs Cold, seeks warmth
Hot, avoids warmth
Pulse
Deep and slow
Shallow and fast, bounding
Tongue
Pale, moist
Red, dry, coated
Respiration
Feeble
Rapid and strong
Thirst
No
Yes
Urine
Clear, copious
Scanty, coloured
Complexion,
Pale
Red
skin

Attack site**
Onset
Progression

Interior, deep (internal

organs)
Cause chronic
Inwards and downwards

Exterior, superficial (Channels and their

collateral branches)
Cause acute
Outwards and upwards

* Moxa (heat cautery) is usually contraindicated in Yang and Hot Syndromes.

** Internal or External attack sites can not always be classified as Yin or
Yang respectively. Yin organs can be attacked by Yang diseases and vice
versa.
Collapse of Yang and the Collapse of Yin are other Yin-Yang Syndromes:
Collapse of Yang: Profuse cold sweat; respiration feeble; pallor; prefers hot drinks; skin cool;
limbs cold; dislikes cold; listless; pulse of Xu type (thready and fading); tongue pale and
moist.
Collapse of Yin: Sticky sweat; respiration rapid and short; face red; thirst and prefers cold
drinks; skin hot; limbs warm; dislikes heat; restless; pulse of Xu type (thready and rapid);
tongue red with little saliva.
To complicate matters, the law of Yin-Yang implies that change can occur; one Syndrome
can change to another: "Cold with fullness moves downwards and transforms into Heat;
Heat, with fullness, moves upwards and transforms into Cold" (Turner and Low, 1981). Also,
some of the features of Cold and Hot Syndromes can give misleading impressions of YinYang balance- they may be False Yin or False Yang conditions. Collapse of Yang resembles a
false Yin Syndrome and Collapse of Yin resembles a false Yang Syndrome.
NORMAL BALANCE OF Yin AND Yang Qi

Yang
Resistance normal

Yin

..........+++++-----............
|

||

||

__________|___||___|____________

b. Hot and Cold Syndromes

Hot Syndromes are caused by pathogenic Heat, Summer Heat and Dryness (3 of the Six
Evils). Cold Syndromes are caused by pathogenic Cold. Also, Excess (Shi) of Yin or Yang
can cause Cold and Hot Syndromes of the Shi type respectively.

Cold Syndrome of the Shi (Excess Yin) type: Chills; limbs cold; no thirst; pallor; excess
sputum; asthmatic breathing; indigestion; vomiting; abdominal pain, worse on pressure; stools
loose; urine clear and copious; pulse deep and slow; tongue pale with white sticky coating;
craves warmth.
Cold Syndrome of the Shi (Excess Yin) type
(Excess Yin consumes or weakens Yang)

Yang

Yin

----Resistance normal

...............|

|............

+++++|

||

__________|___||___|____________

Hot Syndrome of the Shi (Excess Yang) type: Continuous high fever; thirst; face flushed,
eyes red; abdomen full and distended, worse on pressure; consciousness; delirium;
constipation; urine concentrated; pulse rapid; tongue red to deep red, with dry yellow coating;
craves cold.
Hot Syndrome of the Shi (Excess Yang) type
(Excess Yang consumes or weakens Yin)

Yang

Yin

+++++
Resistance normal

..........|

|.................

|-----

||

__________|___||___|____________

c. Shi (Excessive) and Xu (Deficient) Syndromes

In TAP, the needling technique depends on whether the Syndrome is Shi or Xu type. In Shi
type (Excess) the needling method is Xie (reducing type), to dispel the Excess Qi. In Xu type
(Deficiency) the needling method is Bu (reinforcing type), to stimulate the Deficient Qi. The
TCM rule of needling is Shi needs Xie but Xu needs Bu:
Shi Syndrome needs Xie needling;
Xu Syndrome needs Bu needling.
Palpation pressure on the affected areas helps to distinguish the Shi and Xu Syndromes. In
Shi (Excess), with Yang fullness, pressure aggravates discomfort. In Xu (Deficiency), with
Yang emptiness, pressure alleviates discomfort.
In Shi Syndromes, body resistance is normal but the body is attacked by an exogenous
pathogenic factor. The prognosis is not serious if the attacking factor can be expelled, thereby
preventing the disease from reaching the internal organs.
Shi (Excess) Syndromes: Disease recent; elation; robust constitution; restless; spastic; voice
sonorous; breathing coarse; chest and abdomen full and distended; abdominal pain, worse on
pressure or palpation; constipation; tenesmus; urination painful or difficult; urine scanty and
concentrated; pulse of Shi type (coarse, rapid, full); tongue red and coated; skin warm.
Syndromes of Shi (Excess) type are usually (but not always) of the Hot type:
Hot Syndrome of the Shi (Deficient Yin) type
(Deficient Yin allows Yang to predominate)

Yang

Resistance lowered

Yin

.........+++++.................
|

|-----

__________|___||___|____________

Xu (Deficiency) Syndromes: Disease chronic; listless, depressed; weak; asthenic appearance;

apathy; pallor; lies curled-up; voice weak; breathing feeble; palpitation; shortage of breath;
tinnitus; vision blurred; insomnia; memory poor; sweating; night sweats; abdominal pain,
relieved by pressure or palpation; loose stool; nocturnal spermatorrhoea; enuresis; copious
clear urine; pulse of Xu type (fine, weak, irregular); tongue pale, with thin coating; skin cold.

In Xu Syndromes, body resistance is lowered and the disease can reach the internal organs
more easily. The prognosis is more serious. Deficiency (Xu) of Yin or Yang can cause Hot or
Cold Syndromes of the Xu type respectively. In both cases, resistance is low.
Xu (Deficiency) Syndromes are usually (but not always) of the Cold type:
Cold Syndrome of the Xu (Deficient Yang) type
(Deficient Yang allows Yin to predominate)

Yang

Yin

Resistance lowered ...............-----............

|

+++++|

__________|___||___|____________

An example of the Yin Xu Syndrome (Cold Syndrome of the Xu type): Chills; limbs cold;
pallor; no thirst; listless; apathy; weak; sweating; stool loose; urine copious and clear; pulse
slow and deep; tongue pale with white coating.
But, as in most aspects of Chinese thought, the paradox exists also, the Yang Xu Syndrome
(Hot Syndrome of the Xu type): Afternoon fever; malar flush; mouth and throat dry;
insomnia; restlessness; feverish feeling in palms and soles; night sweats; constipation; urine
concentrated; pulse rapid and thready; tongue red with little coating.
d. External and Internal Syndromes
External Syndromes result from invasion of the superficial areas of the body by exogenous
factors. Onset is sudden and duration is short. Exterior Syndromes are usually mild. They are
the early signs of exogenous disease but may develop to Internal Syndromes.
Internal Syndromes result from penetration of exogenous factors to the Interior of the body,
as in an External type which was unsuccessfully controlled, or by direct attack of the organs
by exogenous factors. Internal Syndromes are usually severe and involve functional or
organic damage of the organs. Dysfunction of the organs is also an Internal Syndrome.
Both External and Internal Syndromes can be complicated by Cold, Heat, Xu (Deficient)
and Shi (Excess) Syndromes.
External Syndromes:
Cold: Fever; no sweating; chills; pulse superficial and strong; tongue coating thin and white

Hot: Fever; intolerance of wind; may sweat; mild thirst; pulse superficial and rapid; tongue
coating thin and yellow.
Xu: Sweating; intolerance of wind; pulse superficial and slow
Shi: No sweating; general aches; pulse superficial and strong; tongue coating white
Internal Syndromes:
Cold: Chills; cold limbs; pallor; no thirst; stool loose; urine clear and profuse; pulse deep and
slow; tongue pale
Hot: High fever; thirst; irritable and restless; face flushed; eyes red; constipation; yellow
scanty urine; pulse rapid; tongue red with yellow coating.
Xu: Breathing feeble; apathy; lassitude; palpitation; dizziness; pulse deep; tongue flabby and
pale, with white coating
Shi: Breathing coarse; voice strong; irritability; fullness of chest; distended abdomen;
constipation; pulse deep; tongue rough, with thick coating
Thus, TCM has a set of 8 criteria (the Eight Principles) to define disease Syndromes (the
type (nature) of disease), based on the clinical signs. By combining one type from each of the
4 categories (Yin or Yang; Hot or Cold; Shi or Xu; External or Internal), 8 possibilities
arise (1 X 2 X 2 X 2 = 8). Syndrome classification by the Eight Principles is discussed
further in Lee and Cheung (1978); The Essentials of Chinese AP (1980); Turner and Low
(1981); Porkert (1983).
As well as classification by the Eight Principles, Syndromes are classified according to the
main organs involved and the energy imbalance in them. Each of the following strangelynamed Syndromes has defined clinical and functional upsets:
LU Syndromes: LU Yin Deficiency; Wind attack on LU; LU Damp-Phlegm Retention; LU
Heat-Phlegm Retention
LI Syndromes: Damp-Heat invasion of LI; LI Obstruction; Blood and Heat Obstruction
of LI
ST Syndromes: Retention of food; Retention of fluid; ST Fire Excess
SP Syndromes: SP Qi Deficiency; Cold-Damp invasion of SP
HT Syndromes: HT Qi Deficiency; HT Yin Deficiency; Obstruction of HT Blood; Excess
HT Fire; disturbed Shen (mental derangement)
SI Syndromes: SI Heat
BL Syndromes: Damp-Heat invasion of BL; BL dysfunction
KI Syndromes: KI Qi Deficiency; KI Yin Deficiency; KI Yang Deficiency

PC Syndromes: Heat invasion of PC

GB Syndromes: Damp-Heat invasion of GB
LV Syndromes: LV Qi Deficiency; LV Fire Excess; Cold Obstruction of LV; LV Blood
Deficiency; LV Wind stirred by Heat
There are many other types of Channel Syndromes (see Porkert 1983).
Disease is classified also according to the main Channel involved (LU, LI, ST, SP, HT, SI,
BL, KI, PC, TH, GB, LV). It may be classified also by disturbance in the Eight Mai (Vessels
or Extra Channels): GV; CV; Chong; Dai; Yang Chiao; Yin Chiao; Yang Wei; Yin Wei).
Each of these Channels and Vessels has its own symptomatology.
6. DIAGNOSIS IN TCM
TCM Diagnosis was based on four principles: looking, listening, feeling and smelling, i.e. on
input signals from 4 of the 5 senses (sight, hearing, touch and smell).
LOOKING: The patient is inspected carefully for any abnormalities of gait, posture,
swellings (oedema, inflammation etc), atrophy, muscle spasm, paralysis etc. Great attention is
paid to the skin and face (colour, texture, sweat), ears (abnormal blotches, scales, flakes,
papules), tongue (colour, saliva, coating) and iris. Colour and consistency of stools, urine and
other secretions/excretions are noted.
LISTENING: The case history is taken. The emotions, symptoms and sounds (strength of
voice, respiration, abnormal gut and joint sounds etc) are noted.
FEELING: The patient is palpated carefully to check skin temperature (hot or cold);
variation in skin temperature, for instance one limb colder than the other; location of
abnormal swellings, muscle tension, flaccidity; location of Ahshi (tender) points. Great
attention is paid to palpation of the Mu and Shu points, the Xi, Yuan and Luo points.
Tenderness at these points can indicate the COS involved.
Channel diagnosis by point sensitivity: In severe disorders of a Channel, many points along
the Channel may show abnormal tenderness to pressure palpation, electric current or heat.
This is especially true for the Ting (most distal) points at the nail of a toe or finger). Ting
(Well, near the nail) point sensitivity is the basis of the diagnostic methods of Akabane
(Japanese diagnosis by measuring heat sensitivity) and Voll (German electrodiagnosis). The
Shu and Mu points may also be tender. Other important points (which may be tender in
Channel disorders) lie below the knee or elbow: the Five Phase Points, the Luo, Yuan and
Xi points.
Pulse Diagnosis is the ultimate in TCM diagnostic palpation. According to TCM, the pulse
in the distal, middle and proximal positions on the left radial artery reflects the energy
status of the SI, GB and BL Channels on superficial palpation and the HT, LV, KI
Channels on deep palpation respectively. The pulse in the distal, middle and proximal
positions on the right radial artery reflects the energy status of the LI, ST, TH Channels on
superficial palpation and the LU, SP, PC Channels on deep palpation respectively. Porkert
(1983) describes 31 different pulse types.

Some TCM practitioners claim to be able to make an accurate energetic diagnosis in human
patients (which Channels are involved and whether they are hyper- or hypo-active) on the
basis of Pulse Diagnosis alone ! However, many translations of Chinese medical AP texts
ignore or pay little attention to the classical pulse types.
Classical Pulse Diagnosis is a controversial issue, even in China and Japan. Recent studies
(doppler ultrasonography or use of pressure transducers to measure pulse characteristics) cast
great doubt on the objective validity of Classical Pulse Diagnosis. Most veterinary AP texts
ignore it. In my opinion, pulse diagnosis is not objective but some people can make accurate
diagnosis by the Pulses by subjective (psychic, extra-sensory perceptive) means, as in medical
radiaesthesia/medical divination and Extra-Somato Projection.
SMELLING: In TCM, the practitioner smells the breath, the skin and excreta of the patient.
TCM attributes typical smells to various disorders. For instance, in Earth disorders (SP, ST,
diabetes), there may be a sweet (ketone) smell; in Water disorders (KI, BL), there may be a
putrid smell (uraemia, ammonia) etc.
The aim of TCM/TAP diagnosis is to establish (a) the nature of the disease in terms of the
Eight Principles and the Six Evils and (b) the COSs involved.
Having assessed the patient by the four principles (looking, listening, feeling and smelling),
the nature and location of the disorder is defined in traditional terms. Steps are then taken to
remove or alleviate the cause, or to enhance the body's Wei (Defensive) Qi, or to re-balance
any energetic imbalances which have been diagnosed.
TCM diagnosis was developed at a time when knowledge of internal anatomy and
physiopathology were primitive. Millennia had to pass before the development of current
western concepts of biochemistry, microscopy, immunology, bacteriology, genetics, Selye's
concepts of the Stress Reaction, concepts of nutrition (mineral, vitamin and essential aminoacid imbalances etc) and biotechnology.
In spite of ignorance of modern medicine, the ancient Chinese had one very important
concept: They knew that vital energy (Qi, Vix Naturae) was the key to health and recovery
from disease; they taught that the body healed itself by its own natural defense systems; the
aim in healing is to stimulate and enhance those mechanisms, thereby attaining balance
(homeostasis).
7. THERAPY IN TCM
All methods aim to correct imbalances of Qi. Where the cause is bad lifestyle (XS eating; XS
work; insufficient food or sleep; XS alcohol etc) steps are taken to advise on moderating this.
As far as possible, the patient is advised on environmental, behaviourial or dietary changes etc
which may be necessary to alleviate or remove the cause. To restore the normal balance of Qi
(resistance), many methods are used alone or in combination.
TCM relies heavily on herbal medicine (HM). The Chinese herbal pharmacopoeia is very
extensive, running into thousands of plants, herbs, venoms, inorganic compounds, animal byproducts etc. These remedies are prepared as decoctions, concoctions, powders, ointments etc
and a typical prescription would contain 4-10+ separate components. Many of the crude
extracts have been purified in recent years and the active alkaloids or other compounds have

been isolated. Several HMs, or extracts of them, have potent antitoxic effects in patients on
cytotoxic radiotherapy or chemotherapy (cisplatin etc) for cancer. Herbal products and HM
extracts have many high-ranking pharmacological properties, including immunomodulators,
hypoglycaemic, anticancer, antiinflammatory, antiviral, antibacterial, antiprotozoal,
antiasthmatic, antioxidant, antihypertensive and anti-liver disease activities.
Other methods include physiotherapy (exercises; massage; moxibustion (cautery of the AP
points); Taichi (ritual slow movements to utilise every muscle of the body in conjunction with
breathing exercises) and psychotherapy (Qi Kung (visualisation-meditation of the energy
flow through the Channel circuits, together with specific slow deep breathing exercises,
inhalation for centripetal Channels and exhalation for centrifugal Channels);
mental/emotional exercises to balance the emotions).
AP is only a small part (maybe 20%) of the total TCM system.
8. AP METHODS
For proper use, AP, moxibustion and Chinese massage (acupressure) depend on a detailed
knowledge of the point and Channel system. Having selected the points most suitable for the
patient, these points are stimulated by many different methods, depending on the training and
preferences of the practitioner and the equipment available. The most common type of AP
uses fine stainless steel, solid, needles 1-6 cm long and 25-32 gauge. The most common
needle is about 3.5 cm long, 30 gauge, but others (including some barbaric-looking
instruments) are occasionally used in remote, rural areas. In veterinary AP, the needles vary
with the species. For experimental work in small animals and laboratory animals, the finest
human-type needles may be used. For clinical work in the dog-cats, one usually uses 1-6 cm,
28-30 gauge needles. In larger animals (pigs, ruminants, horses, mules etc), larger and thicker
needles are used (2.5-15 cm needles 18-28 gauge, depending on the preferences of the
practitioner and the depth of the points).
The skin around the point is prepared as aseptically as possible. Sterile needles are inserted to
the correct depth and are stimulated (by twirling and pecking) to obtain DeQi. This
phenomenon ("the arrival of Qi") is regarded as crucial to AP success. It is similar to the
"funny bone sensation": paraesthesia, tingling, numbness, heaviness, "sour feeling" etc in the
vicinity of the point.
In humans, the objective and subjective sensations are unmistakable - the verbal feedback
from the patient ensures this. It is not uncommon for human patients to invoke the name of
the founder of the Christian religion when Qi arrives! In animals, however (because they
cannot relate their subjective feelings), the main signs of DeQi are: sudden change in the
animal's behaviour: a temporarily fractious animal suddenly standing quite motionless or a
quiet animal suddenly beginning to tremble or vocalise. Respiration may be temporarily
inhibited or accelerated. Local muscle spasms or twitches may be seen.
DeQi is more often obvious when the point is directly over a peripheral nerve (such as with
the Great Points of AP, for instance: LI04; PC06; TH05; LI11; ST36; GB34; BL40 etc or
directly over motor points (places where the motor nerve plunges into the muscle).

Once DeQi is obtained, the needle is left for 30 seconds to 20 minutes. In general, acute
conditions require only short periods of needling and chronic conditions require 20 minutes or
more. Before removal of the needle, it is twirled/pecked again.
Classical AP demands specific types of needle manipulation depending on whether the
condition is diagnosed as a Shi (Excess) or Xu (Deficiency) type. These specific Syndromes
of manipulation are described in standard texts but the issue is controversial in that many
successful practitioners ignore them still obtain excellent results - the use the simple method
described above.
The most comprehensive textbook on techniques of AP is "Current AP Therapy" by Lee and
Cheung (1978). This is an excellent text and is recommended as ESSENTIAL reading for
serious students.
Apart from simple needling, cautery and massage, other methods are common. They include
electro-AP (with or without needles); injection of the points; ultrasound-, microwave-, laser-,
cryo-, faradic-, static field-, magnetic field- and other therapies applied to the specific points.
They also include implants, incisions direct massage of the exposed nerves etc.
In general, the simple needling technique is adequate for most purposes and expensive pieces
of equipment (electro stimulators, lasers etc) are luxuries to impress the public rather than to
enhance the results. There are some exceptions to this which will be discussed in other
seminars.
The number of sessions and the intervals between sessions vary with the condition. Chronic
conditions are normally treated 1-2 times per week for 4-20 sessions. In general, if there is not
an obvious response by session 4-6, the chances of ultimate success are poor. Acute (but
simple) conditions are treated every 6-48 hours, depending on the condition. For instance,
acute traumatic pain could be treated for 20 minutes daily (GB34 on the affected side and 1 or
2 local points). Expect 70% success after 1 session and >90% after 3 sessions. Acute
conditions usually require 1 to 5 sessions.
9. METHODS OF CHOOSING EFFECTIVE AP POINTS
Which methods are chosen will depend on the training, skill and experience of the
practitioner. Classical AP has more than 14 laws for consideration, apart from the use of the
Five Phase balancing method:
a. local points
b. distant points
c. points on affected Channel
d. points on related Channels (Husband-Wife pair of Channels or Channels passing near
the affected one)
e. one point on each of the 4 limbs
f. encircling the affected area

g. Ahshi points
h. Mu and Shu points
i. the source point of affected Channel and the Passage (Luo) point of its linked Channel
j. "Fore and Aft" points ((in front of and behind the affected area)
k. a chain of points along the affected Channel
l. points long recognised as highly effective for specific symptoms or body areas (eg) PC06,
ST36 for nausea and vomiting; LI04 for mouth, nose and throat
m. Xi (cleft) points.
On top of these, modern AP adds
n. needling points in the affected dermatome or along the innervation of the affected area
o. needling Scalp, Ear, Face, Nose, Hand or Foot Zone points associated with the affected area
(e.g.) Scalp zone "Lower Motor Area" for leg paralysis; Hand point "Loin and leg" for
lumbago/sciatica etc.
By far the most common prescription is a combination of Ahshi points and local points and
distant points on the affected Channel. This may seem to be a simple matter to resolve but a
look at any standard chart will show the difficulties. One must limit the number of needles to
6-12 in most sessions. Therefore one must discriminate which local and distant points are
most relevant). The textbooks (as individual texts) do not help much either. A careful study of
the texts shows that there is major variation between them in their choice of points for specific
conditions. One solution to the problem is to construct a database from many textbooks and to
use the computer to do a frequency ranking on the points for specific conditions. In this way,
the most commonly recommended points for any specific condition can be output in seconds.
COOKBOOK AND MODERN AP
Although Classical AP is also practised in Europe, USA, Soviet countries, Taiwan and Japan
most countries, MODERN AP in those countries is a much simplified version. It needs less
study of the more difficult classical concepts but it demands competence in western medicine
as the foundation for sound diagnosis good clinical success. The following aspects will be
discussed:
1. WESTERN CONCEPTS OF REFLEX DIAGNOSIS AND THERAPY
2. COMPUTER DATABASES
3. COOKBOOKS
4. TAIWANESE/JAPANESE APPROACH TO AP
5. COMBINATION OF MODERN AP AND WESTERN MEDICINE

6. THE FUTURE ?
1. WESTERN CONCEPTS OF REFLEX DIAGNOSIS AND THERAPY
The body is a unit. Each organ and part belongs to the whole and can influence the whole. The
peripheral, central and autonomic nervous system, together with the endocrine system
controls the harmony of the whole.
American, German, Scandinavian, Eastern European and Soviet (as well as Oriental) research
in recent years has confirmed the enormous potential measuring deviations in of the
autonomic-endocrine system as a diagnostic aid and of stimulating the system to obtain
therapeutic results.
Research with infra-red thermography, Voll-Akabane-Ryodoraku measurements of altered
sensitivity at peripheral points etc has confirmed the diagnostic claim of TCM: that organs
project information of their dis-ease to the periphery via the autonomic nervous system.
Clinical detection of the altered sensitivity aids in diagnosis. Any method (including AP)
which speeds up the return to normal sensitivity is a good therapeutic method and monitoring
the speed of return to normal sensitivity has prognostic value.
2. COMPUTER DATABASES
In every sphere of technology the computer is used to store vast amounts of data. The stored
data can then be sorted, searched, analyzed and output (to screen, printer or graphics plotter or
screen) as required. Many serious students of AP have observed the variation between texts
mentioned in the last section. To overcome the difficulty and to assist in their final selection of
points, they have cross-referenced every indication given for every point in as many
authoritative sources as possible. This was usually done on a card-index or loose-leaf
notebook system. When presented with an unfamiliar problem (say post-CVA aphasia), the
practitioner could consult the card or loose-leaf for "Aphasia" and visually assess the most
important points by frequency-ranking methods. This procedure can take lO-20 minutes for
each condition in a good database. This system worked very well for static databases (i.e.)
ones which were not altered by additions or deletions. Every time a new reference goes in or
out, the ranking would possibly change. Furthermore, the manual system was rather
inflexible, for instance, if a researcher wished to examine the most frequently used points for
"head" (using all the conditions coded under "head") it could take hours to get the result.
This is a simple problem for modern computers. Having collected data from >50 textbooks
and many clinical articles on AP over the past 10 years, I have stored it on computer. The
database has >1170 clinical conditions and can generate prescriptions for any or all
conditions. Every point listed anywhere in the source material is output and the score is also
output. One can see at a glance how well or how badly the point is represented in the
database. One can also see how often the condition is cited; conditions with very few citations
are less likely to respond to AP therapy than those with many citations.
3. COOKBOOKS
Cookbooks usually provide instant details of the ingredients needed to prepare the required
dish. They are used mainly by cooks who (a) have bad memories or (b) have not tried to
prepare the dish before. Either way, they are very useful and many an enjoyable meal was

prepared in this way. Really expert cooks however, through experience and good memory,
seldom need to refer to the cookbook.
Cookbook AP is basically "prescription AP". It is suitable for statistical medicine
(standardised approach to all "similar" cases). It is quite unsuitable for difficult, complicated
or atypical cases, especially in man. To treat such cases successfully by AP would require a
deep study of the classical concepts. Having said that, Cookbook AP is ideal for routine and
simple cases. It is the quickest, least painful way of introducing busy professionals to the AP
techniques. Whether right or wrong, many busy professionals are not prepared to devote the
effort and time to a deep study of AP. Without the cookbook approach, most of these would
never be able to attempt AP therapy, except for the simplest type (TP therapy or Ahshi
therapy).
The main problem with Cookbook AP is which book to use. None of the AP texts available
(even the most comprehensive ones, such as the "Essentials of Chinese AP", "Barefoot
Doctor's Manual", "Acupuncture, a Comprehensive Text" or "Current AP Therapy") lists all
the conditions which can be helped by AP, and there are considerable differences within and
between texts. Thus, the serious student is forced either to construct a personal database (as
already discussed) or to purchase a commercial card-index database (such as that by
Shenberger). The latter is good but is very incomplete - being based on only a few textbooks.
At this time, micro-computer AP databases are available commercially.
One way to use the cookbook method is to select the 6 or 7 points with the highest scores. I
have discussed this method with several highly trained and skilled AP practitioners. There is
general consensus that while this will give useful clinical success ratios, it will not achieve the
success ratio which would be possible if the points were selected from the cookbook not only
by their scores but also keeping the Classical concepts and the laws of choosing points in
mind. This pre-supposes that the user knows these concepts. Thus, in summary:
Cookbook + little AP knowledge = good clinical success
Cookbook + good basic AP " = better clinical success
4. TAIWANESE/JAPANESE APPROACH TO AP
Having discussed some of the fundamental concepts of TCM and TAP we should now
consider how much of the Traditional approach is actually used in modern AP today. This is a
very difficult question to answer and it largely depends on the training and experience of the
respondent.
First, let us examine some of the characteristics of modern AP.
Medical diagnosis in China Today: Side by side with traditional systems, highly scientific,
western oriented medical systems co-exist. This also applies in India, Japan, Taiwan, and most
of the Far East. In the same city, you may find the back-street charlatan, the high-street
Oriental Doctor (Traditional) and the western-style trained medical specialist.
Many Chinese and Japanese doctors, trained in western medicine but also trained (and expert)
in AP ignore or dismiss much of the Five Phase Theory, the Chinese pulse diagnosis method

etc as irrelevant to modern medicine. Lined up against them, as (many or more) of their
colleagues hold fast to these concepts. Thus, a westerner asking "How important are the
traditional concepts today"? cannot arrive at firm conclusions based on talking to these
persons.
We can also try to assess the problem by examining the amount of text space devoted to
Traditional Concepts in the English versions of the AP textbooks from the far East. In
general, few of these texts issued in the past 10 years give more than a cursory nod towards
the traditional concepts. Most of them approach the treatment of clinical disorders from a
pragmatic viewpoint (i.e.) Cookbook AP. Many modern AP textbooks place little importance
on the Six Evils, the Five Phase Theory and its uses etc. Many successful AP practitioners
do not use those concepts in diagnosis or therapy.
However, one should ask the question: why was the traditional aspect understated? Was it
because the authors believed it to be irrelevant or was it because they thought that full
discussion would "turn off" western readers? I believe the latter is nearer the truth. Because of
conceptual differences, there are no words in our languages for many of the Chinese concepts!
Full discussion would be tedious: like trying to discuss nuclear physics with a theology
student. In support of this argument, we must note that some of the authoritative texts place
considerable emphasis on the traditional (Essentials of Chinese AP; AP a Comprehensive
text; Current AP Therapy; Pathogene et Pathologie Energetiques en Medicine Chinoise - Van
Nghi 1971). The fact that the Barefoot Doctor's Manual gives little attention to it is probably
because it is for the barefoot doctor, whose training is too short to assimilate the complex
traditional concepts.
Thus, the terminology and concepts used in medical diagnosis depend largely on where the
patient becomes ill and which doctor is consulted, as is the case in Ireland!
5. COMBINATION OF MODERN AP AND WESTERN MEDICINE
In the Veteran's General Hospital, a huge, excellently equipped Army-Navy-Airforce Hospital
in Taipei, one finds specialists in Oriental Medicine, specialists in western medicine and
(more significantly) specialists in both systems. It follows that the diagnostic and therapeutic
methods depend largely on which doctors are consulted. All the standard lab tests, clinical and
neurological tests etc, are available, if required.
In China, the Barefoot Doctor is a technician with limited training, capable of diagnosing and
treating the common and simple day to day conditions with reasonable accuracy. Where
treatment is unsuccessful or the case appears to be more complex, the patient is referred one
step higher to persons who have a longer, more formal training in Oriental and/or western
medicine. If they need help, the patient is referred further up the pyramid, which is topped by
first rate physicians, surgeons and oriental medical specialists.
Effective therapy is more important than putting traditional or modern names on the origin
and nature of the clinical condition. AP therapy, as is the case with diagnosis, is an artscience as varied as there are practitioners. However, most medical AP practitioners
(including those at the Veterans General Hospital, Taipei) use pragmatic or Cookbook AP in
the majority of their cases: knee problems GB34, SP09, ST35, Hsi Yen (Knee Eyes), BL40;
sciatica BL23,37,40,60, GB30,34 etc. They use their favourite prescriptions for each type of

case, always including any Ahshi points found. This is also the case with practitioners of
western medicine or veterinary medicine.
Thus, we see marked similarities between the actual field problems of diagnosis and therapy
in the East and West. The bottom line for all therapists is "what will I use to treat this case of
osteoarthritis?" etc, or "My patient's sciatica did not respond to BL23....GB34; what should I
try now?".
6. THE FUTURE ?
Computers have invaded social, academic, professional and business aspects of our lives.
Information technology is likely to become a commodity as valuable as oil or gold.
Clerics are using databases of the Gospels/Bible to construct sermons on "war", "love",
justice" etc. Summaries of research papers on medicine, vet medicine, biology etc are already
on databases and available to database subscribers for searches using any key-words of
interest.
In the near future, we will have access at reasonable price to computers of enormous speed
and storage space. Voice input and output will replace/supplement the keyboard/screen. With
advances in computer graphics, the receptionist will be capable of taking a preliminary case
history, to indicate the location of lesions (by interaction with the database and graphic
display unit) and to generate a list of possible diagnoses (from by comparison of signs/lesions
with the database lists). He/she will be able to output graphic charts of relevant points for the
patient's complaints on the plotter.
At that stage, the patient and charts will be presented to the doctor, whose job will be to check
(or alter) the facts on the computerised case-history. The doctor will scan the patient, using
computer-controlled Kirlian-Voll-Akabane methods to determine which Channels are
imbalanced.
When the most appropriate diagnosis is selected, the appropriate therapy (including the AP
point prescription) will be selected and the patient will be directed to the therapy room for
treatment. There, computer-controlled robots, assisted by optical scanners, will insert the
needles at the appropriate points and will monitor the clinical response using electro-magnetic
measurements of the vital energy at the AP points. George Orwell, eat your heart out!
Joking aside, to get the best mental satisfaction from Cookbook AP, the practitioner must
know the basic rules of choosing points, so that the Cookbook recipe can be best modified to
the patient's needs. Computers can store vast amounts of data (more than a human brain can
recall accurately) but the "dead" information must be assessed and adapted by a trained
human mind to be made really "alive".
Finally, the computer can not give the most vital of all therapies: the gift of unselfish love and
compassion in response to the plea for help from a suffering patient.
CONCLUSION

Rambo attitudes ("Let's kill the Bastards !" or "Attack is the best means of defence" etc) are
justified by many governments and generals as sound Defence Policy against perceived
attack.
Ramboism may succeed for a time but, unless the attacked group and its genetic code is
exterminated, that policy usually fails in the long-term, as is shown by the history of invaded
lands. The wheel turns and the natives survive to rise again. (Ireland was occupied but won
back its independence after more than 800 years).
Rambo policy is used in medicine and vet medicine (antibiotics against bacterial diseases, test
and slaughter policy against bovine tuberculosis etc). Although it is very successful in some
cases, it has failed to eradicate many of the infectious diseases (especially chronic diseases).
TCM and holistic medical philosophies of ecology (avoidance of perceived attack and
enhancement of apt adaptive responses) are more likely to succeed.
In western concepts, Avoidance of the Evitable and Adaptation to the Inevitable imply a
fine-tuned balance of the immune, autonomic and neuro-endocrine systems, which can be
brought under a degree of voluntary control (even in animals) by conditioning/self
training/biofeedback/visceral learning. Active pursuit of passive defence is also in line with
Judaeo-Christian guidelines for physical and mental health/wellbeing: a balanced life, in tune
with nature; good diet/fasting, physical/mental work, relaxation/meditation, love of self/love
of others etc. Yin-Yang concepts were not confined to the East.
Non-specific parasites and their reluctant human and animal hosts must learn, or be helped to
learn, to co-exist in some form of harmony/balance. Otherwise, it seems the parasites will
thrive long after the hosts shall have become extinct. But, as Murphy's Law prevails ("If
something can go wrong, it will, at the worst possible time"), Rambo is unlikely to quit.
Meanwhile:
1. The basis for AP lies in a knowledge of the position and functions of the AP points and in
relationships between the Channels, the direction and time sequence of Qi flow in the
Channel circuits and the MASTER (energy transfer) points.
2. Few (if any) Master Acupuncturists know all the points. (There are over 1000 points if all
AP systems are included). However, to claim to be an acupuncturist and not know the main
points is tantamount to charlatanism, if not fraud.
3. Beginners can get good clinical results by Trigger Point (TP) Therapy, Scar Therapy,
Neural Therapy, Dermatomal/Segmental Nerve Stimulation. These are all part of AP therapy
but they are the simplest part and need no knowledge of Oriental medical concepts or AP
principles. Thus, a TP therapist is not always an acupuncturist but an acupuncturist always
uses TP therapy, where appropriate.
4. As a prospective acupuncturist, you can be as good or as mediocre as you wish to be. There
are four main options in the study of AP therapy:
a. TP and allied therapy (very simple, little study needed).

b. Classical AP therapy (very complex; needs years of study; may not be essential; adequate
training difficult to get in some countries).
c. Cookbook AP (Incorporates TP therapy. Relatively simple, if you have good charts, system
- and a minimum of home study of AP methods).
d. Intermediate AP (Cookbook system plus a minimum of formal lectures on basic AP
principles, plus a 6-12 months of part-time home study). The minimum requirement for
proper use of AP is study of the location, function, uses and contraindications of the
main AP points.
I suggest that option 4 is the best for most busy professionals. Your National AP association
can help you to select a suitable course.
ESSENTIAL READING (the most authoritative texts; * = highly recommended)

Anon (1973) Newest Illustrations of the AP Points (Charts & Booklet). Med. &
Health Publ. Co., Hong Kong 100pp.
Anon (1977) Basic AP: Scientific Interpretation & Application. Chin. AP Research
Foundation. 84-223 Taipei, R.0.C. 313pp.
Anon (1980)* Essentials of Chinese AP. Foreign languages Press, Peking 432pp.
Anon (1980)* Barefoot Doctor's Manual -Official paramedical Manual. Running
Press, Philadelphia. 948pp.
Chung, Chien (1983) The Ahshih Point: Illustrated Guide to Clinical AP. Chen Kwan
Books, 5-2-1F Chung Ching South Road, Taipei, Taiwan 212pp.
Connolly, Dianne (1979) Traditional AP: The Law of the Five Elements. Centre for
Traditional AP. American City Bldg. Columbia, Maryland 21044, 197pp.
Lee, Jane F. & Cheung, C.S. (1978) Current AP Therapy, Med. Interflow Publ. House,
Hong Kong 408pp.
O'Connor, J. and Bensky, D.(1983) AP: A Comprehensive Text. Shanghai College of
Trad. Med. (Eastland Press, Chicago) 750pp.

OTHER ORIENTAL TEXTS IN ENGLISH (* = highly recommended)

Anon (1974)* China's New Needling Treatment. Med. & Health Publ. Co., Hong
Kong 80pp.
Anon (1974) Principles & Practical use of AP Anaesthesia. Med. & Health Publ. Co.
Hong Kong 325pp.
Anon (1979)* Treatment of 100 Diseases by New AP. Med. & Health Publ. Co., Hong
Kong, 89pp.
Anon (1980) AP Manual, AP Research Centre, China Medical College, Taichung,
Taiwan, R.O.C. 229pp.
Anon (1983) Anatomical Atlas of Chinese AP Points, Shandong Scientific &
Technical Press, Jinan, China, 256pp.
Cheng, W.C. & Yang, C.P. (1976)* Synopsis of Chinese AP. Light Publishing Co.
Hong Kong 128pp.
Hyodo, Mayayoshi (1980) Recent Advances in AP Treatment. Dept. Anaesthesia,
Osaka Med. College, Japan, 245pp.
Hyodo M. & Kitade, T. (1980)* Guide to Silver Spike Point Electrotherapy, Dept.
Anaesthes. Osaka Med. College, Japan 212pp.

Kao, F.F. & Kao,J.J. (1973) AP Therapeutics, Eastern Press, New Haven, Connecticut,
98pp.
Shen, Chou AI, Stenbaeck, L., Hammond, G.L. & Clausen, T. (1973)* Practical AP,
FADL Publishing House, Copenhagen, 160pp.
Shui, Wae (1976) A research in AP and its clinical Practice. Commercial Press Ltd.,
Hong Kong 231pp.
Silverstein, M.E, Chang, I.L. & Macon, N. (1975) Handbook for Barefoot Doctors of
China. Schocken Books, New York 372pp.
Wong and Law (1982) Chinese AP Handbook. Light Publishing Co., Hong Kong,
150pp.

OTHER WESTERN TEXTS (* = highly recommended)

Austin, Mary (1974) AP Therapy. Turnstone Books, London. 290pp.

Callehr, H. (1976) AP in Psychosomatic Medicine: Diagnostic & Therapeutic
Standards Amer. J. Acup. Vol. 4, 101-.
Chaitow, Leon (1976) AP Treatment of pain. Thorsons Publ. Wellingborough,
Northants, U.K. 160pp.
Chan, Pedro (1975) Finger Acupressure. Price, Stern, Sloan Publishers, Los Angeles,
California 92pp.
Chan, Pedro (1977) Ear Acupressure, Price, Stern, Sloan Publ. Los Angeles, CA.
109pp.
Chang, S.T. (1976) Complete Book of AP Celestial Arts, Milbrae, CA. 244pp.
Connolly Dianne (1979)* Traditional AP: The Law of the Five Elements. Centre for
Traditional AP, American City Building, Columbia, Maryland 21944, USA. 197pp.
Dorrigo, Bruno et al (1979)* Fibrositic Myofascial Pain in Intermittent Claudication,
Effect of TP block on Exercise Tolerance, Pain, Vol 6, 183-.
Fox, W.W. (1975)* Arthritis & Allied Conditions. A New & Successful Approach,
Ranelagh Press, Hampstead, London, 9lpp.
Houston, F.M. (1974) Healing Benefits of Acupressure. Keats Publ. Inc., New Haven,
Connecticut, 76pp.
Huneke, F. (1961) Das Sekunden Phanomen. Karl F. Haug Verlag, Ulm, Germany (In
German)
Hwang F.T.K., Wong, J.S.L. & Chan, P.C.P. (1975) AP made Easy. AP Research
Institute, Chan's Books, Alhambra, CA, USA. 97pp.
Kajdos, V. (1974) Neural Therapy - Its possibilities in everyday practice. Amer. J.
Acup. Vol 2, 113-.
Kaptchuk, Ted (1983)* The Web that has no Weaver. Congdon & Weed, New York,
USA.
Kellgren, J.R. (1939-42) On the Distribution of Pain arising from Deep Somatic
Structures & Charts of Segmental Pain Areas. Clin. Sci., Vol 4, 35-.
Khoe, Willem (1979)* Scar Injection in AP. Amer. J. Acup. Vol 7, 15-.
Lau, P.D. (No Date) Explanatory Manual of AP Hampton Gen. Hospital, Hampton,
Virginia, U.S.A
Lavier, J. (1974) Points of Chinese AP. Health Science Press, Wellingborough,
Northants, U.K. 115pp.
Lawson Wood, D. & J. (1973) AP Handbook. Health Science Press, Wellingborough,
Northants, U.K. 141pp.
Lee, I.J. & Lee, T.D.H. (1975) AP Atlas. Lycee Trading Corp. Melville, New York,
203pp.

Lewitt, Karel (1979) The Needle Effect in Relief of Myofascial Pain. Pain, Vol 6, 83-.
Lu, Henry C. (1974) Complete Textbook of Auricular AP. Acad. Oriental Heritage,
Vancouver, Canada, 250pp.
Manaka, Y & Urquart, I.A. (1973) Quick and easy Chinese Massage. Japan Publishing
Trading Co., 1255 Howard St. San Francisco 31pp.
Mann, Felix (1973)* AP cure of many Diseases. Heinemann Medical Books, London,
UK.
Mann, Felix (1974) Meridians of AP. William Heinemann Med. Books; London
174pp.
Mann, Felix (1974) Treatment of Disease by AP. William Heinemann Med. Books
Ltd. London 202pp.
Matsumoto, Teruo (1973) AP for Physicians, Charles C. Thomas, Springfield, Illinois
202pp.
Melzack, Ronald et al (1977)* Trigger Points and AP Points for pain; Correlations and
Implications. Pain, Vol 3, 3-.
Macdonald, Alex (1983)* Trigger Mechanisms and Myofascial Fain. 3rd Nordic
Congress on AP (May 1983) and Annals Roy. Coll. Surg. Eng., Vol 65,44-.
Moss, Louis (1972)* AP and You. Paul Elek Books, London, 196pp.
Namikoshi, Tokujiro (1974) Shiatsu. Japan Publ. Trading Co., San Francisco, CA,
USA. 81pp.
Niboyet J.E.H. et al (1973) L'anaesthesie par l'acupuncture, Maisoneuve, Saint
Ruffine, France 433pp.
Patterson, Margaret (1975)* Addictions can be Cured. Lion Publ. Co., Berkhamsted,
Herts, U.K. 95pp.
Porkert, M. (1983) The Essentials of Chinese Diagnostics. Acta Medicinae Sinensis,
Chinese Medical Publications Ltd., Zurich, Switzerland. 292pp.
Rogers, Carole (1982)* AP Therapy for Post-Operative Scars. Amer. J. Acup., Vol 10,
201-.
Pontinen, Pekka (1982) AP Seminar for Swedish Physicians, AP Research Dept.,
Tampere Univ. Finland.
Shenberger, R.M. (1980) AP Therapy Prescription Index. Shenco, 205 Pinecroft
Drive, Roselle, ILL 60172 U.S.A.
Travell, J. and Simons M. (1984) Myofascial pain and dysfunction - the Trigger Point
Manual, Part 1. (Williams & Wilkins, Baltimore & London), 713pp.
Turner, Roger, N. & Low, Royston, H. (1981)* Principles & Practice of Moxa.
Thorson's Publ. Wellingborough, Northants, UK 95pp.
Ulett, G. (1982) Principles and Practice of Physiological AP. Warren Greene Inc.,
8356 Olive Blvd., Missouri 63132, U.S.A. 220pp.
Van Nghi, Nguyen (1971) Pathogenie et Pathologie Energetiques en Med. Chinoise.
Imprimerie Ecole Don Bosco, Marseille. 679pp.
Warren, F.Z. & Fischman, W.L. (1980) Sexual AP and Acupressure. Unwin
Paperbacks, London, Boston, Sydney 238pp.
Wu Wei Ping (1973) Chinese AP. Health Science Press, Holsworthy. Devon, UK.
181pp.

SYMPOSIUM PROCEEDINGS, OVERVIEWS, REVIEWS (* = highly recommended)

Anon (1975) Summaries of Rep. of China (Taiwan) Delegation to 5th World Congress
of AP 136pp.

Anon (1975) Proc. 3rd World Symposium on AP and Chinese Medicine, New York
(Amer. J Chin. Med., 3, Supp 1, 54pp.
Anon (1979)* Abstracts from Symposium on AP, Moxa and AP analgesia. Peking and
Jean Bossy's Synthesis (Doin Editors, Paris) 286pp.
Anon (1981)* Symposium on Myofascial Trigger Points (Melzack, Renolds, Rubin,
Simons, Travell) Archives of Rehabilitation Medicine, March 1981, 97-117.
Lin, J.H. & Rogers, P.A.M. (1980) AP effects on the body's defence systems: a review.
Vet. Bulletin, 50, 633-.
Rogers, P.A.M. & Ottaway, C.W. (1974) Success claimed for AP in domestic animals:
a veterinary news item. Irish Vet. J., 28, 182-.
Rogers, P.A.M., White, S.S. & Ottaway, C.W. (1977) Stimulation of the AP points re
analgesia and therapy of clinical disorders in animals. Vet. Annual (Wright
Scitechnica, Bristol, UK), 17, 258-.
Rogers, P.A.M. & Bossy, J. (1981) Activation of the defence systems in animals and
man by AP and moxibustion. Acup. Res. Quart., (Taiwan), 5, 47-.
Rogers, P.A.M. (1983) The Taiwan Report. Acup. Res. Quart., (Taiwan), 7, 44-.

QUESTIONS
1. One of the following statements is not correct. Indicate the incorrect statement:
(a) The diagnostic, therapeutic and preventative value of AP depends totally on a knowledge
of the AP points, the Channels and their functional and anatomical relationships with each
other
(b) AP points are of two main types: (a) Ahshi points and (b) codified AP points
(c) Most codified AP points are reactive electro-permeable points (REPP) relative to nearby
skin areas
(d) Hyper-reactive AP points, whether Ahshi or codified, are hyper-sensitive to pressurepalpation, electric current or heat
(e) Ahshi points are abnormally tender to palpation pressure. Human patients are usually
aware of their presence even if they are not pressed
2. One of the following statements is not correct. Indicate the incorrect statement:
(a) When Ahshi points are pressed, the human patient usually grunts, groans, swears or jerks
(b) Ahshi = Ah! Yes !, or "Ouch!"
(c) In animals, pressure on Ahshi points elicits definite defensive or aversive behaviour
(d) Some Ahshi points are just painful locally, corresponding with "fibrositic nodules",
"motor points" and other irritable foci in muscle and fasciae.
(e) Ahshi points are never Trigger Points (TPs)
3. One of the following statements is not correct. Indicate the incorrect statement:

(a) Up to 70% of Ahshi points occur at codified AP points

(b) Ahshi points are not related to the Shu (paravertebral reflex) and Mu (front alarm) points
(c) Ahshi points are usually present in myofascial syndromes
(d) Ahshi points are useful in diagnosis and prognosis: in the absence of signs of other
pathology, they confirm that muscular spasm is the main problem and that the prognosis is
very good if they can be eliminated successfully
(e) In heart/pericardial disease, pressure along T4,5,6 (BL14,15,16) or from under the xiphoid
cartilage to a point between the nipples (CV14-17) may be painful
4. One of the following statements is not correct. Indicate the incorrect statement:
(a) Ahshi points are always treated as part of AP therapy
(b) Point tenderness always occurs in clinical disease
(c) There are over 1000 codified AP points in humans
(d) The "New", "Strange", "Hand", "Ear", "Foot", "Scalp", "Face", "Nose", "Red Doctor
Zone" points etc are mainly non-Channel points
(e) The average TSUN ("Body Inch") in humans is the width of the joint of phalanx 1-2 of the
patient's index finger. However, the length of the TSUN varies slightly with the part of the
body being searched
5. One of the following statements is not correct. Indicate the incorrect statement:
(a) AP points influence: the organ and associated functions of the Channel; the Channel and
areas anatomically close to it; local tissue and functions
(b) Thoracic and abdominal AP points, including paravertebral points, influence organs
anatomically close to them
(c) Point GB34 influences GB function and disorders (cholecystitis, cholelithiasis etc); pain
and dysfunction along the course of the Channel from eye, to lateral headache, to
neck/shoulder area pain, to lateral thoracic/abdominal pain, to hip, lateral thigh, knee, lateral
leg, ankle, to 4th toe pain/sprain/paralysis
(d) All AP points on a Channel are equally powerful as regards local and distant effects. For
example GB30 is as good as GB34 in stifle/femoro-tibial pain and cholecystitis
(e) MASTER POINTS include Shu and Mu points; Five Phase Points; Luo (Passage)
Points; Yuan (Source), Xi (Cleft), Tonification, Sedation, Hour Points etc
6. One of the following statements is not correct. Indicate the incorrect statement:

(a) Because of overlap in the spinal nerve supply to the organs, the Shu and Mu points are not
as organ-specific as classical theory states
(b) Shu and Mu point sensitivity is a guide but not a definitive indication as to the organ
affected
(c) The Five Phase Points transfer Qi between the Channels in the Five Phase Cycle
(d) Luo (Passage) Points transfer Qi between the Husband and Wife Channel within each
Yin-Yang pair within each Phase
(e) The Chinese term HSIN (HT) relates to the Fire Phase. It controls the heart, tongue and
psyche. Neurasthenia, restlessness, insomnia, excitability, rapid speech, angina pectoris, red
complexion, dislike of summer weather or heat etc indicate a disorder in Fire, manifest in a
disturbance in Heart function.
In that case, the diagnosis usually can be confirmed by western methods: abnormal ECG and
elevated heart muscle enzymes in serum
7. One of the following statements is not correct. Indicate the incorrect statement:
(a) TCM has Eight Principles for defining disease Syndromes, based on the clinical signs: it
combines one type from each of 4 categories (Yin or Yang; Hot or Cold; Shi or Xu;
External or Internal)
(b) Many translations of Chinese medical AP texts ignore or pay little attention to the
classical Pulse types. Recent studies (doppler ultrasonography or use of pressure transducers
to measure pulse characteristics) cast doubt on the objective validity of Classical Pulse
Diagnosis.
(c) According to TCM, the pulse in the right radial artery reflects the energy status of the SI,
GB and BL Channels on superficial palpation and the HT, LV, KI Channels on deep
palpation.
(d) A disease of Yang, Hot , Shi, External type has a good prognosis
(e) A disease of Yin , Cold, Xu , Internal type has a poor prognosis
8. One of the following statements is not correct. Indicate the incorrect statement:
(a) In TCM therapy, AP is more important than herbal medicine
(b) All methods of TCM aim to correct imbalances of Qi. Where the cause is bad lifestyle
(XS eating; XS work; insufficient food or sleep; XS alcohol etc) steps are taken to advise on
moderating this
(c) The patient is advised on environmental, behaviourial or dietary changes etc which may be
necessary to alleviate or remove the cause

(d) To restore the normal balance of Qi (resistance), many methods are used alone or in
combination: herbal medicine; physiotherapy; AP and moxibustion; Taichi; psychotherapy
(Qi Kung); mental/emotional exercises to balance the emotions
(e) The most common needle used in human AP is about 35 mm long and 30 gauge
9. One of the following statements is not correct. Indicate the incorrect statement:
(a) DeQi ("the arrival of Qi") is regarded as crucial to AP success: paraesthesia, tingling,
numbness, heaviness, "sour feeling" etc in the vicinity of the point
(b) In humans, DeQi is indicated by verbal feedback from the patient. In animals, the main
signs of DeQi are: sudden change in behaviour; respiration may be temporarily inhibited or
accelerated. Local muscle spasms or twitches may be seen
(c) DeQi is more often obvious when the point is directly over a peripheral nerve or directly
over motor points
(d) It is very difficult to obtain DeQi at LI04; PC06; TH05; LI11; ST36; GB34; BL40
(e) Acute conditions require only short periods of needling and chronic conditions require 20
minutes or more
10. One of the following statements is not correct. Indicate the incorrect statement:
(a) By far the most AP common prescription is a combination of Ahshi points and local
points and distant points on the affected Channel
(b) COOKBOOKS, based on frequency-ranking of point use in specific conditions aid in the
selection of AP points for therapy
(c) Infra-red thermography, Voll-Akabane-Ryodoraku measurements of altered sensitivity at
peripheral points etc has confirmed that organs project information of their dis-ease to the
periphery via the autonomic nervous system
(d) Clinical detection of the altered sensitivity aids in diagnosis
(e) Any method (including AP) which speeds up the return to normal point sensitivity is a
good therapeutic method and monitoring the speed of return to normal sensitivity has
prognostic value
(f) One must use at least 12 needles in most AP sessions
11. One of the following statements is not correct. Indicate the incorrect statement:
(a) Few (if any) Master Acupuncturists know all the AP points
(b) Beginners can get good clinical results by Trigger Point (TP) Therapy, Scar Therapy,
Neural Therapy, Dermatomal/Segmental Nerve Stimulation. These need no knowledge of
Oriental medical concepts or AP principles

(c) A TP therapist is not always acupuncturist but an acupuncturist always uses TP therapy,
where appropriate.
(d) There are four main options in the study of AP therapy: TP and allied therapy; Classical
AP therapy; Cookbook AP, with TP therapy; Intermediate AP (Cookbook plus the basics of
classical AP)
(e) The minimum requirement for proper use of AP is study of the location, function,
uses and contraindications of the main AP points. One intensive week's course (such as the
Sydney Veterinary Postgraduate Course) is all that is needed.
1 = e 2 = e 3 = b 4 = b 5 = d 6 = e 7 = c 8 = a 9 = d 10 = f 11 = e

FIVE PHASE THEORY AND ITS USE IN MEDICINE

SUMMARY
Nature and the body are unities, in which mutual control and harmony are maintained by
creation (anabolism) and destruction (catabolism). Five Phase Theory extends Yin-Yang
Theory, in which all things in nature are classified into five basic types or Correspondences:
Fire, Earth, Metal, Water, Wood. The Phases and their Correspondences interact in
predictable ways. As Yin and Yang have anabolic and catabolic aspects, so also have the Five
Phases. Thus, the Five Phases have a Sheng (Mother-Son, anabolic, creative, nourishing =
->) and a Ko (Grandmother-Grandson, catabolic, controlling, destructive, = X) Cycle.
The Sheng Cycle is: Fire -> Earth -> Metal -> Water -> Wood -> Fire. In the Sheng Cycle,
Fire is the Mother of (feeds or strengthens) Earth and Metal is the Son of (is nourished by)
Earth.
The Ko Cycle is : Fire X Metal X Wood X Earth X Water X Fire. In the Ko Cycle, Fire is the
Grandmother of (dominates or controls) Earth and Metal is the Grandson of (is brought under
control by) Earth.
Each Phase (or ELEMENT) relates to a specific Yin/Yang pair of the Channel-Organ System
(COS) and to a wide list of Correspondences (function, emotion, excretion, body tissue,
season, food etc). Thus, Fire relates to the COSs Heart and Small Intestine (HT and SI) and
their Correspondences (sweat, tongue, speech, face, circulation, excitability, psyche, bitter
taste, red, summer, south etc).
Disease involves imbalance (Excess, Deficiency or Stagnation) of Qi in one or more COSs.
Therapy involves restoration of the balance of Qi. Each Channel has 5 special Points,
corresponding to each of the Five Phases and a Luo (Passage) Point. These Points are used to
transfer Qi between COSs when there is one or more with Qi Excess and an equal number
with Qi Deficiency. This restores the balance and harmony of Qi. One usually stimulates the
Deficient COS, to draw Qi from its Yin/Yang mate (via the Luo Point) or from another COS
(via the Sheng or Ko Cycle). Any Deficiency thus created in the donor COS is filled from an
Excess elsewhere. However, if only one COS is involved, it may be Tonified by needling its
Mother Point, or Sedated by needling its Son Point.

Five Phase Theory has many implications in medicine. However, the theory is incomplete and
it has its limitations. It is a useful guide to aetiology, diagnosis, prognosis and therapy but it is
not absolutely necessary for therapeutic success. Knowledge is an ongoing process. While AP
can produce good clinical results without a knowledge of the use of Five Phase Theory, the
theory enhances the probability of optimal results, especially in complex disease syndromes.
INTRODUCTION
The Traditional Chinese Medical (TCM) law of Yin-Yang is the UNIVERSAL LAW of
mutual control by mutual antagonism and dependence of all things. (See the papers on
Holistic concepts of health and disease and on Traditional versus modern AP). The interplay
of Yin-Yang is an endless cycle of action and interaction.
The concept of cycles is fundamental to TCM. Nothing is static. Nothing is absolute.
Everything is dependent on (relative to) everything else. All things must CHANGE. The Five
Phase Cycle is another fundamental concept of TCM. In essence, everything and every
concept in creation is a manifestation of Qi (energy). Qi has attributes or characteristics of one
or more of five basic types, and can transform from one Phase to another. The types or
Phases are called: Fire, Earth, Metal, Water, Wood. For instance, suppose you are sitting in
your armchair, looking into a fire and meditating on the nature (or type) of Fire. You might
see it as primarily heat and light (energy-giving). However, the same fire once was (and still
contains an element (Phase) of) living organic material (Wood, peat, coal, methane). As it
burns, it produces (and contains an element of) ash (Earth) and mineral residue (Metal) and
the hydrogen in most burning fuels is oxidised to Water. Thus Fire also contains aspects
(elements, Phases) of the other Phases (Wood, Earth, Metal and Water). In turn, earth and
minerals, when fed by Water can produce a new tree (Wood). Thus, all the basic components
Fire, Earth, Metal, Water and Wood are needed for (inherent in) every other Phase.
Each Phase has typical characteristics or Correspondences. Each has also its Yang and Yin
aspects. The Phases create (engender, nourish, help) one another and destroy (control, restrain,
dominate) one another in a ceaseless, dynamic cycle, the dance and rhythm of life and death.
In TCM, the Two Phase (Yin-Yang) and Five Phase Cycles are universal Laws. They are
the source and manifestation of evolving creation and destruction in all its aspects. They apply
to every aspect of life and politics, art, music, science, philosophy, sociology and medicine.
They are primitive (yet ultra-sophisticated) concepts of the balance and inter-dependence
of all things. If one Phase becomes imbalanced (too strong or too weak), the whole cycle is
upset and disharmony can arise in other Phases and their Correspondences. Restoration of
balance depends on recognition of which Phases are upset and the redistribution of Qi
between them so as to restore harmony, if this is possible.
The Five Phase Cycle has two major components, the Sheng Cycle (Mother nourishing
Son) and the Ko Cycle (Grandmother restraining Grandson). The Sheng is anabolic,
creative, nourishing, feeding. The Ko is catabolic, destructive, weakening, controlling.
Sheng Cycle: Things of a Fire nature promote (create or nourish) things of an Earth nature,
which promote or create things of a Metal nature etc. The Cycle is Fire -> Earth -> Metal ->
Water -> Wood -> Fire.

Sheng mnemonic: To remember the Sheng Cycle, visualise a gardener Watering a seed. The
seed grows into a tree. The tree is cut down for fireWood. The Fire produces ashes which
could be further refined to produce Metal. The sequence is Water -> Wood -> Fire -> Earth ->
Metal -> Water. Because a cycle has no beginning and no end, it is not important which Phase
is put at the top of the diagram, but it is usual to put Fire on top because (as will be seen later)
four COSs are associated with Fire and the top position is the most aesthetic, as will be seen
when the COSs are added to the diagram.
In this Cycle, things of Fire are Mothers of things of Earth (which are Sons of Fire). In turn,
things of Earth are Mothers of things of Metal (which are Sons of Earth).
Another Mother and Son concept was discussed elsewhere in relation to the Diurnal Qi
Cycle (daily Qi tide) from: LU -> LI -> ST -> SP -> HT -> SI -> BL -> KI -> PC -> TH ->
GB -> LV -> LU. In the Qi Cycle, LU is the Qi Mother of LI and BL is the Qi Son of SI etc.
The following diagram shows the relationships between the Phases in the Sheng Cycle.
The Sheng Cycle is represented by a clockwise circle. It is continuous, having no beginning
and no end. Although Fire creates Earth, Earth is necessary for Fire: (without Earth the
succeeding Phases (Metal, Water and Wood) would not be, and Fire itself would die!).
Fire

Wood

Water <==

Earth

Metal

The Sheng Cycle is the concept of Interpromotion among Phases: the Mother is necessary for
the creation/nourishment of the Son. Thus, the Sheng Cycle is a GROWTH AND
PROMOTION (anabolic) Cycle.
Ko Cycle: All growth (Sheng) must be controlled or restrained, otherwise abnormalities like
cancer, overpopulation, starvation and crime etc arise. The Ko Cycle is the important
controlling or restraining force between the Five Phases. It is a cycle of mutual controlinhibition-restraint. In this cycle things of a Fire nature restrain-control-inhibit things of a
Metal nature. Metal restrains Wood etc. The following diagram shows the relationships of the
Ko (restraint) Cycle.
The Ko Cycle is: Fire X Metal X Wood X Earth X Water X Fire. It is represented by a
clockwise pentagram or star. It is continuous, having no beginning and no end. Although Fire
restrains Metal, Metal has some control on Fire also, because without Metal, Water and Wood
could not be (in the Sheng Cycle), therefore Fire could not be. Thus the Ko Cycle is a cycle
of mutual CONTROL and RESTRAINT (the Grandmother disciplines, brings order to,
restrains, the Grandson):

Fire

Wood -----> Earth

Water

Metal

COMBINATION OF SHENG AND KO CYCLES BALANCES THE FIVE PHASES

Without Sheng (nourishment) there can be no growth and development. Without Ko
(restraint), excessive development would be harmful.
Thus, both the Sheng and Ko Cycles are necessary for balance. They represent a state of
continuous dynamic anabolism and catabolism respectively. All things in nature must change.
In biology, as in nature, nothing is static (i.e.) the system is in continuous movement, one
Phase becoming another. During this movement (rhythm) there are active (Yang) and passive
(Yin) phases. The combination of Sheng and Ko is represented in the following diagram:
===> represents Sheng Cycle (nourishing, promoting anabolic); ---> represents Ko Cycle
(restraining, controlling, catabolic); +++> represents Counteracting (a Reverse Ko) Cycle:
Fire X Water X Earth X Wood X Metal X Fire. Earth restrains (controls) Water (in the Ko
Cycle) but Water may Counteract on Earth (in the Reverse Ko Cycle):
Fire

Wood -----> Earth

Water <== Metal

The balance of growth (Sheng) and restraint (Ko) is necessary for harmony in the system.
Thus, by a process of mutual synergism and antagonism, harmony is maintained.
DISHARMONY, DISORDER
If there is an Excess, Deficiency or Stagnation (Blockage) in one Phase, abnormal
phenomena may appear in other Phases because the primary imbalance may Overact or
Counteract on other Phases.
Overacting means attacking a Deficient Phase via the Ko route. A Phase with normal Qi, but
especially one with an Excess of Qi may attack a Deficient Phase via the Ko Cycle (the

Grandmother annoys (or weakens further) the Weak Grandson). A normal (or, especially
hyperactive) Grandmother harms the Deficient Grandson Phase. For example, if Wood is
Deficient (weak), Metal could Overact on it, thereby exaggerating the problem. If Wood is in
Excess, it can Overact on Earth (weaken it). Counteracting is another type of attack by one
Phase on another, via the reverse Ko route (the Grandson annoys the Grandmother). If Wood
is in Excess it can Overact on Earth and simultaneously can Counteract on Metal. If Wood is
Deficient it can be Overacted upon by Metal and be Counteracted upon by Earth at the same
time.
The Sheng, Ko, Overacting and Counteracting forces are the basis of all interactions between
diseased organs. We will see later that each Phase has a set of Correspondences, including a
solid Yin Organ and hollow Yang Bowel. For now, it is sufficient to know that Fire, Earth,
Metal, Water and Wood are associated with the Yin COSs HT, SP, LU, KI, LV respectively.
Disease in any one of these COSs can have secondary effects on any other member of the
group. For instance, Lung disease could be primary. However, it could be secondary to
disease in Spleen (Mother (Earth) affecting the Son (Metal) in the Sheng Cycle); to disease in
the Kidney (Son (Water) affecting the Mother (Metal) in the Sheng Cycle); to disease in the
Liver (Liver (Wood) Counteracting on Liver (Metal)) or to disease in the Heart (Heart (Fire)
Overacting on Lung (Metal)).
In summary (so far), Five Phase Theory is a UNIVERSAL THEORY relating types of
things in a harmonious, balanced system (the Sheng and Ko Cycles). If one of the Phases
becomes too weak or too strong, the entire system can become unbalanced. By Overacting
and Counteracting forces, one imbalanced Phase may affect others. Any one Phase may be
imbalanced by imbalance in any other Phase. Correction of the balance depends on
recognition of the Excess and Deficient parts of the system and in redistributing the Qi to the
correct parts of the system to restore harmony. This concept is the first documented concept of
Holistic medicine: any one organ is related to, and can influence the functions of, any other
organ.
CORRESPONDENCES OF THE FIVE PHASES
(see the following tables)
Each Phase has a whole series of characteristics associated with it. The following tables show
some of these Correspondences. Students who wish to study the Five Phase Theory in depth
are referred to standard textbooks (Wu 1973; Connolly 1979; Hsu 1982; Kaptchuk 1983;
Porkert 1983; Wiseman et al 1985; Anon 1993).
The Correspondences of the Five Phases may help in diagnosis of health problems by
indicating which Phases are imbalanced. For instance, if a human patient has a history of
lacrimation, blurred vision and defects in the nails, one might suspect imbalance in the Wood
Phase (see tables of Correspondences). If he/she has an angry temperament, shouted a lot and
had a history of muscle aches and tendon pain, this would be further evidence of Wood
imbalance. Further examination would help to distinguish between LV and GB. For instance,
palpation of the bladder Shu (reflex) Points, front Mu (Alarm) Points, Yuan (Source) and
TEST Points (see paper on the study techniques) would be very helpful to distinguish between
LV and GB. Pulse diagnosis might also suggest that another Phase, for instance Earth, was
also imbalanced. For instance, in a liverish patient, a frequent picture might include
indigestion, weakness, nausea and Watery eyes. The Qi diagnosis may be LV Excess with ST
Deficiency. In Five Phase Theory, the treatment of such a case is very simple. One needle at

the Grandmother/Wood Point of ST (ST43) would suffice. By stimulating this point on the
Deficient ST COS, Excess Qi is drained from LV (Wood, Yin) to fill the Deficiency in ST
(Earth, Yang) via the Ko Cycle. (In Ko Cycle, Wood controls (is the Grandmother of) Earth
and therapeutic Qi passes from Yin to Yang (or Yang to Yin) in the Ko Cycle). (Don't worry if
you do not understand this example. It will become clearer when you have studied the entire
paper).
In the Five Phase Cycle, the following relationships apply to the Channels, their
Organ/Bowels, Functions and Correspondences. The Yang COSs appear outside the circle
in the diagram. They are: SI=Small intestine; TH=Triple Heater; ST=Stomach; LI=Large
Intestine (Colon); BL=Bladder; GB=Gall Bladder. The Yin COSs appear inside the circle.
They are: HT=HearT; PC=Pericardium, Circulation-Sex, Heart Constrictor); SP=SpleenPancreas; LU=Lung; KI=Kidney; LV=Liver.
Fire

Wood

SI

TH

HT

PC

GB

ST
LV

SP

KI
Water

Earth

BL

LU
LI

Metal

Note that the linked COSs form a Yin-Yang Pair within each Phase: Fire HT-SI and PC-TH;
Earth SP-ST; Metal LU-LI; Water KI-BL and Wood LV-GB. Qi can be transferred from HT to
SI (or SI to HT, as required) by the use of the correct Luo (passage) Point, always stimulating
the Luo of the Deficient COS to draw Qi from its linked COS. Also, in therapy, the points can
help SI problems and vice-versa.
In the Sheng Cycle, HT nourishes SP and SI nourishes ST etc, (i.e.) the Qi in the Sheng
Cycle passes from Yin to Yin or from Yang to Yang only. The Qi transfer in the Sheng Cycles
is as follows (-> = creates or nourishes):
Sheng Cycle
Fire -> Earth -> Metal -> Water -> Wood -> Fire
Yang to Yang transfer SI -> ST -> LI -> BL -> GB -> SI
Yin to Yin transfer
HT -> SP -> LU -> KI -> LV -> HT

CORRESPONDENCES OF THE FIVE PHASES

Correspondence

Fire

Earth

Metal

Water

Wood

Yin Organ COS

HT,PC

SP

LU

KI

LV

Yang Bowel COS

SI,TH

ST

LI

BL

GB

Phlegm, saliva

Mucus

Saliva,
urine

Tears

Mouth, taste

Ears,
genitals,
Nose, smell anus,
urethra,
hearing

Body fluid,Secretion Sweat

Orifice & sense

organ controlled

Tongue,
speech,
words

Manifests externally Face,

Lips, mouth, throat, Skin &
or expands into
complexion flesh
body
Nourishes or
Governs

Blood
vessels,
arteries,
blood circulation

Joy,
happiness
Main Temperament, excitability
emotions
manic
depressive
extrovert

Eyes, vision,
foresight

Hair on the
Nails
head

Fatty tissue,
muscles

Skin &
Bones,
Tendons,
body hair; teeth; bone
ligaments,
mucous
marrow;
muscles
membranes brain

Obsession, worry
meditation
sympathy,
depression greedy

Anguish,
Fright, fear, Anger,irrgrief,
timidity,
itability,
melancholy
phobias,
depression
negativity,
introversion unstable
sympathy

Verbalisation
emotional sound

Laughter,
grieving,
stuttering
excessive
speech

Stores or controls
the non-material
energies of

Soul, spirit,
Spiritual
ConsciousLife energy
faculties
ness; spirit, Thoughts, ideas,
(Qi)
Willpower, "First cure
the will to inspirationsopinions Animal
ambition the spiritthen
live, psychic , physical energy
spirit, vital
cure the
energy
energy
body",blood,
energy

Body flavour, likes

or dislikes

Bitter

Sweet

Hot, spicy,
Salty
pungent

Acid, sour as
in vinegar

Creates (->) (via

Sheng Cycle)

Earth
HT -> SP
SI -> ST

Metal
SP -> LU
ST -> LI

Water
LU -> KI
LI -> BL

Wood
KI -> LV
BL -> GB

Fire
LV -> HT
GB -> SI

Water
SP X BL
ST X KI

Wood
Fire
LU X GB KI X SI
LI X LV BL X HT

Earth
LV X ST
GB X SP

Metal
Destroys (X) (via Ko
HT X LI
Cycle)
SI X LU

Groaning,
Weeping, moaning, Shouting,
Singing, sing-song
Sobbing, humming, crying out,
voice
lamenting yawning, bossiness
snoring

Governs (via reverse Water

Ko Cycle)
KI, BL

Wood
LV, GB

Fire
HT, SI

Exertion (which
weakens)

Too much
walking

Too much sitting

Too much Too much

lying down standing

Body Time

1100-1500h
0700-1100h
1900-2300h

03000700h

1500-1900h 2300-0300h

Face Colour

Red

Yellow

White

Blue-Black Green

Climate (Good/bad) Heat

Damp,
Humidity,Late
Summer

Dryness

Cold

Wind

Season

Late Summer

Autumn

Winter

Spring

Growth/developmen
Growth
t

Transformation

Reaping

Storing

Germination

Direction

South

Centre

West

North

East

Dreams

Fires,blazes, Hunger,no
looking for food/drink,
fire; fear & buildings walls and
laughter
houses, playing
hills;
music; chanting;
mountains ruined buildings;
towns,
body heavy; can't
streets
rise; hills; marshes;
storms

White
objects,
cruel;
killing of
people
crying;
flying in
the air;
strange
metal
objects;
fields;
countryside;
landscape,
frightful
dreams

Water,
drowning,
ships;
fright;
fears; back
& waist
feeling
open &
split apart,
ravines
walking &
excursions

Being
trapped,
mushrooms;
lying under
tree ; afraidto
get up; trees
in mountain
forest; battles
& fight;
cutting open
one's body

Summer

Earth
SP, ST

Metal
LU, LI
Too much
use of eyes

Meat

Mutton,
lamb dog

Beef

Horse

Pork, fish

Fowl,chicken

Vegetable

Coarse
greens

scallions

onions

leeks

mallows

Fruit

Plum

apricot

chestnut

dates

peaches

Grain

Millet

millet,rye

rice

beans, peas,
wheat

Note

Chih

Kung

Shang

Yu

Chio

Number

In the Ko Cycle, there are two types of Qi transfer (a) Therapeutic Qi transfer and (b)
Pathological Qi transfer.

a. In the Ko Cycle, transfer of Therapeutic Qi is always from Yin to Yang or Yang

to Yin only. This will be discussed later.
b. In the Ko Cycle, transfer of Pathological Qi is always Yin to Yin or Yang to Yang,
as follows (X = weakens or damages or controls), i.e. Kidney disease can damage the
Heart and Heart disease can damage the Lung; Gallbladder disease can damage the
Stomach:
Ko Cycle
Fire X Metal X Wood X Earth X Water X Fire
Yang to Yang transfer SI X LI
X GB X ST X HT X SI
Yin to Yin transfer
HT X LU X LV X SP X KI X HT
The distinction between pathological transfer of Qi (Yin -> Yin; Yang -> Yang) and the
therapeutic transfer (Yin -> Yang; Yang -> Yin) is most important in diagnosis and therapy.
In the Five Phase Cycle the term Heart, HT etc refers not only to the heart organ but to all
attributes of HEART (i.e.) Function, COS and Correspondences. This principle is applied to
all COSs. Thus, when a master acupuncturist diagnoses a Deficiency in HT or Excess in LI, it
does not necessarily mean physical weakness of the heart organ or hyperactivity of the colon
organ. Rather, it means that the functions of HT are Deficient or that the functions of LI are
Excessive. (There may be physical changes in the respective organs also). If the condition is
not treated, physical changes will almost certainly occur in due course.
MEDICAL IMPLICATIONS OF THE FIVE PHASE CYCLE
Five Phase Theory has many implications in medicine: aetiological, diagnostic, prognostic
and therapeutic.
a. Interaction: All the major organs, functions and Correspondences interact with
each other and are interdependent in maintaining health. If one organ is irreparably
damaged, life is threatened or secondary disorders can arise in other organs.
Unnecessary surgery, especially removal of organs, may be dangerous.
b. Correspondences: Imbalance (Deficiency or Excess) in one COS or its
Correspondence may influence other COSs, their functions and Correspondences. For
example, Excess Qi in HT COS may weaken LU COS (via Ko Cycle); Deficient Qi in
the KI COS may allow Excess Qi in the HT COS, also via the Ko Cycle. Similarly a
Deficient LV COS may render the HT COS Deficient also, via the Sheng Cycle.
Bone pain (rheumatism) is more likely in cold, wet weather (winter-kidney (Water)
controls bone). Too much excitement may cause heart attack (excitement injuries
Fire). Septic inflammation of the throat often arises with kidney pains (KI (Water)
controls kidney and throat). These (and many other) examples illustrate the great
diversity of concepts which are intrinsic to Five Phase Theory.
The TCM view of the interdependence of the COSs and the psyche and external
environment is truly a holistic view of health and is the early ancestor of modern
Psycho-Somatic medicine and of dynamic self-controlling systems.

c. Balancing the COSs: Five Phase relationships are used in classic human
acupuncture (AP) to guide the choice of the best points for AP therapy. The principle
of balancing the COSs assumes that one or more COSs are in Excess and an equal
number are Deficient. If so, the Deficient COSs are filled by draining Qi from the
Excess in another COS. If this can not be done directly, Qi is drained from a normal
COS, which is then filled by draining from the COS which is in Excess. (Examples
will be given later).
IF there is no Excess, do not create a Deficiency in another COS! This would
merely change the location and nature of the disease! Thus, attempts at Five Phase
balancing are contraindicated unless there is an Excess to fill each Deficiency.
THE USE OF FIVE PHASE POINTS
Each Channel begins or ends at the fingers or toes. As Qi flows in the Arm Channels (LU ->
LI; HT -> SI; PC -> TH) and in the Leg Channels (ST -> SP; BL -> KI; GB -> LV), a
change Qi polarity occurs at the digits. As the Qi flows in the Arms, the polarity change is
Yin to Yang (e.g. LU -> LI). In the Legs it is Yang to Yin (e.g. ST -> SP). (Note: at the chest
and face, no polarity change occurs. In the face, the changes are Yang to Yang: (LI -> ST; SI
-> BL; TH -> GB). In the chest, the changes are Yin to Yin: (SP -> HT; KI -> PC; LV ->
LU).
The easiest place to influence the COS Qi by AP is at the extremities, where the Qi polarity is
changing naturally. Therefore, the most important points influencing Qi transfer in AP therapy
occur at the extremities: between elbow and digit in the thoracic limb and between knee
(stifle) and digit in the pelvic limb.
a. Each of the 12 main COSs has a point for each Phase (i.e.) a Fire, Earth, Metal,
Water and Wood Point. The location of each of the 12 x 5 ( = 60) Phase Points is
given elsewhere (in the paper "The Study of AP: Sources and Study Techniques").
These points are used according to the Five Phase Cycle to redistribute Qi in the COS
circuits, if imbalances are detected between the Phases.
If the imbalance is within a Phase (for instance between LU and LI, both in Metal), the
Luo (passage) Point of the Deficient COS is used to balance Qi by draining the Excess
from the linked COS. Thus, Qi can be transferred from any one COS to any other COS
by using the Five Phase Points according to the Sheng and/or Ko Cycle and/or the Luo
Points, as the case requires.
b. In the Sheng Cycle, Qi travels from Yang to Yang (SI -> ST -> LI -> BL -> GB
-> SI) or Yin to Yin (HT -> SP -> LU -> KI -> LV -> HT) only. By use of Five Phase
Points it is not possible to transfer Qi from SI (Yang) to SP (Yin) directly (although
Earth is the Son of Fire). If the SP is Deficient and SI is in Excess, Qi is taken from
HT by needling the Fire Point of SP. (Yin to Yin transfer). HT is then filled by draining
the Excess from SI by needling the Luo Point of HT (Qi transfer from Yang to Yin
within the same Phase via the Luo Point of the (now) Deficient COS). Similarly, if ST
is Deficient and HT in Excess, it is not possible to transfer Qi directly from HT (Yin)
to ST (Yang) although Earth is the Son of Fire. In this case, a needle in the Deficient
ST COS at its Fire Point would fill ST (via Sheng Cycle), emptying SI in the process.

SI would then be filled by needling its Luo Point, thereby draining the Excess from its
linked COS, HT.
c. In the Ko Cycle, therapeutic Qi travels from Yang to Yin or Yin to Yang only
(e.g.) from: HT -> LI -> LV -> ST -> KI -> SI -> LU -> GB -> SP -> BL -> HT.
Some authors (for example, Are Thoresen (Norway)) do not agree on this point but the
majority take this view. In the classic view, it is not possible to transfer Qi from HT
(Yin) directly to LU (Yin), although LU is controlled by HT in the Ko Cycle. In a case
where LU was Deficient and HT was in Excess, the approach would be: first needle
the Fire Point LU. This would drain Qi from SI into LU, creating a Deficiency in SI.
The Deficiency in SI would then be filled by needling the Luo Point of SI, thereby
emptying the Excess from HT. Similarly, it is not possible to transfer Qi directly from
SI (Yang) to LI (Yang) via the Ko Cycle. In a case where LI was Deficient and SI was
in Excess the approach would be: first fill the Deficiency in LI by needling the Fire
Point of LI, thereby draining Qi from HT (Yin to Yang transfer by Ko Cycle). Then fill
HT by needling the Luo Point of HT, thus draining the Excess from SI.
d. Whether using the Sheng or Ko Cycle to transfer Qi, always fill the Deficient
COS first, draining Qi from some other COS. Any Deficiency which is thus created
is filled by draining from a COS which is in Excess. If there is no Excess, do not
create a Deficiency elsewhere.
RULES OF USE OF FIVE PHASE POINTS
The use of the Phase Points, together with the Luo (passage) Points is easy to understand in
principle, if one grasps the following rules:
1. Therapeutic Qi can be transferred along the Sheng Cycle from Yin to Yin or Yang to
Yang only.
2. Therapeutic Qi can be transferred along the Ko Cycle from Yin to Yang or Yang to
Yin only.
3. Therapeutic Qi can be transferred via the Luo (passage) Points from Yin to Yang or
Yang to Yin only, and only between linked COSs:
LU <-> LI; ST <-> SP; HT <-> SI; BL <-> KI; PC <-> TH; GB <-> LV. These
linked COSs are always within the same Phase, i.e. LU, LI = Metal; ST, SP = Earth
etc.
When solving a problem of Qi transfer to balance imbalances in the COSs, many solutions are
possible. The ideal solution uses the shortest possible route (i.e.) the fewest possible number
of needles. A solution may involve either or both of the Sheng and Ko Cycles and/or 1 or 2
Luo Points. Most solutions require no more than 3 points and many can be solved with 1 or 2
points only.
ALWAYS BEGIN BY STRENGTHENING A DEFICIENT COS. Some examples follow. See
diagram below:

a. HT Deficient with SI Excess. This is very simple. The imbalance is within the
same Phase (Fire). A needle in the Luo Point of HT (Yin) will drain the Excess from
its linked COS, SI (Yang) and replenish the HT Qi at the same time.
SI

TH

HT

PC

Fire

GB LV

BL KI

Wood

Earth SP ST

Water

Metal LU LI

b. HT Excess with SI Deficient. Similar to (a) but the Deficiency is in the Yang
member of the linked pair. Needle the Luo Point of SI (Yang).
In both of the above cases, the imbalance was within one Phase, with no other imbalances.
Therefore, only the Luo Point is used and there is no reason to use the Phase Points.
c. HT (Fire) Deficient with LV (Wood) Excess. This one is easy as Wood supplies
from Yin to Yin. One needle in the Wood Point of HT drains the Excess from LV and
fills the Deficiency in HT at the same time.
SI

TH

HT

PC

Fire

GB LV Wood

BL KI Water

Earth SP ST

Metal LU LI

d. SI (Fire) Deficient and GB (Wood) in Excess. Similar to (c) but the Yang COSs
are involved. Solution: needle the Wood Point of SI. This drains GB and fills SI via
the Sheng Cycle.
e. SI (Fire) Deficient with LV (Wood) in Excess. Though the Sheng Cycle can move
the Excess from Wood to Fire, it requires 2 points. First needle the Wood Point of SI.
This fills SI but drain GB via the Sheng Cycle (Qi goes Yang to Yang). Then needle
the Luo Points of GB to fill GB and drain the Excess from LV at the same time.

f. HT (Fire) Deficient and GB (Wood) in Excess. Similar to (e). First needle the
Wood Point of HT, filling HT and draining LV via the Sheng Cycle (Yin to Yin). Then
needle the Luo Point of LV. This fills LV by draining the Excess from GB (its linked
COS).
g. HT (Fire) in Excess and LV (Wood) Deficient. One solution is to needle the Metal
Point of LV, filling LV and draining LV by the Ko Cycle (Qi goes from Yang to Yin).
Then needle the Fire Point of LV, filling LV and draining the Excess from HT via the
Ko Cycle (Yin to Yang transfer) at the same time.
h. SI (Fire) in Excess with LV (Wood) Deficient.
Solution 1: Needle the Metal Point of LV, filling LV and draining LI by the Ko Cycle,
as in (g). Then needle the Luo Point of LI, filling LI and draining LU. Then needle the
Fire Point of LU, filling LU and draining SI (via Ko Cycle) at the same time.
Solution 2: Needle Metal Point of LV; then Fire Point of LI (fills LI by draining HT,
via Ko Cycle); then Luo Point of HT (fills HT and drains SI at the same time).
Solution 2, although possible, is not as good as solution 1, as it drains HT before
refilling it. In general DO NOT DRAIN HT UNLESS HT IS IN Excess (danger of
fainting or heart failure).
i. LI (Metal) in Excess with HT (Fire) Deficient. Two solutions, both equally good,
are possible: HT03 plus BL40 (solution 1) or HT09 plus LI04 (solution 2). Other
solutions are possible, but less efficient.
Solution 1: Fill HT from BL, suing Water Point of HT (via Ko Cycle). Then fill BL
from LI, using the Metal Point of BL (via Sheng Cycle).
Solution 2: Fill HT from LV (via Sheng Cycle) by Wood Point of HT. Then fill LV
from LI (via Ko Cycle), using the Metal Point of LV.
EXERCISES ON FIVE PHASE THEORY
If you wish to master the use of the Five Phase Points, you must practice with many different
problems, until you are fully familiar with Sheng, Ko and Luo uses. As a test of your grasp of
the therapy, please study the entire paper (up to this point) again. Then attempt the following
questions. Use the Five Phase diagram to help you.
Fire

Wood

SI

TH

HT

PC

GB

ST
LV

SP

Earth

KI
Water

LU

BL

LI

Metal

QUESTIONS: Which points would be used in Five Phase and Luo Theory to solve the
following problems? (My answers are on the next page).
Q01 ----- HT in Excess and LI Deficient
Q02 ----- SP in Excess and KI Deficient
Q03 ----- LV in Excess and LI Deficient
Q04 ----- ST in Excess and BL Deficient
Q05 ----- SP in Excess and ST Deficient
Q06 ----- GB in Excess and KI Deficient
Q07 ----- BL in Excess and KI Deficient
Q08 ----- LI in Excess and ST in Excess
Q09 ----- SP Deficient and ST Deficient
Q10 ----- BL in Excess
Q11 ----- LU Deficient
Q12 ----- BL and KI Deficient with SP and ST in Excess
Q13 ----- BL Deficient and ST in Excess
Q14 ----- GB in Excess and LI Deficient
ANSWERS: The following are my answers. Other solutions are possible but these are the
most efficient solutions (in my opinion!). You MUST begin with the Deficient COS. In the
Sheng Cycle, Qi is transmitted only from Yang to Yang or from Yin to Yin. In the Ko Cycle,
Qi is transmitted only from Yang to Yin or from Yin to Yang.

Fire

Wood

SI

TH

HT

PC

GB

ST
LV

SP

KI

LU

Earth

Water

BL

LI

Metal

Q1
Fire Point of LI (fills LI from HT, via Ko Cycle).
Q2
Earth Point of KI (fills KI from ST, via Ko Cycle). Then Luo Point of ST (fills ST by
emptying SP).
Alternative 2: Metal Point of KI (fills KI from LU, via Sheng Cycle). Then Earth Point of LU
(fills LU from SP).
Alternative 3: Luo Point of KI (fills KI from BL). Then Earth Point of BL (fills BL from SP,
via Ko Cycle).
Q3
Earth Point of LI (fills LI, empties ST, via Sheng Cycle). Then Wood Point of ST (fills ST and
drains LV, via Ko Cycle).
Alternative 2: Fire Point of LI (fills LI by draining HT in Ko Cycle). Then Wood Point of HT
(fills HT from LV in the Sheng Cycle). This is a bad solution because of the effect on the HT
COS.
Q4
Metal Point of BL (fills BL from LI via Sheng Cycle). Then Earth Point of LI (fills LI from
ST, via Sheng Cycle).
Alternative 2: Luo Point of BL (fills BL, empties KI). Then Earth Point of KI (fills KI,
draining ST, via Ko Cycle). Both solutions are equally good.
Q5
Luo Point of ST
Q6
Earth Point of KI (fills KI, empties ST via Ko Cycle). Then Wood Point of ST (fills ST,
empties LV, via Ko Cycle). Then Luo Point of LV (fills KI, empties ST, via Ko Cycle). Then
Luo Point of ST (fills ST, empties SP). Then Wood Point of SP (fills SP, empties GB, via Ko
Cycle). Both are equally good solutions.
Q7
Luo of KI
Q8 to 11 were trick questions. The Sheng/Ko/Luo methods do NOT apply in such cases: there
is no way to balance these cases by internal adjustment of Qi by AP. Some external help is

needed here, according to classical concepts. However, modern texts on AP do not always
obey classical concepts. This will be discussed in the next section.
Q8
Trick question! Balance by classic AP needling is not possible here. Use vomition, purgation,
fasting, enemas etc to empty the ST and LI.
Q9
Trick question! In this case SP (which follows ST in the Diurnal Qi Cycle) is probably empty
because the ST is empty. Eat something, especially sugar!
Q10
Trick question! There is no imbalance within or between the Phases here! Empty the bladder
(urinate!)
Q11
Trick question! There is no imbalance. LU Deficient (sleepiness, drowsiness, poor energy)
often occurs in seminar rooms with poor ventilation and tobacco smoke. Open the windows
and get some fresh air! Deep breathing exercises!

Fire

Wood

SI

TH

HT

PC

GB

ST
LV

SP

KI
Water

Q12

Earth

BL

LU
LI

Metal

Earth Point of BL (fills BL, drains SP, via Ko Cycles) and Earth Point of KI (fills KI, drains
ST, via Ko Cycle).
Q13
Earth Point of BL (fills BL, empties SP, via Ko Cycle). Then Luo Point of SP (fills SP, drains
ST).
Alternative 2 (equally good): Metal Point of BL, then Earth Point of LI (fills BL from LI and
fills LI from ST via Sheng Cycle).
Q14
Earth Point of LI (fills LI, empties ST, via Sheng Cycle). Then Fire Point of ST (fills ST,
empties SI, via Sheng Cycle). Then Wood Point of SI (fills SI, drains GB, via Sheng Cycle).
Alternative 2: Luo Point of LI (fills LI, empties LU). Then Fire Point of LU (fills LU, empties
SI, via Ko Cycle). Then Wood Point of SI.
Alternative 3: Luo Point of LI (fills LI, empties LU). Then Earth Point of LU (fills LU,
empties SP, via Sheng Cycle). Then Wood Point of SP (fills SP, drains GB, via Ko Cycle).
Other alternatives are possible but avoid draining the HT in this case.
If you have answered Q1 to Q14 correctly, you have excellent knowledge of the classic
system of point selection by the Five Phases and Luo principles. All that remains for you to
learn is the location of the Phase Points and Luo Points! (see the paper "The Study of AP:
Sources and Study Techniques").
If you have done badly in these questions, please study this paper again and repeat the test. If,
despite repeated attempts, you fail to grasp the concept, please do not despair! Leave if for a
few weeks and try again later. You will succeed if you want to.
TONIFICATION-SEDATION TECHNIQUE: ANOTHER USE OF PHASE POINTS
The classical balancing method of using the Five Phase Points has been described above.
Another method (which disagree with some of the principles in the first method) has been
described in some textbooks, including a recent from text from Beijing (Anon 1993. It is used
especially where one Phase or one COS is in an Excess or Deficient (hyper- or hypo-) state,
without the opposite state existing in another COS.
Tonification and Sedation Points for each COS are given in the following table:
Affected COS

LU LI ST SP HT SI BL KI PC TH GB LV

Mother Point (Bu needle to tonify,

strengthen)

09 11 41 02 09 03 67 07 09 03 43 08

Son Point (Xie needle to sedate, weaken)

05 02 45 05 07 08 65 01 07 10 38 02

The type of needle manipulation differs between diseases of Deficiency (Xu) and Excess
(Shi). The Tonification (Bu) technique is used in Deficiency (Xu) diseases, when a COS is
weak. The Sedation (Xie) technique is used in Excess (Shi) diseases, when a COS is in
Excess. The needling techniques are described in another paper (Techniques of stimulation of

the AP Points) (q.v.). For further discussion of Xu and Shi diseases, see the paper on Holistic
concepts of health and disease.
Using the points and Bu or Xie needling techniques respectively, as above), the TonificationSedation Law states: if a COS is Deficient, supply Qi to it by draining from its Mother COS,
using the Mother Point of the affected COS; if a COS is in Excess, drain the Excess Qi into its
Son COS, using the Son Point of the affected COS. For example, if a clinical syndrome was
associated with Deficiency of LI (with no other COS showing abnormality), the classical
balancing system can not be used, but the Tonification-Sedation technique can be used. The
solution to LI Deficiency by this method is to tonify (Bu needle) LI (Metal) at its Mother
(Earth) Point (LI11). The solution to LI Excess by this method is to sedate (Xie needle) LI
(Metal) at its Son (Water) Point (LI02).
These Tonification-Sedation techniques use the Sheng Cycle only. The Ko Cycle and the Luo
Points are not involved. The Tonification-Sedation Law is summarised as follows: to Tonify a
COS use its Mother Point. To Sedate a COS, use its Son Point.
Other examples:
a. Deficient SP. SP is Earth. Fire is the Mother of Earth. Tonify SP by Bu needling SP
at its Mother (Fire) Point (SP02). This supplies Qi (via Sheng Cycle) from HT (the
Mother of SP).
b. Excess BL. BL is Water. Wood is the Son of Water. Sedate BL, by Xie needling BL
at its Son (Wood) Point (BL65). This drains Excess Qi from BL into GB (the Son of
BL).
Fire

Wood

SI

TH

HT

PC

GB

ST
LV

SP

KI
Water

Other examples are:

Earth

BL

LU
LI

Metal

PC (Fire ) Deficient: use Wood Point of PC (Wood is Mother of Fire).

PC (Fire ) Excess : use Earth Point of PC (Earth is Son of Fire).
ST (Earth) Deficient: use Fire Point of ST (Fire is Mother of Earth).
ST (Earth) in Excess: use Metal Point of ST (Metal is Son of Earth)
CONCLUSION
Five Phase Theory has a beautiful simplicity and symmetry. It has an aesthetic appeal to the
poetic, artistic and intuitive in those who study it in depth. It also has a considerable basis in
scientific relationships within the body.
The interdependence of the Five Phases (together with COSs and Correspondences) proves
that the ancient Chinese Masters regarded all functions and parts of the body as one unit. Each
could influence the other, directly or indirectly in health and disease. For instance, too much
anger injures the liver; too much salt injures the kidney (vasopressin) and may cause
secondary effects on the heart (hypertension). Furthermore, the concepts prove that the
Ancients were aware of cosmic, seasonal and other external influence on health. They were
also aware that health was a relative state of adaptation to environment (external and internal).
In treating disease, the aim was to restore balance and harmony between the various organs
and functions, including the spirit (Fire), the will (Metal), the appetites and desires (Earth),
the skeletal and muscular system (Water and Wood). In this respect, the Chinese were among
the first of the ancient physicians to practice psychosomatic and holistic medicine and to teach
the theory of adaptation to environment.
Despite the aesthetic appeal of Five Phase Theory, some of its interactions and
Correspondences are not valid from a viewpoint of western medicine. However, the system
has worked very well as a general guideline for hundreds of western acupuncturists in recent
years. It is used to help diagnosis and also to indicate effective dietary, psychosomatic or AP
therapy etc. Its greatest value is to indicate which points can be used to transfer Qi most
efficiently from Excessive to Deficient COSs. Using the Sheng, Ko and Luo concept, points
can be chosen to transfer Qi from any one COS to any other one. Tonification-Sedation
techniques can be used when classical Five Phase balancing can not be applied.
Because of the difficulty in locating some of the Phase Points in animals (especially horses)
and because very few vets have taken long residential courses in AP, the system has received
little attention in veterinary medicine outside of France. The majority of practical
acupuncturists (in both the human and veterinary areas) ignore these principles. They work on
a system of symptomatic (Cookbook) AP, using modern concepts of segmental and
intersegmental reflex and autonomic effects. Their clinical results, are, nevertheless, very
good, despite their omission of the classic concepts. Also, many recent AP textbooks from
China, Taiwan and Japan give little or no discussion on these classical concepts.
I find it very difficult to assess whether or not classical (Five Phase Theory) AP is
significantly superior to modern Cookbook AP (as outlined in the paper on Selection of Points
for Therapy). Intuition and experiences since 1991 tell me that in certain difficult cases, the
classic concepts may be more helpful than the Cookbook alone. Therefore, I think it is worth
the effort to try to understand these principles.
REFERENCES

Anon (1993) Essentials of Chinese Acupuncture (College of Traditional Chinese

Medicine Peking, Shanghai, Nanking, with Academy of Trad. Chinese Medicine)
Foreign Languages Press, Beijing, 432pp.
Austin, Mary (1974) Acupuncture therapy: Turnstone Books, London, 290pp.
Connolly, Dianne (1979) The Law of the Five Elements. Centre for Trad.
Acupuncture, American City Building, Columbia, Maryland 21044, USA, 197pp.
Hsu,H.Y. ed. (1982) Natural Healing with Chinese Herbs. Oriental Healing Arts
Institute, LA., California, U.S.A.
Kaptchuk,T. (1983) The Web that has no Weaver. Congdon & Weed, New York,
USA.
Mann, Felix (1973) Acupuncture cure of many diseases. Heinemann Medical
Books, London, 123pp.
Porkert,M. (1983) The Essentials of Chinese Diagnostics. Acta Medicinae Sinensis,
Chinese Medical Publications Ltd., Zurich, Switzerland. 292pp.
Van Nghi, Nguyen (1971) Pathogenic et Pathologic Energetiques en Medicine
Chinoise. Imprimerie Ecole Tech. Don Bosco, 78 Rue Stanislas Torrents, 13
Marseille, France, 699pp.
Wiseman,N., A.Ellis, C-Y.Li & P.Zmiewski. (1985) Fundamentals of Chinese
Medicine (English translations and amendments of texts by the Beijing, Nanjing and
Shanghai Colleges of Chinese Medicine). Paradigm Publications, 44 Linden St.,
Brookline, Mass 02146, USA, 606 pp.
Wu,Wei-Ping (1973) Chinese Acupuncture. Health Science Press, Wellingborough,
Northants, UK 181pp.

QUESTIONS
The COS codes used in these questions are:
Metal / Earth / Fire / Water / Fire / Wood
LU-LI / ST-SP / HT-SI / BL-KI / PC-TH / GB-LV
1. In Five Phase Theory, one of the following statements is not correct. Indicate the
incorrect statement:
a. ST is the Son of SI and the Mother of LI
b. LV is the Son of KI and the Mother of H
c. LI is the Son of GB and the Mother of SP
d. KI is the Son of LU and the Mother of LV
e. HT is the Son of LV and the Mother of SP
2. In the Ko Cycle, one of the following statements is not correct. Indicate the incorrect
statement:
a. HT controls (weakens, damages) LU
b. ST controls (weakens, damages) BL
c. SP controls (weakens, damages) KI
d. LU controls (weakens, damages) GB
e. BL controls (weakens, damages) SI
3. In Five Phase Theory of Water, one of the following statements is not correct. Indicate
the incorrect statement:

a. The Yin-Yang organs are KI-BL

b. The COLOUR is Blue-Black
c. The TASTE is Salty
d. The main EMOTION is Fear
e. The SEASON is Spring
4. In Five Phase Theory, one of the following statements is not correct. Indicate the
incorrect statement:
a. One needle at the Luo (Passage) Point of LI should balance a patient whose LU is in Excess
and LI is Deficient
b. One needle at the Luo (Passage) Point of LV should balance a patient whose GB is in
Excess and LV is Deficient
c. One needle at the Luo (Passage) Point of HT should balance a patient whose SI is in Excess
and HT is Deficient
d. One needle at the Luo (Passage) Point of ST should balance a patient whose ST is in
Excess and GB is Deficient
e. One needle at the Luo (Passage) Point of LU should balance a patient whose LI is in Excess
and LU is Deficient
5. In Five Phase Theory, only one of the following statements is correct. Indicate the
correct statement:
a. LU09, PC07, HT07, SP03, LV03, KI03 are Earth Points for their respective COSs
b. KI04, SP04, HT05, LV05, TH05, LI06, PC06, LU07, SI07 are Fire Points for their
respective COSs
c. KI27, SP21, HT01, LV14, TH23, LI20, PC01, LU01, SI19 are Water Points for their
respective COSs
d. LI01, TH01, SI01, ST45, GB44, BL67 are Wood Points for their respective COSs
e. LI20, TH23, SI19, ST01, GB01, BL01 are Metal Points for their respective COSs
6. In the Sheng (Creative) Cycle, 2 Phases are placed in the wrong position. Indicate the
switch needed to give the correct sequence, i.e. switch ( ) for ( ):
(a)
(b)
(c)
(d)
(e)
Fire -> Wood -> Earth -> Metal -> Water

7. In the Ko (Controlling) Cycle, 2 Phases are placed in the wrong position. Indicate the
switch needed to give the correct sequence, i.e. switch ( ) for ( ):
(a)
(b)
(c)
(d)
(e)
Fire -> Metal -> Wood -> Water -> Earth

8. In the Sheng (Creative) Cycle, one of the following statements is not correct. Indicate
the incorrect statement:

a. LU is Mother of KI
b. LI is Mother of BL
c. ST is Mother of LI
d. SP is Mother of LU
e. HT is Mother of LV
9. In the Sheng (Creative) Cycle, one of the following statements is not correct. Indicate
the incorrect statement:
a. LU is the Son of SP
b. LI is the Son of ST
c. ST is the Son of BL
d. SP is the Son of HT
e. HT is the Son of LV
10. In the Ko (Controlling) Cycle, one of the following statements is not correct. Indicate
the incorrect statement:
a. LU controls LV
b. LV controls BL
c. ST controls BL
d. SP controls KI
e. HT controls LU
11. One of the following statements is not correct. Indicate the incorrect statement:
a. LU and LI diseases are more likely in autumn
b. KI and BL diseases are more likely in spring
c. HT and SI diseases are more likely in early summer
d. SP and ST diseases are more likely in late summer
e. GB and LV diseases can be triggered by Wind and AP points to treat them often contain the
name Feng (=wind)
12. One of the following statements is not correct. Indicate the incorrect statement:
a. Excess LU with Deficient LI can be balanced by Tonifying LI06
b. Excess GB with Deficient LV can be balanced by Tonifying LV05
c. Excess GB with Deficient SI can be balanced by Tonifying GB38
d. Excess HT with Deficient LU can be balanced by Tonifying LU07 and then Tonifying LI05
e. Excess SP with Deficient LU can be balanced by Tonifying LU11
f. Excess SP with Deficient BL can be balanced by Tonifying BL65
1 = c 2 = d 3 = e 4 = d 5 = a 6 = switch a for b 7 = switch d for e 8=e 9=c 10=b 11=b 12=c

THE STUDY OF ACUPUNCTURE: SOURCES AND STUDY TECHNIQUES

SUMMARY
1. Sources of acupuncture (AP) literature (textbooks, journals), equipment supply houses,
societies, training courses and schools are discussed.
2. AP study techniques are discussed.
3. Memory aids help the learning of the Channel-Organ Systems (COSs) , direction and
importance of Qi flow, Qi tides, first and last points on the Channels.
4. The course of the Channels is outlined.
5. Memory aids help the learning of Master Points: Shu-Back Association (Paravertebral
Reflex) points; Mu-Front Alarm points; Luo-Connecting points; Yuan-Source points; Five
Phase (Wood, Fire, Earth, Metal, Water) points; Xi-Cleft points; Hour points; Earpoints and
other important points.
6. This paper contains the basics of AP as regards the Jing-Luo (Channels and Collaterals), the
COSs, and the main AP points. Its intrinsic difficulty is acknowledged but students are
encouraged to read and re-read it until its contents are mastered.
INTRODUCTION
Elsewhere, we discussed the necessity of the transposition method from human AP as the
essential starting point for a study of vet acupuncture (AP). In this paper, we consider
information sources on human AP. Some techniques which I found useful to my study of the
basic and classic concepts are discussed also.
TEXTBOOKS, JOURNALS, SUPPLY HOUSES AND EQUIPMENT
There are dozens of textbooks in English on human AP and Traditional Chinese Medicine
(TCM). If one also counts those in French, German and other European languages, the
number of texts is very great. The beginner should be aware of few difficulties in choosing
texts.
1. Many textbooks in European languages are poor copies of the originals in Chinese. They
contain errors in the location of points and in the therapeutic indications. If possible, the
beginner should choose texts published in European languages by the Chinese themselves.
Examples are the Beijing text (1), the Shanghai text (2), Hong Kong texts (3,4,5) or the
Shanghai charts (6). Having studied these texts, the student will be better able to integrate
material from European sources.
2. Many texts (even some Chinese ones) use point names and alphanumeric point codes which
differ from other texts. The beginner is advised to use one text as his/her basic reference work
for point name and code and to check, point by point, each new text against that reference,
making appropriate adjustments to point names and codes in the margins of the new book.
This is essential, as most therapeutic indices which the student will create for personal use,

use the alphanumeric point code. Thus, if the student uses the code LI04 for HoKu (Large
Intestine 4) and another text uses Co (Colon) 4 for the same point, it is obvious that she/he
must be aware of the difference. Similarly, some texts use ST01 for Tou Wei. Some
differences occur between texts in the coding of Bladder points from the shoulder area to the
back of the knee. The student is strongly advised to adopt one convention and to retain that
one as his/her reference. It is not difficult to make appropriate changes in all new textbooks.
Basic charts: I suggest the Newest illustrations of the AP Points (1975), Medicine and Health
Publishing Co., Hong Kong) (3) as a primary reference. The other texts (Beijing, Taiwan etc)
can all be referenced back to this.
Basic texts: Basic texts recommended by IVAS are: The Essentials of Chinese AP (1);
Chinese AP and Moxibustion (1a) and Grasping the Wind (1b). Other textbooks which I found
helpful are listed in the Appendix. Some texts however, do not mention the classic AP Laws.
They are purely technical or mechanical/pragmatic in their approach to AP.
Texts on Classical AP: For mastery of AP, one must study and incorporate into one,s day-today thinking the classical laws and concepts of AP. These are covered very well in The Web
that has no Weaver (15b) and the Fundamentals of Chinese Medicine (15d); see also
references 14, 14a, 15, 15a, 15c and 16.
Veterinary Texts: Having grasped the principles and the anatomy of human AP, one may then
study the vet texts. Later in this paper, we will discuss aids to help memorize the human
system. Unfortunately, I have no help to give you in memorizing the vet texts! They are
difficult to learn because they are poorly integrated as compared with human texts. However,
vets who deal mainly with horses and cattle can gain valuable information from Klide and
Kung (9), Kothbauer (12a), Rubin (13), Westermayer (11, 12), White (12b) and Yu & Hwang
(12c). Those who deal mainly with small animals will benefit from Altman (7a), Brunner (8),
Demontoy (7c), Gilchrist (8a), Janssens (7b), Molinier (7d).
Journals which specialise in the publication of AP articles, or which frequently publish such
articles are listed in the Appendix. One of the best, as regards clinical articles is the American
Journal of AP. The latest (1990) is the International Journal of Clinical AP.
It must be understood that some of the papers which are accepted by specialist journals would
not be accepted by more critical scientific or medical journals, as their quality would not pass
professional referees on technical or academic grounds. Some of the "research" articles are of
poor or very poor quality, have poor experimental design, no controls, have group sizes which
are too small, lack detail, have no or poor statistics or are written badly. Nevertheless, these
journals are the main source of new information on AP and allied methods.
AP Supply Houses are common in most European countries now. Some addresses are given
in the Appendix, in case some of you have not made contacts in this area already.
AP EQUIPMENT
a. Needles: Standard hypodermic needles are satisfactory for occasional use: Large animals;
12-100 mm, 19-24 gauge. Small animals, 12-50 mm, 21-26 gauge.

Solid AP needles are preferable for routine AP. Small animals: human AP needles 12-50 mm,
21-30 gauge are satisfactory. Large animals: 12-150 mm, 21-24 gauge. The Richter Company
(Feldgasse 19, A-4600 Wien, Austria) makes excellent needles for small and large animals
but, as for most equipment, Hong Kong supply houses are usually cheaper for equipment,
even if one pays air-freight and import taxes.
b. Moxa: Standard moxa punk is available at all Supply Houses.
c. Stimulators: There are dozens of electro-AP stimulators of Chinese, Japanese, American,
Canadian and European manufacture on the market. Most of these are designed for human use
but IVAS has assessed some veterinary models. In general, human stimulators are also
suitable for vet work and ones with bipolar electrodes are less likely to cause electrolytic
lesions than ones with conventional positive and negative electrodes. I am not competent to
advise on which model is best. However, I find the Chinese model 71-3 General Purpose AP
Apparatus or the cheaper AWQ-100 Multipurpose Electronic Acupunctoscope to be
satisfactory for routine use. The latter has a variable resistor in the Point Detection facility,
which may help beginners to locate low-resistance points in the vicinity of the AP point to be
stimulated.
Other equipment which is available from Supply Houses includes magnetic-, static-,
electrostatic-, electromagnetic, ultrasonic-, microwave- and laser- stimulators, TENS,
TENS/roller stimulators etc.
SOCIETIES, TRAINING COURSES, SCHOOLS
SOCIETIES: Vet AP has a very short history in the West, dating from about 1973 (except for
countries like France, Austria and Germany). At present, between 0.5 and 10% of vets in most
Western countries use AP. Most countries in northern Europe now have formal vet AP
societies. Medical AP societies exist in these and in many other countries and they often
accept vets and dentists as associate members. The Appendix lists some of the vet societies.
VET AP TRAINING COURSES
Australia: Vet AP courses have been organised by AVAA.
Austria: Oswald Kothbauer (Fax: 43-724-62438) organises training courses with assistance
from other vet colleagues and medical colleagues from the Ludwig Boltzmann AP Institute
(Vienna).
Belgium: Luc Janssens (Fax: 32-3825-0040) and Emiel van den Bosch (Fax: 32-1656-1374)
have run IVAS-standard (120-hour) courses with assistance from other colleagues in the
BVDA.
France: l'AVAF (led by Milin, Molinier, Demontoy, Janacek and others) organises a course
and week-end seminars.
Finland: In 1980, the Government introduced AP to the official university training of med,
vet and dental students. Finland is the first Western country to do this and she must be
congratulated for having set the precedent for other countries. Jukka Kuussaari (Fax: 358-247391381) was the organiser of the Helsinki Course.

Norway: Are Thoresen (Fax: 47-334-66775) organised the first IVAS Course in the Vet
School, Oslo, 1988-1989. A formal course will be run in 1996.
Sweden: Ritva Krokfors (Fax: 46-141-10371) organises training courses in Sweden.
USA: IVAS, founded in 1974, organizes training courses each year. Contact David Jagger,
5139 Sugarloaf Rd., Boulder, CO 80302-9217, USA (Fax: 1-303-449-8312). Though most
participants are from North or South America, some European, Australian, South African and
Far Eastern participants have taken the course. IVAS now has a policy to give the full course
(in English) in any country which can organise enough participants to cover the cost of IVASapproved lecturers.
Apart from these, recent AP seminars and training courses for vets in European countries have
been run mainly by individuals or by national Vet AP groups, or in association with medical
AP groups. Such courses have been given in Denmark, Germany, Sweden, UK. Details of
future courses may be available from the national Vet AP societies (see Appendix).
AP SCHOOLS: Vets who wish to study AP formally have to decide whether to rely on weekend seminars or full-time study. Week-end seminars are run by the medical AP groups in most
countries. Vets are usually welcome to attend as associate members.
Study of human AP in detail over a period of months to years is possible in special AP
Schools. Some vets go to Vienna, Hong Kong, Taipei, Beijing or other Chinese centres for
intensive training but most rely on their local schools. Unfortunately, there is little
standardisation between schools. Some are excellent. Some are merely "diploma mills". Many
of these "schools" are run by persons with no qualifications in medicine, vet medicine or
science. They can be fine acupuncturists but poor clinicians. The student should seek advice
from an experienced acupuncturist before she/he enrols in one of these schools.
INTERNATIONAL CONTACTS: When one travels abroad, it is often very useful to have a
contact in another country who can introduce one to people with similar interests. Therefore,
should you be interested to meet other vet acupuncturists you may consult the addresses of
contacts in the Appendix.
STUDY TECHNIQUES
On the assumption that most of you will not be able to attend full-time, intensive training in
AP it follows that your knowledge of AP must be self-taught, at home. Most of the vet
acupuncturists whom I know began in this way.
When I began my study of AP in 1973, I spent 3 hours a night, 5 nights a week for 6 months
studying in the wrong way! I had no friend or colleague who could help my study, as I knew
no vets or doctors in Ireland at the time who were acupuncturists. I bought the wrong
textbooks (bastardized copies of the original Chinese) and tried to understand classic AP in
too short a time. Most frustrating of all, my Western-trained mind asked too many questions
which could not be answered to my satisfaction by the classic concept.
After 6 months of frustration, I was about to give up this study as hopeless, when, without
warning, the picture began to "click" into position. Since then, I have made many valuable

contacts who guided my study and I have learned from my many mistakes. I am still a
student, with much to learn yet.
To those of you who wish to study AP in depth, I give the following advice:
1. Forget your Western training while you study the AP textbooks especially those
dealing with classic AP, such as those by Austin, Connolly, Kapchuk, Mann, van Nghi
or Wiseman.
2. "Skim" the books a few times in the beginning; read from cover to cover, quickly
to get the general "feeling". Later, read them more slowly, trying to absorb as much
detail as possible.
3. Use memory aids to remember the circuits of the Channel-Organ Systems (COSs),
the Master Points (including the 66 Command Points), the first and last points etc.
Examples of memory aids are given later; if these do not meet your needs, make up
your own memory aids.
4. From the beginning, using one basic reference, as mentioned earlier, learn the
points by their alphanumeric code and the Chinese name. As you study the details
of each main point, check that the alphanumeric code refers to the correct point
location. Repeat the exercise for each new textbook. (Codes are not the same in all
books). Locate each point on your own body (or on a friend's body if the location is
not visible on your own) and mark it with a pen. Remind yourself of its location
frequently in the next days.
5. Learn one point on each Channel first (e.g.) LU07, LI04, ST36, SP06, HT07,
SI06, BL23, KI03, PC06, TH05, GB34, LV03, CV12, GV26. Later add more points
when you know these well.
6. Pick 3 or 4 common conditions, such as gastroenteritis, low-back syndrome,
muscular lameness, dystocia. Compare the approach to treating these conditions in the
various textbooks which you use and make a synthesis of your own approach. Expect
to encounter differences in approach between the various sources and make your study
interesting by noting where the authors agree and where they take alternative courses.
7. Experiment with AP on yourself and on family volunteers. Try to treat the
simple day-to-day conditions such as toothache, headache, pulled muscles, stomach
ache etc, using especially the massage technique or the non-invasive techniques using
transcutaneous electrostimulation, ultrasound etc. If you have the courage, arrange
with your dentist that he/she does your dentistry under AP analgesia. For this you will
need a good electro-stimulator. Use needles in points Chia Che (ST06) and the Earlobe
Dental Anaesthesia Point (10 mm needles, 30 gauge). Electro-stimulate to maximum
tolerance for 30 minutes before surgery. You can sit in the car if you don't want to
alarm other patients in the waiting room! (While the stimulator is working, your face
will contract strongly in time with the stimulator, say 5 Hz!). Leave the stimulator on
during surgery. For surgery on both sides of the mouth, needles will be required on the
left and right sides.

8. Join med and/or vet AP study groups. As often as you can, meet medical and vet
colleagues who use the method. Discussions on and observation of their techniques,
successes and failures are very helpful.
9. Read the AP Journals, especially the American Journal of AP. Encourage your
nearest University Library to subscribe to as many of these Journals as possible.
LEARNING THE COSs, DIRECTION OF QI FLOW AND THE QI TIDES
There are 12 pairs of main COSs (the main Channel (Meridian) Organ Systems of AP). The
Channels either begin or end on a finger or toe: Lung (LU); Large Intestine (LI); Stomach
(ST); Spleen-Pancreas (SP); Heart (HT); Small Intestine (SI); Bladder (BL); Kidney
(KI); Pericardium (PC, Circulation-Sex, Heart Constrictor); Triple Heater (TH,
Respiration-Digestion-Reproduction-Elimination and Endocrine); Gall-bladder (GB);
Liver (LV). The superficial paths of the Channels are bilaterally symmetrical longitudinal
lines of low electrical resistance (high conductivity) which connect AP points of similar
function. The deep paths are planes of low electrical resistance (high conductivity) which
connect the superficial path to their related organs. Each Channel (Jing) has a Mate Channel
in the same Phase. Its connection to the Phase-Mate is by a special Luo (Collateral, or
Connecting Channel).
There are Eight Extra Channels in addition to the 12 Main Channels. These are: the Du
(Governing Vessel, GV) in the dorsal midline; the Ren (Conception Vessel, CV) in the
ventral midline, plus six other Channels, which link other parts of the body. These are the:
Chong; Dai; Yangqiao; Yinqiao; Yangwei and Yinwei. The Eight Extra Channels are seen
as Qi reservoirs or regulators, which can help to maintain optimal levels of Qi in the main
Channels. Each Extra Channel has its own superficial and deep pathways, which link with a
number of the main COSs and with specific organs, such as the uterus, brain, eyes etc. Each
has its own symptomatology, as described elsewhere (Anon 1993; Wiseman & Ellis 1995).
MEMORY AID FOR THE 12 MAIN CHANNELS AND THE DAILY QI CIRCUIT
A simple memory aid teaches the 12 main pairs of COSs: "LULISTo/SPHTSI/BLaKIPC/TRI-GALL-LV" = LU LI ST / SP HT SI / BL KI PC / TH GB LV.
LULISTo/SPHTSI/BLaKI-PC/TRI-GALL-LV. Repeat this aloud, like a child, until you
know it by heart. It is the basic memory aid. You must know it, or one like it.
LULISTo/SPHTSI/BLaKI-PC/TRI-GALL-LV: LU = Lung; LI = Large Intestine/Colon; ST
= Stomach; SP = Spleen/Pancreas; HT= Heart; SI = Small Intestine; BL = Bladder; KI =
Kidney; PC = Pericardium/Heart Constrictor/Circulation-Sex; TH = Triple Heater; GB =
Gallbladder; LV = Liver.
LULISTo/SPHTSI/BLaKI-PC/TRI-GALL-LV. Say it aloud until you can say it in your
sleep! Write it out forwards, backwards, downwards, upside-down. You must know this one
(or your own version of it) inside-out!
TCM teaches that the vital (defence) energy (Qi) circulates in the Channels, which have
superficial courses and deep (internal) connections to their respective organs and associated

parts of the body. The COSs (LULISTo SPHTSI BLaKI-PC TRI-GALL-LV) are connected
in a definite sequence, like a series of hose-pipes joined end to end in one continuous circuit.
The Qi flows through the COS circuit, in a diurnal cycle, like a tide. It begins in the LU COS
at 4 a.m. (3-5 a.m.), going to the LI COS at 6 a.m. (5-7 a.m.) -> ST -> SP -> HT -> SI -> BL
-> KI -> PC -> TH -> GB -> LV at 2 a.m. (1-3 a.m.). It then returns to the LU COS to begin
a new day.
In the diurnal Qi circuit, the LU is called the Mother of LI (because it feeds LI) and LI is
called the Son of LU (because it is fed by LU). In turn, LI is Mother of ST and ST is the Son
of LI.
During the circuit of Qi through its daily cycle, it travels three times around the body (i.e.)
each 24-hour cycle it composed or 3 X 8 hour revolutions:

Circuit 1 (0300-1100 h): The Qi tide is full in LU-LI-ST-SP.

Circuit 2 (1100-1900 h): The Qi tide is full in HT-SI-BL-KI.
Circuit 3 (1900-0300 h): The Qi tide is full in PC-TH-GB-LV.

Each or these 8-hour circuits is further divided into 4 X 2 hour phases: chest to finger, finger
to face, face to toe and toe to chest (where a new, similar revolution around the body begins
again). Thus in one day, the Qi travels three times around the body (Chest -> Finger -> Face
-> Toe -> Chest in each circuit).
LULISTo / SPHTSI / BLaKI-PC / TRI-GALL-LV is the basic memory aid of all AP. It can
be arranged in 3 circuits of 4 COSs as shown below.
DIRECTION OF FLOW OF Qi

chest to

finger

eye to

toe to

finger

to face

toe

chest

Circuit

LU

->

LI

->

ST

->

SP

(revolution 1)

(0300 - 1100h)

(------<---------------------------<----)
|
2

HT

->

SI

->

BL

->

KI

(revolution 2)

(1100 - 1900h)

(------<---------------------------<----)
|
3

PC

->

TH

->

GB

->

LV

(revolution 3)

(1900 - 0300h)

(------<---------------------------<----)
|
LU (new daily cycle begins at 3 a.m.)

Let us call these groupings Sequence 1.

Now construct a simple format as follows (see below): put 6 boxes in a line on top and 6
boxes in a line underneath this (See Diagram below). Starting at the top left, join all the boxes
in a clockwise spiral. Put "LU"in the top left box and mark it 0400h (4 a.m.). Fill in the
remaining circles, using Sequence 1 (above). Add 2 hours to each new position.
Let A to B divide the diagram vertically and C to D divide the diagram horizontally. Put
an X where A-B intersects the spiral. Call this Diagram 1. This diagram (a very important
memory aid) contains most of what you need to know on the COS sequence, the direction of
flow, the Yin-Yang COSs, the Chinese Clock (Qi Tide times), the paired COSs and the Arm
and Leg COSs.
DIAGRAM 1.

BASIC MEMORY AID TO THE 12 MAIN COSs.

< - - - - YIN - - - - > < - - - - YANG - - - >

Metal
>------------->--------X---------->---------->|

Fire

Chest to

>---->--------X------------>-

Finger to

Finger

Fire

Face

>----X--->-

LU

HT

PC

TH

SI

LI

0400h

1200h

2000h

2200h

1400h

0600h

Arm

|
C

|<----.-----<--.--<
.
.

.
.

Arm

Leg

SP

KI

LV

GB

BL

ST

Toe to

1000h

1800h

0200h

0000h

1600h

Chest

<----X---<-

Wood

<----<--------X------------<-

Water

Leg

0800h Face (eye)

to Toe

<-------------<--------X----------<----------<Earth
< - - - - YIN - - - - > < - - - - YANG - - - >

In Diagram 1 (above), X indicates the Phase-Mates (Yin-Yang Pairs within each Phase).
Also, note that the superficial Channels of:
LU, HT, PC begin on the chest and go to the fingers;
TH, SI, LI begin on the fingers and go to the face;
GB, BL, ST begin at the eye and go to the toes;
SP, KI, LV begin at the toes and go to the chest;
to the left of line A-B are Yin COSs:
LU, HT, PC = Arm Yin Channels;
SP, KI, LV = Leg Yin Channels;
to the right of line A-B are Yang COSs:
TH, SI, LI = Arm Yang Channels;
GB, BL, ST = Leg Yang Channels.
The Arm Yins (LU, HT, PC) begin on the chest and go to the fingers (fingers 1, 5, 3, or
thumb, little and middle fingers, respectively). They all run on the palmar/flexor (Yin) side of
the forearm and hand.
The Arm Yangs (TH, SI, LI) begin on the fingers (fingers 4, 5, 2, or ring, little and index
fingers, respectively) and go to the face. They all run on the dorsal/extensor (Yang) side of
the hand and forearm.
The Leg Yangs (GB, BL, ST) begin on the face (near the eye) and go to the toes (toes 4, 5
and 2 respectively). They all run on the antero-lateral (Yang) side of the leg and foot

The Leg Yins (SP, KI, LV) begin on the toes (toes 1, s, 1, or big toe, sole and big toe,
respectively) and go to the chest. The only exception is KI, which modern texts place on the
sole of the foot. (In ancient texts, it was placed at the medial angle of the nail of the little toe,
in a place analogous to HT at the medial angle of the nail of the little finger).
In Diagram 1, all the COSs above the C-D line go to or come from the fingers, i.e. are Arm
COSs. All below the C-D line come from or go to the toes (i.e.) are Leg COSs. Thus, LU, HT,
PC (Yin) and TH, SI, LI (Yang) are Arm COSs and SP, KI, LV (Yin) and GB, BL, ST (Yang)
are Leg COSs.
The Qi of LU is maximal at 4 a.m. (0300-0500h). Going around the clockwise spiral, simply
add 2 hours to fill in the time of high (Qi) tide in the other COSs: LI (0600h); ST (0800h);
SP (1000h); HT (1200h, noon); SI (1400h); BL (1600h); KI (1800h); PC (2000h); TH
(2200h); GB (0000h, midnight); LV (0200h). This is the concept of the body Qi tide.
Note: six COSs are related to sexual organs/function and activity. They are:
LI, ST, SP (0600-1000h, the time for lazy weekend lie-in sex?)
and KI, PC, TH (1800-2200h, the time for active, urgent sex?).
LV (0200h) also plays a role in metabolising steroids. In case some of you are worried that
your sex-clock is out of order, not to worry! These are memory aids and any time will do in an
emergency!
In diagram 1, the X on each pair of COSs marks the Phase-Mate Pairs (linked COSs within
the same Phase). These are:
LU X LI
Metal

-> ST X SP -> HT X SI -> BL X KI -> PC X TH

-> Earth
-> Fire
-> Water
-> Fire

-> GB X LV
-> Wood

Note that the underlined one in each-pair is Yin and the other one is Yang. The Yin COS of
each pair is called the Wife and the Yang COS called the Husband. The arrow (->) indicates a
Change of Phase.
Though this paper will not discuss the Five Phase Theory in great detail, the linked pairs are
related to the Five Phases as follows:

Limb
Arm
=
=
Leg
=
=

Phase
Metal
Fire
Fire
Wood
Water
Earth

Yin
(Wife)
Lu
HT
PC
LV
KI
SP

Yang
(Husband)
LI
SI
TH
GB
BL
ST

The Phase-Mates (linked COSs, Wife-Husband pairs within each Phase) are important in
classic AP, mainly because:
a.points on one of them (for example LI points) can help to treat disorders of the other
member of the pair (LU); the Husband helps the Wife, and vice-versa and

b.the Luo-Connecting points (see Master Points later) allow Qi to be transmitted

from one member of the Phase-Mates to the other member (for example from ST to
SP or vice-versa). For instance, if there are symptoms of Excess Qi in SP and
Deficient Qi in ST, needling the Luo-Connecting point of ST will divert the Excess
from SP into ST, thus balancing the system. Also, in the Law of the Five Phases (see
later), the Luo points are also used in both the creative (SHENG) cycle and the
destructive (KO) cycle to balance the cycle.
Thus, it is important to know which COSs are linked (the Husband-Wife pairs within each
Phase) and the Luo points which allow interchange of Qi between them. (Note: in classic AP
one always treats the Deficient COS, drawing Qi directly or indirectly from some other COS
which has Excess Qi.
To return to the sequence of Qi flow, there are 3 complete Circuits or revolutions of Qi around
the body every 24 hours. Then a new cycle begins.
Sequence 1 "LULISTo / SPHTSI / BLaKI-PC / TRI-GALL-LV" can be re-written:
Qi (ENERGY) CIRCUIT
TIME

BODY

SUPERFICIAL PATH THROUGH THE BODY

Arm Yin

-> Arm Yang

-> Leg Yang

chest-hand -> hand-face -> eye- toe

REVOLUTION

-> Leg Yin

-> toe-chest

0300-1100h

LU

->

LI

->

ST

->

SP

1100-1900h

HT

->

SI

->

BL

->

KI

1900-0300h

PC

->

TH

->

GB

->

LV

The midline Extra Channels, GV (Governor vessel, dorsal) and the CV (Conception Vessel,
ventral) are not included in the 12 Main Channels. They are regarded more as reservoirs of Qi
and their points are used mainly for local symptoms or disorders anywhere along their course
and in some general prescriptions. They are not considered in relation to the Five Phase Laws,
body Qi tide etc.
LEARNING THE FIRST AND LAST POINTS OF THE CHANNELS
One must know the position of the first and last points on the superficial path of each of the
12 main Channels for two reasons:
a.It helps to give a mental picture of the general course of the superficial Channel.
This is relevant to diagnosis and AP therapy, especially of local problems.
b.It reminds you of the direction of Qi flow. In normal circulation, Qi always flows

from the first to the last point. For instance, LU01 is on the chest and LU11 (last point)
is on the thumb. (The Qi flow is from Chest to Thumb).
INJURY, SCARS ON CHANNELS: If there is a physical blockage along the course of a
Channel (for instance strongly fibrosed scar tissue due to injury or surgery), one may see
symptoms of Excess COS Qi up-stream (above the blockage) and Deficient COS Qi downstream (below the blockage). Also, the Excess Qi may back-up into the Mother COS
(upstream from the blocked Channel in the basic Qi circuit) and the Deficient Qi
(downstream of the blocked Channel) may weaken the Qi in the Son COS (Sequence 1)).
WHY LEARN CHANNEL ANATOMY AND QI FLOW? The importance of
scars/Channel blockage and of knowing the Qi circuits, direction of flow and
anatomical/organ/function relationships of COSs is shown by the following:
A middle-aged man complained of a bewildering number of symptoms over a period of 8
years. First, he had haematuria and kidney/bladder pain which was treated by hospitalization
and antibiotics as nephritis-cystitis. He had a few incidents of right-sided sciatica, which were
temporarily relieved by hospitalization, ultrasound and traction. He had interscapular and
shoulder-area pain on the right side; tinnitus in the right ear; conjunctivitis and headache on
the right side. His most bizarre symptom (which occurred 2 or > times in 8 years) was to
wake up at night with his right arm in spasm and a very severe pain shooting down the inner
side of the right arm into his little finger.
Over an 8-year period, he had been treated by various specialists in urology, orthopaedics, an
ear specialist, an eye specialist and a cardiologist. None of these specialists bothered to ask
him about his scar! Two years before the first of the above symptoms (nephritis/cystitis), he
had a right lobectomy for pulmonary TB. His thorax was incised from the sternum to within a
few inches of his spine. Eight years later, when he consulted an acupuncturist, it was found
that most of the scar was well healed but that, in the area of the two lines of the BL Channel
on the right paravertebral area of the thorax, marked twisting and pulling of the tissues was
caused by the scar. The acupuncturist knew that in TCM all the patient's symptoms could be
traced to that scar, which was causing a blockage of Qi in the BL Channel. According to
TCM, a block at the thoracic level of the BL Channel would cause Excess Qi above the block
and Deficient Qi below it. The nephritis/cystitis, sciatica, interscapular pain, headache and
conjunctivitis could be traced to the upset in the BL Qi. (The BL Channel begins at the inner
canthus of the eye, passes across the head, down by the interscapular area, down over the
kidney area and goes down the back of the leg (the classic sciatic area). The tinnitus and the
arm spasm/ inner arm pain to the little finger could be traced to Excess Qi in the SI COS. The
tinnitus and nephritis also relate to Deficient Qi in the KI COS (KI is the Son of BL and is
related to the kidneys and ears, as well as to urogenital function). Note, in the sequence of Qi
flow (LU-LI-ST-SP-HT-SI-BL-KI-PC-TH-GB-LV), the SI COS is the Mother of (precedes)
the BL and Excess Qi in BL can back-up into SI) and KI is the Son of BL. Weakness in the
lower part of BL would weaken the KI COS; the weak Mother can not feed the Son. The SI
Channel begins at the little finger, runs the inside of the arm and ends at SI19, at the ear. The
KI Channel begins at the sole of the foot and connects to the kidney and ear.
The acupuncturist did not believe that he could influence the case very much but he decided
to try. Thus, he advised procaine injection of the tender points along the scar, a short course of
needles in BL points and regular massage and physiotherapy of the scar and BL Channel,
especially in the area of the scar. Although predicted by classic concepts, the outcome was

quite fantastic. All the symptoms disappeared and, to my knowledge, did not return. This was
the first time that the acupuncturist had used procaine injection in Scar Therapy. Since then,
he has used it many times in patients with trigger points on scars, with excellent results.
A friend of mine had bunion-surgery on her big toe. After surgery, she had very severe pain in
the toe and medial aspect of the foot. For 18 months she could not put weight on the medial
aspect of the foot and was in constant pain. Six sessions of electro-AP at LV03, SP06; KI03,
GB34, SP03 and web of toe 1 to 2, with one needle running under the scar give an
improvement of 90%. Complete relief of pain followed two procaine therapies of the scar.
The pain has not returned since.
Mary Austin and Felix Mann also give examples of trauma and scar tissue formation causing
blockage of Channels and symptom pictures which were successfully eliminated by treatment
of the scar. Also, the German-Austrian system of Neural Therapy and Scar Therapy pays
particular attention to scar tissue. There are many examples of bizarre human symptoms
which disappear after scar-therapy by massage, injection or other physiotherapy to release the
blockage.
Be very careful to investigate scars: In taking the case history of a new human patient, a
skilled acupuncturist will always inquire about body scars and will examine them for any
possible connection between them and the symptom-picture of the patient in relation to
Channel paths, the Mother and Son COSs and the symptomatology. This is also important in
vet AP and it is advisable to check it out, just in case there may be a cause and effect
relationship. If there is any connection, the scar must be treated as part of the therapy.
FIRST AND LAST POINTS ON THE CHANNELS: As a memory aid, prepare the
following sequence (F = Finger; T = Toe):

BODY CIRCUIT

SIX LEVELS OF QI
Yang

(2)

(5)

-----------4

Yin
-------------

--------------------Yang

(3)

(1)

-----------2

Yin
-------------

--------------------Yang

(1)

-----------

Yin
-------------

---------------------

Let us call this Sequence 2. The boxes are numbered (2), (3), (1) from top to bottom,
indicating which Qi Body Circuit will occupy them.
Note that: finger/toe 1 and 3 are Yin; finger/toe 2 and 4 are Yang and finger/toe 5 has 2
Channels each, one Yin and one Yang.
Now, using Body Circuit 1 from Sequence 1 (LU-LI-ST-SP), fill in the Channels in the
bottom box, as shown below. Then, using Body Circuit 2 from Sequence 1 (HT-SI-BL-KI),
fill in the Channels in the top box below. Finally, using Body Circuit 3 from Sequence 1 (PCTH-GB-LV), fill in the Channels in the centre box below:
(Body Circuit)
Channel
Finger

Toe

Arm

Leg

SI --->--- BL
^
|

(5)

SIX LEVELS OF Qi
GREAT Yang (Tai Yang)

|
(2)

KI

LITTLE Yin (Shao Yin)

------------

-------------

---------------------

TH --->--- GB

LITTLE Yang (Shao Yang)

HT

^
|
3

(1)

|
(3)

PC

|
LV

EXTREME Yin (Chueh Yin)

------------

-------------

---------------------

LI --->--- ST

SUNLIGHT Yang (Yang Ming)

^
|
1

-----------

LU

|
(1)

|
SP

-------------

GREAT Yin (Tai Yin)

---------------------

We know from Diagram 1 that LU goes from chest to finger. Sequence 2, therefore, tells us
that the last point (LU11) is on F1 (thumb). Similarly, LI goes from finger to face, therefore
LI01 is on F2 (index finger).
There are two small anomalies in this memory aid. Firstly, KI01 is now shown as being on the
sole of the foot (see standard texts). However, in ancient texts, it was shown on the 5th toe.
Also, LV01 is not on the 3rd toe, but is on the 1st (big) toe. To distinguish them, think of
stubbing the inside of your big toe on a rock. In English, to vent Spleen = to show ANGER .
SP01 is on the medial side of the big toe nail. Also, a very important liver point (Tai Chung,
LV03) is between the upper ends of metatarsal bones 1 and 2, in the same position as HoKu
(LI04) of the hand. Remember LV03 as the HoKu equivalent of the foot. (This helps you
remember LV01 as lateral side of big toe nail).
Similarly, two COSs are associated with the little finger (F5) (HT and SI). The last point of
HT (HT09) is on the thumb-side (radial side) of the nail of F5 and SI01 is on the opposite
(ulnar) side of the nail of F5 (the side next to the chopping edge of the hand). Another way to
remember this is to hold your hand, palm open, towards your face. Now look at the "Heart
Line" of the palm. (This line runs from the little finger side, towards the index finger. Now, if
you slowly clench your fist, you will see that the heart line makes a crease which ends at the
edge of the fist near the little finger. The end of this crease is SI03 (an important point).
Again, open the hand and slowly flex the 4th and 5th fingers. They will touch the "Heart
Line" in the palm. This point is HT08. Thus, if you can remember SI03 and HT08 you can
work out where HT09 and SI01 should be.
The TSUN, CUN, or Chinese INCH: When learning the location of AP points, the TSUN is
used as the unit of body measurement. In the human adult 1 TSUN is approximately 1 inch
(25 mm), but it varies with body size. It is better understood as a ratio in relation to fixed body
landmarks:
between the nipples is 8 TSUN;
umbilicus to symphysis pubis is 5 TSUN;
umbilicus to sternum is 8 TSUN;
pubic symphysis to upper edge of patella is 18 TSUN;
lower edge of patella to medial malleolus of tibia is 15 TSUN;
anterior axillary crease to elbow crease is 9 TSUN;
elbow crease to wrist crease is 12 TSUN;
see textbooks for further measurements.
THE POSITIONS OF THE TWELVE POINTS NEAR THE NAILS ARE:
Arm Yin (last points at a finger nail)

LU11 At root of thumb-nail on the radial side

HT09 At nail root or little (5th) finger on the radial side
PC09 At tip of third finger

Arm Yang (first points at a finger nail)

LI01 At nail root of index (2nd) finger, on the radial side

SI01 At nail root of little (5th) finger on the ulnar side

TH01 At nail root of ring (4th) finger, on the ulnar side

Leg Yang (last points at a toe nail)

ST45 At nail root of 2nd toe on lateral side

BL67 At nail root of 5th toe on lateral side
GB44 At nail root of 4th toe on lateral side

Leg Yin (first points at a toe nail)

SP01 At nail root of 1st (big) toe on medial side

KI01 At sole of the foot, between the midpoints of metatarsals 2-3
LV01 At nail root of 1st (big) toe on lateral side

However, we are still missing 12 more points (the chest and face points). Diagram 1 tells us
that LU, HT, PC begin on the chest; LI, SI, TH end on the face; ST, BL, GB begin at the eye
and SP, KI, LV end on the chest. The positions of these points are:
Arm Yin (first point on chest)

LU01 In 1st intercostal space, 6 TSUN lateral to CV line (ventral midline) (in animals
it is usually in 2nd intercostal space, behind shoulder)
HT01 In centre of axilla, just medial to axillary artery
PC01 In 4th intercostal space, 1 TSUN lateral to nipple

Arm Yang (last point on face)

LI20 Between midpoint of outer border of ala nasi and naso-labial groove
SI19 In depression between Ear tragus and mandibular joint, with mouth open
TH23 On lateral border of orbit at lateral tip of eyebrow

Leg Yang (first point near eye)

ST01 At border of orbit, directly below pupil of eye

BL01 At inner canthus of eye
GB01 0.5 TSUN lateral to outer canthus of eye

Leg Yin (last point on chest)

SP21 6th intercostal space, midway between axilla and free tip of rib 11
KI27 1st intercostal space, 2 TSUN lateral to CV line, midway CV to nipple
LV14 6th intercostal space, 2 TSUN directly below nipple (3.5 TSUN lateral to CV14,
which is 2 TSUN below xiphoid or 6 TSUN above umbilicus)

THE SUPERFICIAL COURSE OF THE CHANNELS

When learning this section, students should consult standard AP texts (see references 1, 1a, 3).
Trace the pathways on your body, or that of a friend. Mark in the first and last points, and
other "landmark" points.

LU begins at LU01, in 1st intercostal space, travels down the arm to LU05 (on the radial side
of the biceps tendon), to LU09 (in the depression on the radial side of the radial artery, at the
tip of the transverse crease of the palmar surface of the wrist, to LU11 on the radial side of
thumb-nail.
LI begins at LI01 on the radial side of the nail on the index finger. It travels up the finger to
LI04 (at the middle of the 2nd metacarpal bone, towards the thumb side (at the highest point
of the muscle when the thumb and index finger are brought close together) to LI11 (at the
lateral aspect of the elbow, half-way between the biceps tendon and the lateral epicondyle of
the humerus), to LI15 (at the acromio-clavicular joint) to LI20 near the ala nasi.
ST begins at ST01, at the lower edge of the orbit, directly under the pupil of the eye. It runs
down the face to the labial canthus (ST04), around to ST06 at the angle of the jaw. It receives
a branch from the temple (ST08, Tou Wei). It goes to ST09 on the carotid artery to ST17 on
the nipple (forbidden to moxa or needle!!), to ST25 (2 TSUN lateral to umbilicus), to ST36 (4
finger-breaths below patella, one finger breath lateral to anterior crest of tibia), to ST45 on the
lateral side of the nail of toe 2.
SP begins at SP01 at the medial side of the nail on the big toe. It runs along the side of the
foot to the ankle and up the leg to SP06 (3 TSUN above the tip of the medial malleolus of the
tibia, just behind the posterior border of the tibia. SP06 is a most important point in AP. Its
name (SanYinChiao) means "Three Yins Meeting" (the crossing point of the 3 Yin Channels).
This point influences the functions of SP, KI, LV COSs and should be studied. The line then
continues up to SP10 (2 TSUN above superior border of patella, at middle of the bulge of the
vastus medialis). It then runs up the inside of the thigh to the groin to SP12 (lateral to femoral
artery, 3 TSUN lateral to midpoint of upper border of pubic symphysis). From there, it travels
up the abdomen to SP20 (in second intercostal space to 6 TSUN lateral to the sternum) and
SP21 (in the 6th intercostal space, midway from axilla to free tip of rib 11).
HT begins at HT01 in the axilla, travels down the inner aspect of the arm to HT03 (between
the medial end of the transverse cubital crease at the medial epicondyle of the humerus when
the elbow is bent) to HT07 (on the palmar surface of the wrist at the posterior border of the
pisiform bone at the wrist crease) to HT08 (on the heart line of the palm of the hand, where
the flexed 4th and 5th fingers meet the palm) to HT09 on the radial side of the nailbed of
finger 5.
SI begins at SI01 on the ulnar side of the nail on the little (5th) finger, travels up the ulnar side
of the finger to SI03* (at the end of the transverse crease proximal to the 5th metacarpalphalangeal joint when the hand is half-clenched). SI03 may also be found by clenching the
fist. It is at the end of the "Heart Line" on the palm, where it meets the chopping edge of the
fist. It goes to SI06 (flex elbow with palm placed on the sternum; SI06 is in the bony cleft on
the radial aspect of the styloid process of the ulna), to SI08 (between the olecranon process of
the ulna and the tip of the medial epicondyle of the humerus) to SI09 (1 TSUN above the
upper tip of the posterior axillary fold). It then zig-zags over the scapular area, up the posterolateral aspect of the neck to SI18 (in the depression below the lower border of the zygomatic
bone, directly below the outer canthus of the eye), to SI19 between the ear tragus and the
mandibular joint when the mouth is opened.
BL begins at BL01 at the inner canthus of the eye, runs upwards and backwards over the head
about 1 TSUN lateral to the midline; it runs down the back of the head to BL10 (about 1.3

TSUN lateral to the midline, level with the space between vertebral spines C1-C2). Here the
BL Channel splits into two lines, an inner and an outer line.
The inner BL line goes to BL11 (1.5 TSUN lateral to the midline, level with the lower edge
of the spinous process of the 1st thoracic vertebra, half-way between midline of the spine and
the medial border of the scapula). It continues down to BL30 (1.5 TSUN lateral to midline,
level with the 4th sacral foramen. (BL13 to 28 are the Shu points- among the most important
points in AP- and each one should be studied in detail). From BL30, the Channel runs
upwards to BL31 (level with the 1st sacral foramen, midway between the posterior superior
iliac spine and the midline) and passes down through BL32,33,34 at the level of 2nd, 3rd and
4th sacral foramina. Thus, BL27,28,29,30 (over the 4 sacral foramina) are level with
BL31,32,33,34. Then the Channel passes down the back of the thigh to join the second BL
line at BL40, (WeiZhong) in the middle of the popliteal crease.
The outer BL line leaves BL10 to join BL41 (FuFen, 3 TSUN lateral to midline level with
the lower border of the spinous process of vertebra T2). This line continues downward 3
TSUN from the midline to BL52, level with BL23 (between L2-3). Between vertebrae T2 and
L3 (BL12 to 23), each point on the outer line is paired with a point on the inner line; each pair
of points has similar functions. These pairings are easy to remember: the code of the outer
point = 29 + the code of the inner point, i.e. BL12 and 41 are paired, BL21 and 50 are paired
and BL23 and 52 are paired:
Outer BL Points (IVAS BL40=WeiZhong, mid-popliteal

crease)

Thoracic

Lumbar

Sacral
4

Vertebra

9 10 11 12

Inner line

- 12 13 14 15 16 17

Outer line 36 37 38 39 40 41 42 43 44 45 46

18 19 20 21

22 23

28

47 48 49 50

51 52

53

30
54

IVAS Outer No. = Inner No. + 29)

From BL52, the outer line passes back to BL53 (outside BL28, level with foramen S2), to
BL54 (outside BL30 and 34, level with foramen S4). From BL54, the Channel passes straight
down the back of the thigh to BL40 (WeiZhong), where it joins the first line. From here it
passes down the back of the calf to BL57 (8 TSUN below BL40) and then curves outwards
towards the lateral malleolus of the tibia to BL60 (between the lateral malleolus and the
Achilles tendon. The Channel then passes along the lateral edge of the foot to the last point
(BL67) at the outer angle of the nail on the little toe.
If you would learn only one Channel, choose the BL Channel!! It has points (Shu points, see
later) for all the major organs, is involved in neck and back problems, sciatica, leg problems,
reproductive problems and is most important in obstetric analgesia, dystocia etc.

KI begins at KI01, on the sole of the foot between the upper half of the 2nd and 3rd
metatarsal-phalangeal joints. It runs up the medial aspect of the foot to KI03 (opposite BL60,
i.e. between the Achilles tendon and the medial malleolus). From here it does a loop through
KI04,5,6 in the ankle region and then climbs upwards to points KI07,8,9 on the inner side of
the leg, to KI10 on the postero-internal thigh and then emerges above the pubis at KI11 (at the
superior border of the pubic symphysis 0.5 TSUN lateral to the midline). From here it climbs
parallel to the midline to KI21 (0.5 TSUN lateral to midline, level with CV14 (6 TSUN above
the umbilicus). From KI21 the line passes to KI22 - KI27, running parallel to midline but 2
TSUN lateral to it. The last point (KI27) is 2 TSUN lateral to midline in hollow between the
lower border of the clavicle and rib 1.
PC begins at PC01 in the 4th intercostal space, 1 TSUN lateral to the nipple. It passes down
the anterior aspect of the arm to PC03 on the ulnar side of the biceps tendon of the elbow
crease. It continues down the anterior surface of the forearm to PC06 (2 TSUN above the
palmar wrist crease, between the flexor tendons) to PC08 (on the palm of the hand between
2nd and 3rd metacarpal bones, where the fully flexed middle finger meets the palm) to the last
point (PC09), at the midpoint of the tip of the middle (3rd) finger.
TH begins at TH01 at the nail of the 4th (ring) finger, towards the ulnar side. It climbs the
back of the hand, to TH05 (2 TSUN above the dorsal wrist crease, between the radius and the
ulna), to TH10 (1 TSUN behind and above the olecranon process of the ulna), to TH14
(between the acromion process of the scapula and the greater tubercle of the humerus), to
TH17 (between the mastoid process and the angle of the mandible). It then curves behind the
ear and ends at TH23 at the lateral tip of the eyebrow, on the lateral border of the orbit.
GB begins at GB01, 0.5 TSUN lateral to the outer canthus of the eye. It goes to GB12 behind
the ear, then curves forward again to GB14 (one TSUN above the midpoint or the eyebrow).
Then the Channel curves across the head, on a line with the pupil-midpoint of the eyebrow, to
GB20 (in the depression between the acromion process and GV14 (between the spinous
process of vertebrae C 7 and T 1) on the highest point of the shoulder muscles). From here,
the line zig-zags down the lateral aspect of the thorax and abdomen to GB28 (anterior and
interior to anterior-superior iliac spine) to GB30 (behind the great trochanter of the femur).
From here it passes down the lateral aspect of the thigh and knee to GB34 (in the depression
anterior and interior to the little head of the fibula, to GB40 (below and in front of the lateral
malleolus of the tibia, to the last point (GB44) on the lateral angle of the nail of the 4th toe.
LV begins at LV01 at the lateral angle of the nail of the big toe, passes up to LV03 (between
the upper heads of the 1st and 2nd metatarsal bones) to LV04 (1 TSUN antero-lateral to the
medial malleolus). From here the line curves up the inner aspect of the leg to points LV07,8,9
in the region of the postero-medial aspect of the knee, to LV11 (on the femoral nerve, just
lateral to the artery in the inguinal groove), to LV13 (at the free end of the 11th rib) to LV14
(directly below the nipple, in the 6th intercostal space.
CV begins at CV01, between the anus and the scrotum/vulva in the midline. It runs up the
midline of the abdomen, through the umbilicus (CV08) to the tip of the xiphoid (CV15) to
between the nipples (CV17), to the sternal notch (CV22), to end in the cleft between the chin
and the lower lip (CV24).
GV begins at GV01 (between the tip of the coccyx and the anus, in the midline). It travels up
the back, in the vertebral midline, through GV04 (between spinous processes of vertebrae L2-

L3) to GV14 (between the spinous processes of vertebrae C7-T1) to GV26 (the SHOCK
POINT, in the philtrum, 1/3 the distance from the nose to the upper lip), to GV28 (on the
frenum between the upper lip and the upper gum).
Let us recall once again the number of points on each Channel:
LU
11

LI ST
20 36

SP
21

HT
09

SI BL
19 67

KI
27

PC
09

TH
23

GB
44

LV
14

CV
24

GV
28

Beginners need only learn in detail the position and function of only 1 or 2 points on each
Channel. The exception is the BL Channel, where BL13-30 (Shu Points) should be studied
in detail.
Later, as your knowledge increases, try to integrate the position of points in relation to each
other. For instance, using the Beijing or Hong Kong or Shanghai charts (1, 1a, 3), study the
position of the following points and mark them on your own body:

Wrist area: see HT07; PC07; LU09; LI05; TH04; SI05

Elbow area: see HT03; PC03; LU05; LI11; TH10; SI08
Clavicle area: see LI16; LU02; CV22; ST11,12
Nipple to nipple line: see SP18; PC01; ST17; KI23; CV17
Navel line: see GB26; SP15; ST25; KI16; CV08
Pubic border: see SP12,13; ST29,30; KI11; CV02
Knee area: see LV08; KI10; BL40; GB33; ST35; Hsi Yen (L 16)
Ankle area: see KI03,4,5,6; SP05; LV04; ST41; GB40; BL60,61
Laryngeal prominence: see LI18; ST09; CV23
Point of left to point of right shoulder, through spine of T 2: see LI15; TH14;
SI10,12,13,14; BL10; GV13
From lower (caudal) angle of left to right scapula, through spine of T 8: see
BL17,46; GV09
From free tip of left to right rib 12, between spines of L1-L2: see LV13; GB25;
BL22,51; GV05
Line joining points 1 TSUN below highest points of left and right femoral
trochanters, through lower rim of sacral foramen 4: see GB30; BL30,34,54; GV02
Line between left SI09 and right SI10: see relationships with right LI15; TH14;
SI10,12,13; BL13,41,42,43; GV12; SI09,11
Join a line from 2 TSUN below highest point of left femoral trochanter and the
free end of right 12th (last) rib, via space between spines of L4-L5: see relationship
with left GB30; BL26,53; GV03; Right BL24,52; GB25

LEARNING THE MASTER POINTS

In the Appendix of the last paper the Master Points were mentioned briefly. The Master
Points include Shu-Mu, Luo-Yuan, Five Phase, Xi-Cleft, Hour, Test and RYODORAKU
electro-test points.
These points are important in AP and some of them, especially the paravertebral Shu points,
the Front Mu points, the Luo-Connecting points, the Yuan-Source points and the Xi-Cleft
points are very useful in diagnostic and therapeutic AP. They should be learned. Memory aids

help the learning process. Memory aids are given below but if they don't suit you, make up
your own versions.
THE 18 SHU POINTS
There are 18 pairs of Shu points; 12 relate to one of the 12 main COSs (LU-LI / ST-SP /
HT-SI / BL-KI / PC-TH / GB-LV) and 6 relate to other functions (see below).
The 18 pairs of Shu points are BL13-30, on the 1st BL line, paravertebral from T3 to S4.
The Chinese name for each point indicates its function, i.e. FeiShu (BL13) means Lung Shu;
HsinShu (BL15) means Heart Shu; KeShu (BL17) means Diaphragm Shu etc.
The Shu points (BL13-30 inclusive) are located 1.5 TSUN from the dorsal midline (GV line),
at the lower border of the spinous process of the vertebra indicated in the memory aid and
tables below.
Shu points are called the Back-Association, or Paravertebral Reflex points. (The Mu points
are called Front Alarm points, see later). Shu (and Mu) points often are tender to palpation
when their associated organs are diseased. Each COS has a corresponding Shu and Mu point.
If the Shu and Mu point is tender to light palpation, this indicates hypofunction (Deficiency,
Yin) of the associated organ; if tender to heavy palpation, this indicates a hyperfunction
(Excess, Yang) of the associated organ. In AP diagnosis, always palpate the Shu and Mu
points. Note: Injury/scar on a Shu or Mu point can disturb the function of the corresponding
organ!
Shu points may be combined with Mu points (see later) in treating disorders of the associated
organs. For instance, needling BL13 and LU01 (LU Shu and Mu) helps in asthma; BL18 and
LV14 (LV Shu and Mu) helps in hepatitis.
Also, Shu and Mu combinations can help in diseases of the sense organs of other functions
associated with the corresponding internal organ. For instance, the eye/vision and ear/hearing
are associated with the LV and KI COS respectively. In eye diseases, needling BL18 and
LV14 (LV Shu and Mu) or in ear diseases BL23 and GB25 (KI Shu and Mu) respectively
would be indicated. Bone and throat are also associated with KI function. Thus, BL23 and
GB25 could be used in bone and throat diseases. The skin is controlled by LU, so BL13 and
LU01 (LU Shu and Mu) can be used in skin diseases. Speech is controlled by HT COS. BL15
and CV14 (HT Shu and Mu) help speech disorders.
MEMORY AID FOR THE SHU POINTS:
T 3 - T 7
Lung Constricts HearT VeryGood Diana
Shu point of

LU

PC

HT

GV

Diaphragm

Name (x-Shu)

Fei

ChuehYin

Hsin

Tu

Ke

T4

T5

T6

T7

Below spine of T3

BL point

13

14

15

16

17

T 9 - T12
Live Gall Splutters & Stutters
Shu point of

LV

GB

SP

ST

Name (x-Shu)

Kan

Tan

Pi

Wei

Below spine of T9

T10

T11

T12

BL point

19

20

21

18

L 1 - L 5
Though

Kidney Seas

Colon's Gate

Shu point of

TH

KI

LI

Name (x-Shu)

SanChiao

Shen

ChiHai

TaChang KuanYuan

Below spine of L1

L2

L3

L4

L5

BL point

23

24

25

26

22

(Uterus)

S 1 - S 4
Small

Bladder

Midback

White-Circle

Shu point of

SI

BL

Name (x-Shu)

HsiaoChang PangKuang

ChungLu

PaiHuan

Below spine of S1

S2

S3

S4

BL point

28

29

30

27

THE LOCATIONS AND FUNCTIONS OF THE 18 PAIRS OF SHU POINTS ARE:

BL
Shu Point point

Location

Organ- function

Sense/other functions

LU Shu

BL13

below T 3

lung/respiration

touch/skin/mucosa

PC Shu

BL14

below T 4

pericardium/circ./sex

HT Shu

BL15

below T 5

heart/circulation

GV Shu

BL16

below T 6

spine/local function

speech/tongue

KeShu

BL17

below T 7

diaphragm

blood, haemorrhage

LV Shu

BL18

below T 9

liver/metabolism

vision/eye/muscles

GB Shu

BL19

below T10

gallbladder

proprioception/tendons

SP Shu

BL20

below T11

spleen/pancreas

taste/mouth/lips/muscle

ST Shu

BL21

below T12

stomach/digestion

TH Shu

BL22

below L 1

respir./digest./reprod.

KI Shu

BL23

below L 2

kidney/gonad

ChiHaiShu

BL24

below L 3

back, general energy

LI Shu

BL25

below L 4

colon/elimination

endocrine
ear/throat/bone/brain

KuanYuanShu BL26 below L 5

uterus, back

SI Shu

BL27

below S 1

small intestine

BL Shu

BL28

below S 2

bladder/urination

ChungLuShu BL29

below S 3

back/bladder/urethra

PaiHuanShu BL30

below S 4

back/anus

Six pairs of Shu points (BL16,17,24,26,29,30) do not belong to a specific pair of the 12 main
COSs. They have local uses:
Shu

Chinese Name

Translation

Therapeutic uses

BL16

Tu Shu

GV Shu

GV problems, spine, endocarditis,

borborygmus, abdominal pain, hair
loss, pruritus, hiccough

BL17

Ke Shu

Diaphragm Shu

Diaphragm, hiccough, respiration,

blood diseases, haemorrhage

BL24

Chi Hai Shu

Sea of Qi Shu

Lumbago, haemorrhoids

BL26

Kuan Yuan Shu

Gate Origin Shu

Uterus, enteritis, cystitis,

urinary incontinence, lumbago

BL29

Chung Lu Shu

Middle of Back Shu

Lumbo-sacral pain, sciatica,

enteritis
BL30

Pai Huan Shu

White Circle Shu

Anus, sacral pain, sciatica,

endometritis

THE 12 MU POINTS
As Shu points are called the Back Association or paravertebral reflex points, the Mu points
are called Front Alarm points.
Mu (and Shu) points often are tender to palpation when their associated organs are diseased.
Each COS has a corresponding Mu and Shu point. If the Mu and Shu point is tender to light
palpation, this indicates hypo-function (Yin) of the associated organ; if tender to heavy
palpation, this indicates a hyper-function (Yang) of the associated organ. In AP diagnosis,
always palpate the Shu and Mu points. Note: Injury/scar on a Shu or Mu point can disturb the
function of the corresponding organ!
Mu points may be combined with Shu points in treating disorders of the related organs and of
the local area. For instance, needling LV13 and BL20 (SP Mu and Shu) helps in chronic
diarrhoea, with undigested food in the stool (Deficient SP Qi) and GB24 and BL19 (GB Mu
and Shu) helps in cholecystitis. In disorders of the large intestine/ appendix, needling ST25
and BL25 (LI Mu and Shu) can help. Similarly, LV14 + BL18 can help in hypochondriac pain
and ST25 + BL25 can help in lower abdominal pain.
Also, Mu points may be combined with Shu points in diseases of the sense organs of other
functions associated with the corresponding internal organ. For instance, the eye/vision and
ear/hearing are associated with the LV and KI COSs respectively. In eye diseases, needling
LV14 + BL18 (LV Mu and Shu) or in ear diseases GB25 + BL23 (KI Mu and Shu)
respectively would be indicated. Bone and throat are also associated with KI function. Thus,
GB25 + BL23 could be used in bone and throat diseases. The skin is controlled by LU, so
LU01 + BL13 (LU Mu and Shu) can be used in skin diseases. Speech is controlled by HT
COS. CV14 + BL15 (HT Mu and Shu) help speech disorders.
THE 12 MU-ALARM POINTS:
COS

LU

LI

ST

SP

HT

SI

Mu Point

LU01

ST25

CV12

LV13

CV14

CV04

COS

BL

KI

PC

TH

GB

LV

Mu Point

CV02

GB25

CV17

CV05

GB24

LV14

Memory aid for the Mu points (6 of the points are on the CV line):
CV03,04,05 = BLoody SIlly THeme (= BL, SI, TH)
CV12,14,17 = STuffed HearTs Constrict (= ST, HT, PC)

Lung and Liver, First and Last (LU = LU01, LV = LV14)

Spleen before Liver (SP = LV13)
KI = free tip of last rib (last costal arch in animals) (KI = GB25)
GB before KI (GB = GB24)
LI = McBurney (appendicitis) point = ST25
THE NAMES AND LOCATIONS OF THE MU POINTS:
COS Mu

Name

Location

BL

CV03 ChungChi

4 TSUN below umbilicus, in midline

SI

CV04 KuanYuan

3 TSUN below umbilicus, in midline

TH

CV05 ShihMen

2 TSUN below umbilicus, in midline

ST

CV12 ChungWan

4 TSUN above umbilicus, in midline

HT

CV14 ChuChueh

6 TSUN above umbilicus, 1 TSUN below xiphoid, in

midline

PC

CV17 ShangChung

Midline of sternum, level with 4th intercostal space,

midway between nipples

LU

LU01 ChungFu

In 1st intercostal space, 2 TSUN lateral to nipple, below

coracoid process. (In animals, LU01 is in 2nd intercostal
space, behind the shoulder)

LV

LV14 ChiMen

In 6th intercostal space, directly below nipple (4th

intercostal space)

SP

LV13 ChangMen

At free tip of rib 11

KI

GB25 ChingMen

At free tip of last rib

GB

GB24 JihYueh

In 7th intercostal space, 1 rib or 1.5 TSUN below and just

lateral to LV14

LI

ST25 TienShu

In rectus abdominis m., 2 TSUN lateral to umbilicus

LUO-CONNECTING POINTS
Referring back to Diagram 1, you will remember that each of the Five Phases has a Yin-Yang
(Wife-Husband) pair of COSs (the Phase-Mates) and the Fire Phase has two pairs:

Limb
Arm
=
=
Leg
=
=

Phase
Metal
Fire
Fire
Wood
Water
Earth

Yin
(Wife)
Lu
HT
PC
LV
KI
SP

Yang
(Husband)
LI
SI
TH
GB
BL
ST

Each of the 12 main COSs has a Luo point, used in classic AP to transfer Qi from the
Husband to the Wife (or vice versa) of each linked pair of COSs (LU-LI / ST-SP / HT-SI / BLKI / PC-TH / GB-LV).
The Luo point for each COS is distal to the elbow or knee. Luo points are used in two main
ways in AP:
a. the Yuan-Luo combination and
b. in balancing Excess Qi in one COS and Deficient Qi in another, using Five Phase
Principles.
a. The Yuan-Luo combination uses the Yuan-Source point, see below) of the
affected COS with the Luo-Connecting point of the linked COS (Wife or
Husband), i.e in lung disease, LU09 (Yuan of LU) plus LI06 (Luo of LI).
b. In Five Phase Theory, when there is Excess Qi in one COS and Deficient Qi in
another, the Luo point of the Deficient COS is always used. For instance, if LU is
Deficient and LI has Excess Qi, needle the Luo point of LU (LU07). This will remove
the Excess from the Husband (LI) and restore Qi to the Wife (LU). If GB is Deficient
and LV has Excess Qi, needle the Luo of GB (GB37). This will remove the Excess
from the Wife (LV) and restore Qi to the Husband (GB). (For details of other uses of
Luo points, see paper on Holistic Concepts and on The Use of Five Phase Theory in
Medicine).
NAMES AND LOCATIONS OF THE 12 LUO-CONNECTING POINTS:
COS Luo

Name

Location

KI

KI04 TaChung

Just above calcaneus (medial ankle), in front of Achilles

tendon (opposite BL60)

SP

SP04 KungSun

On medial side of foot, distal to upper head of metatarsal 1

HT

HT05 TungLi

On the ulnar-palmar forearm, 1 TSUN above pisiform bone

LV

LV05 LiKou

5 TSUN above medial malleolus of tibia, just behind tibia

TH

TH05 WaiKuan

2 TSUN above dorsal wrist crease, between radius and ulna

LI

LI06 PienLi

3 TSUN above LI05 (which is in the "snuff-box", on the

radial-dorsal part of the wrist, between the tendons to the
thumb and index finger)

PC

PC06 NeiKuan

2 TSUN above the palmar wrist crease, between the flexor

tendons of the hand

LU

LU07 LiehChueh

just above the radial styloid process, 1.5 TSUN above the
wrist

SI

SI07 ChihCheng

On the ulnar side of forearm, 5 TSUN above the wrist, on a

line between SI06 and SI08

GB

GB37 KuangMing

5 TSUN above tip of external malleolus of tibia, just

behind the fibula

ST

ST40 FengLung

8 TSUN below patella, 1 TSUN lateral to tibia

BL

BL58 FeiYang

7 TSUN directly above BL60, which is between the

Achilles tendon and the lateral malleolus of tibia

MEMORY AID FOR THE LUO-CONNECTING POINTS:

4 = KISP (KI04, SP04)
5 = HTLVTH (HT05, LV05, TH05)
6 = LIPC (LI06, PC06)
7 = LUSI (LU07, SI07)
From '37-'40 GreatBritain STarred 58 BLondes (GB37, ST40, BL58)
THUS, THE 12 LUO-CONNECTING POINTS ARE:

COS

LU

LI

ST

SP

HT

SI

Luo Point

LU07

LI06

ST40

SP04

HT05

SI07

COS

BL

KI

PC

TH

GB

LV

Luo Point

BL58

KI04

PC06

TH05

GB37

LV05

THE YUAN-SOURCE POINTS

Each of the 12 main COSs has a Yuan point, which is often tender to palpation when its COS
is diseased. The Yuan point may be used alone (or with the Shu-Mu combination) in disease
of its organ. The Yuan-Luo combination uses the Yuan of the affected COS with the Luo of
the linked COS (Husband or Wife), i.e in lung disease, LU09 (Yuan of LU) plus LI06 (Luo
of LI).
MEMORY AID FOR THE 12 YUAN-SOURCE POINTS:
They are very easy to memorise if you know the YU point for the COS. (See Five Phase
points, next section!)
a. For Yin COSs, the Yuan point = 2 points proximal to the most distal point, (i.e.
Yuan point = YU point, Position 3, Earth). These are:
Arm Yin: LU09, PC07, HT07
Leg Yin: SP03, LV03, KI03
b. For Yang COSs, the Yuan point = 3 points proximal to the most distal point
(with the exception of GB, for which the Yuan is 4 points proximal to the most distal
point). Thus, for Yang COSs, the Yuan point = one point proximal to the YU, Wood
point. These are:
Arm Yang: LI04, TH04, SI04
Leg Yang: ST42, GB40, BL64
THUS, THE YUAN-SOURCE POINTS ARE:

COS

LU

LI

ST

SP

HT

SI

BL

KI

PC

TH

GB

LV

Yuan point LU09 LI04 ST42 SP03 HT07 SI04 BL64 KI03 PC07 TH04 GB40 LV03

LEARNING THE FIVE PHASE POINTS AND THEIR USES

Each of the 12 main COSs has a point for each Phase (Wood, Fire, Earth, Metal, Water).
There are thus 60 points (5 x 12 = 60). The theory of the Five Phases and the use of the 60
Phase POINTS to drain Excess Qi in one COS to augment Deficient Qi in another is covered
in detail in the paper The Theory of Five Phases and its use in Medicine, to which the reader
is referred. Methods of using the Phase points to balance imbalances of Qi are discussed in
that paper.
LOCATION OF THE PHASE POINTS:
The Five Phase points are located between the digits and the elbow or knee (stifle). Let us call
the most distal location (at a nail) Position 1 and the most proximal (near the elbow or knee)
Position 5. The Chinese terms and their translation for the 5 positions are:
Position

Chinese term

TSING

YUNG

YU

CHING

HO

TING

YONG

YU

CHING

HO

(Jing)

(Ying)

(Shu)

(Jing)

(He)

Well

Spring

Stream

River

Sea

Translation
Location

most distal

(.......

see later .......)

most proximal

at finger/toe nail

at elbow/knee

(LU11, LI01 etc)

(LU05, LI11 etc)

Apart from their use in balancing Qi in the Five Phase Cycle, the TSING points are used in
emergencies (shock, collapse etc), in mental disorders and in sensations of suffocation or
fullness in the chest. YUNG points are used in fevers. YU points are used in bone and joint
rheumatism and in diseases/pain caused by exposure to wind and damp. CHING points are
used in asthma, cough and disorders of the throat. HO points are used in disorders of the Yang
COSs (LI, ST, SI, BL, TH, GB).
The first 3 positions (TSING, YUNG, YU) are easy to remember. They are the 3 most distal
points on each of the 12 main COSs, with one exception: GB, in which case the YU point is
the 4th point from the end (GB41, not GB42).
Channel
Position

LU

LI

ST

SP

HT

SI

BL

KI

PC

TH

GB

LV

1 (TSING, most distal)

11

01

45

01

09

01

67

01

09

01

44

01

2 (YUNG, one point proximal) 10

02

44

02

08

02

66

02

08

02

43

3 (YU, one point proximal)

03

43

03

07

03

65

03

07

03

41* 03

09

02

* the only exception to the pattern is GB, in which case the YU point = 4th point from the end
(GB41, not GB42).
The last 2 positions (CHING and HO), unfortunately, do not form an easily remembered
number-pattern, but they lie at or above the wrist/ankle (CHING) and at or near the
elbow/knee (HO). The HO position (elbow/knee) is the Earth point for the Yang Channels and
the Water point for the Yin Channels. The points are:
Channel
Position

LU

LI

ST

SP

HT

SI

BL

KI

PC

TH

GB

LV

4 (CHING, near wrist/ankle)

08

05

41

05

04

05

60

07

05

06

38

04

5 (HO, near elbow/knee)

05

11

36

09

03

08

40

10

03

10

34

08

The relationship between the 5 Positions and the Five Phase points is as follows. Note: To
grasp these and following principles, beginners should also study the paper on the Five
Phases.
In the following table, the symbol "->" means "engenders, creates, nourishes, fosters or
feeds". The symbol "|" means "controls, restrains, governs, disciplines, brings order to".
POSITION

Yang COS

Yin

COS

Well

Spring

Stream

River

Sea

TSING

YUNG

YU

CHING

HO

Metal ->

Water ->

Wood

Earth ->

Metal ->

Water

Wood

->

Fire

->

->

Fire

->

Earth

coal !

For Yang COSs, Position 1 is Metal and positions 2 to 5 follow the SHENG (Creative) Cycle
of the Five Phases: (Metal -> Water -> Wood -> Fire -> Earth).
For Yin COSs, Position 1 is Wood and positions 2 to 5 follow the SHENG (Creative) Cycle
of the Five Phases: (Wood -> Fire -> Earth -> Metal -> Water).
MEMORY AID FOR THE YIN CHANNELS: Remember a red-hot coal (Fire) in the
palm of the hand (YUNG, Position 2)! Therefore, Wood is distal (TSING, Position 1,

fingers) and Earth, Metal, Water are proximal (Positions 3-5, i.e. YU, CHING, HO at wrist,
forearm, elbow respectively).
MEMORY AID FOR THE YANG CHANNELS: Remember that at each of the 5 positions,
the Yang Phase controls the Yin Phase, as in the KO (Controlling) Cycle. In Position 2
(YUNG, opposite the palm of the hand), Water (of Yang Channels) controls Fire (of Yin
Channels); in the TSING position, Metal (of Yang Channels) controls Wood (of Yin
Channels); in the YU position, Wood (of Yang Channels) controls Earth (of Yin Channels); in
the HO position, Earth (of Yang Channels) controls Water (of Yin Channels).
From the tables of points corresponding to the 5 positions (above), we can re-write the table
for SI and HT as follows:
POSITION

Yang COS SI

Yin

COS HT

Well

Spring

Stream

River

Sea

TSING

YUNG

YU

CHING

HO

Metal ->

Water ->

Wood

SI01

SI02

SI03

SI05

SI08

HT09

HT08

HT07

HT04

HT03

Earth ->

Metal ->

Water

Wood

->

Fire

->

->

Fire

->

Earth

Rearranging the points by their Phases (starting with Wood), this becomes:
Wood

Fire

Earth

Metal

Water

COS HT

HT09

HT08

HT07

HT04

HT03

Yang COS SI

SI03

SI05

SI08

SI01

SI02

Yin

Applying the same principle (rearranging the points for the 5 Positions by Phase rather than
by Position), the Five Phase POINTS are:
Channel
Phase

LU

LI

ST

SP

HT

SI

BL

KI

PC

TH

GB

LV

Wood

11

03

43

01

09

03

65

01

09

03

41

01

Fire

10

05

41

02

08

05

60

02

08

06

38

02

Earth

09

11

36

03

07

08

40

03

07

10

34

03

Metal

08

01

45

05

04

01

67

07

05

01

44

04

Water

05

02

44

09

03

02

66

10

03

02

43

08

Thus, the Earth Point of SI is SI08; the Water Point of ST is ST44; the Fire Point of LV is
LV02 etc. The 60 Five Phase points + the 6 Yuan points of the Yang COSs make up the 66
Command Points. (The Yuan Points of the Yin COSs = the YU/Earth Points).
THE XI-CLEFT POINTS
Each of the 12 main COSs has a Xi-Cleft Point, which may be used in acute disorders of the
associated organ and in pain along the course of the affected Channel.
MEMORY AID FOR THE 12 XI POINTS:
I visualise a lazy Sunday, disrupted by thoughts of pre-war ('34-'36) blabbering between the
Kremlin and Whitehall:
Sex at 4 (the PC COS is also called Circulation-Sex; PC04)
KIds at 5 (KI05)
HearTy LUnch of LiVerSI at 6 (HT06, LU06, LV06, SI06)
Stoned (LI-TH) (lith = stone) at 7 (LI07, TH07)
SParkling wine at 8 (SP08)
Between '34 and '36, STalin and GreatBritain / BLabbered 63 times (ST34, GB36, BL63).
THE XI-CLEFT POINTS ARE:

COS

LU

LI

ST

SP

HT

SI

BL

KI

PC

TH

GB

LV

Xi Point LU06 LI07 ST34 SP08 HT06 SI06 BL63 KI05 PC04 TH07 GB36 LV06

THE HOUR POINTS

Each of the 12 main COSs has an Hour Point, which = the Phase Point for each COS.
The Fire points of the Fire COSs are HT08, SI05, PC08, TH06.
The Earth points of the Earth COSs are ST36, SP03.
The Metal points of the Metal COSs are LU08, LI01.
The Water points of the Water COSs are BL66, KI10.
The Wood points of the Wood COSs are GB41, LV01.
THE HOUR POINTS CAN BE RE-WRITTEN:

COS

LU

LI

ST

SP

HT

SI

BL

KI

PC

TH

GB

LV

Hour POINT LU08 LI01 ST36 SP03 HT08 SI05 BL66 KI10 PC08 TH06 GB41 LV01

LEARNING THE EARPOINTS

Human Earpoints: Vets who wish to learn AP are advised to study the human Earpoints.
There are good ear charts, such as in the Beijing text (1), the Shanghai charts (6), the Hong
Kong charts (3) or Practical Ear-Needling Therapy (5).
As one will usually have access to Ear charts, it is not necessary to memorise the locations of
all the Earpoints. Certain points are important, as they are frequently used. Their functions are
listed in the texts which accompany the charts.
The important human Earpoints are: LU, HT, KI, ST, Adrenal, Shenmen, Sympathetic,
Internal Secretion (Endocrine), Subcortex, Occiput. If one is interested in treating pain and
lameness, one should note the points for the main body regions: Neck, Thoracic vertebrae,
Lumbo-sacral vertebrae, Shoulder, Elbow, Hip, Knee, etc. Note also the Dental Analgesia
point on the earlobe.
Sensitive Earpoints are relatively easy to detect. In practice, rather than using Earpoints listed
in Cookbook prescriptions, points which may not be sensitive on probing/electrical detection,
one is more likely to use the sensitive/reactive earpoints (irrespective of their location).
Animal Earpoints: The ear in animals is anatomically quite different from that in humans.
There is little evidence that human Ear-reflex locations (Ear-AP points) can be transposed
simply to the animal ear. Some studies have been done in small animals by Jan Still et al
(Brno Vet School) and by French, American and other colleagues but documentation of the
location and uses of animal Earpoints is incomplete at present.
THE MOST IMPORTANT POINTS FOR STUDY
An analysis of a database from > 55 textbooks and other articles on AP indicates that certain
points are very frequently used in clinical AP. These points should be studied in detail by
beginners. They include the following points, with the more important ones underlined:
Channel Number and Name of Points for Study

LU 05 ChihTse; 07 LiehChueh; 09 TaiYuan

LI 04 HoKu; 11 ChuChih; 15 ChienYu
ST 25 TienShu; 36 TsuSanLi; 40 FengLung; 41 ChiehHsi
SP 04 KungTsui; 06 SanYinChiao; 09 YinLingChuan; 10 HsuehHai
HT 03 ShaoHai; 05 TungLi; 07 ShenMen
SI 03 HouHsi; 06 YangLao; 08 HsiaoHai; 11 TienTsung
BL 11 TaChu; the Shu points 13-30; especially 23 ShenShu; 41 FuFen; 42 PoHu; 43
KaoHuang; 44 ShenTang; 45 YiHsi; 36 ChengFu; 40 WeiChung; 57 ChengShan; 60
KunLun
KI 03 TaiHsi; 08 ChiaoHsin
PC 03 ChuTse; 06 NeiKuan
TH 05 WaiKuan; 14 ChienLiao; 17 YiFeng
GB 20 FengChih; 30 HuanTiao; 34 YangLingChuan; 39 HsuanChung
LV 03 TaiChung; 13 ChangMen
CV 03 ChungChi; 06 ChiHai; 12 ChungWan; 22 TienTu
GV 04 MingMen; 12 FengFu; 14 TaChui; 20 PaiHui; 26 JenChung

In complex cases, if one has difficulty in deciding on a prescription, it is advisable to include

a few points from that list.
CONCLUSIONS
This is probably the most difficult paper, which you will have to study on AP. It contains a lot
of (apparently useless) detail, much of which needs to be interpreted against other papers,
such as those dealing with classical AP and the Five Phases. However, please read and re-read
it, using memory aids (mine or your own). When you master this paper, you will know most
of the basics relating to the principles of AP and the relationships of the COSs and points.
As aids to your study of AP, the following are suggested:
1. "Skim" a few good textbooks a few times. Then go through them in detail,
referring to the notes in this paper.
2. Learn the Channel circuits, the position and function of the first and last points.
3. Study one other point on each COS in detail (LU09, LI04, ST36, SP06, HT07,
SI03, BL23, KI03, PC06, TH05, GB34, LV03, CV12, GV26). Add others when you
know the location and uses of these.
4. Learn the positions of the Master Points (Shu-Mu, Yuan-Luo, Xi). Add the Five
Phase points later. Study the uses of these points.
5. Experiment on yourself, your family and friends, using first-aid AP without
needles (transcutaneous electro-stimulation, AP-point massage etc) in common human
conditions (headache, toothache, muscle pain etc).
6. Pick a few simple conditions in animals (disc disease, muscle lameness, dystocia,
female infertility etc). Study the approach to their treatment, comparing and
contrasting the approaches in your reference texts.
The student must not expect to become an expert in all aspects of AP in a short time. It is
better to study slowly over months and years than to attempt to learn the complete AP system
quickly. It is a difficult, deep subject to master. Long-term commitment and great patience are
needed. If you have the commitment, the mental rewards are great.
APPENDIX
GENERAL INFORMATION
INTERNET (WWW) SITES ON AP
The Medical Acupuncture Web Page (Great site in Greece for medical acupuncture; will open
a veterinary acupuncture site there soon)
Alternative Vet Medicine
American Soc of Dowsers

Osteopathy Links
The Mage's Guide to WWW)
EMAIL GROUPS :
Complementary and Alternative Med and Vet Med (CAM&VM-L): This List is confined
to professionals, mainly medics, vets and students of these subjects. To join the group, email
your application to: swynn@emory.edu, or swynn@mindspring.com, or
jbergeron@monmouth.com
IVAS: You may contact IVAS by emailing IVASJAGG@msn.com
COMPUTER DATABASES OF AP:
IVAS (c/o David Jagger, 5139 Sugarloaf Rd., Boulder, CO 80302-9217, USA; Fax +1-303449-8312) has a listing of computerised abstracts on AP (email: IVASJAGG@msn.com).
Professor Jean Bossy, Centre Hospitallier et Universitaire de Nimes, Nimes-Cedex, France
has an extensive computerised bibliography of AP
JOURNALS ON AP AND ALLIED FIELDS

Alternative Therapies in Health and Medicine, InnoVision Communications, 101

Columbia Ave, Aliso Viejo, CA 92656, USA. e-mail: alttherapy@aol.com
Alternative and Complementary Therapies, Bimonthly, Mary Ann Liebert Inc.
Publishers, 1651 Third Avenue, New York, NY 10128, USA.
Alternative Medicine J, Prime National Publishing Corp, 470 Boston Post Road,
Weston, MA 02193, USA. Tel: (617) 899-2702.
American Academy of Medical AP, 4126 Southwest Freeway, Suite 200, Houston, TX
77027, USA.
American J of Acupuncture, 1840 41st Ave., Suite 102, POB 610, Capitola, CA 95010,
USA.
American J of Chinese Medicine, Box 555 Garden City, New York, USA.
Australian J of AP, POB 417, Mullumbimby, NSW 2482, AUSTRALIA.
Australian J of Holistic Nursing, PO Box 5005, East Lismore, NSW 2480,
AUSTRALIA. e-mail: cgame@scu.edu.au
AP and Electrotherapeutics Research (Pergamon Press, Oxford, UK).
AP in Medicine (British Medical AP Society, Newton Lane, Lower Whitley,
Warrington, Cheshire WA4 4JA (Tel: (44) 01925 730727; Fax: 01925 730492)
AP Research Quarterly (C.A.R.F. Box 84-223, Taipei, Taiwan).
Bulletin de l'Association Veterinaires Acupuncteurs de France (3 rue Letellier, Paris
75015, France)
California J of Oriental Medicine, 1231 State Street, Suite 208-A, Santa Barbara, CA
93101, USA. Tel: (800) 477-4564; e-mail: CAAOM@aol.com
Chinese Medical J (English). Guozi Shudian, Box 399 Beijing, China.
Complementary Therapies in Medicine, Quarterly, Pearson Professional Ltd, PO Box
77, Harlow , Essex, CM19 5BQ, UK. Tel: (44) 01279-623623; Fax: 01279-639609.
European J of Oriental Medicine (Biannually), 179 Gloucester Place, London, NW1
6DX, UK. Tel: (44) 0171-724-5756

FootPrints, J of the Reflexology Association of Australia, P.O. Box 1032, Bondi

Junction, NSW 2022, AUSTRALIA. Fax: 612/9913-2815
Guidepoints: AP in Recovery, J&M Reports, 7402 NE 58th Street, Vancouver, WA
98662-5207, CANADA. Tel/Fax: 360/260-8620; e-mail: JayRenaud@aol.com
International J Alternative and Complementary Medicine, Monthly, Green Library,
Homewood House, Guildford Road, Chertsey, Surrey KT16 0QA, UK.
International J Chinese Medicine, 5266 Pomona Blvd., Los Angeles CA 90022, USA.
International J Clinical AP. Allerton Press Inc., 150 Fifth Ave., New York, NY 10011,
USA.
J of Alternative and Complementary Medicine: Research on Paradigm, Practice and
Policy, Quarterly, Mary Ann Leibert,Inc, Publishers, 2 Madison Avenue, Larchmont
NY 10538, USA. Fax: (914)834-3771, Managing Editor: Jackie Wootton: e-mail:
jackiew@clark.net
J of Chinese Medicine, Quarterly, 22 Cromwell Road, Hove, Sussex, BN3 3EB, UK.
Fax: (44) 01273-748588.
J of Complementary Medicine, Churchill Livingstone, Maple House 149, Tottenham
Court Rd, London, W1P 9LL, UK.
Lasers in Surgery and Medicine
Newsletters from the various National Vet AP Societies
North American J of Oriental Medicine, 896 West King Edward Ave, Vancourver, B.C,
V5Z 2E1, CANADA.
Oriental Medicine, 3723 N. Southport, Chicago, IL 60613, USA. Tel: (312) 477-1000;
e-mail: silkroad@ix.netcom.com.
Research and Information in Complementary Medicine, Quarterly, RCCM, 60 Great
Ormond Street, London, WCIN 3JF, UK. e-mail: rccm@gn.apc.org
Sciences of TCM, 1835 S. Del Mar Ave, #102, San Gabriel, CA 91776, USA. e-mail:
STCM@VIVIDNET.COM
Traditional AP J, Suite 100, American City Building, Columbia, MD 21044, USA.
World J of AP and Moxibustion, Quarterly, 18 Beixincang, Dongzhimen Nei, Beijing
100700, PR CHINA. Tel: 4014411-2925.

ACUPUNCTURE AS A KEYWORD IN ABSTRACTING JOURNALS

Current Contents
Index Medicus
Index Veterinarius
Veterinary Bulletin

VETERINARY AP GROUPS/SOCIETIES/ASSOCIATIONS
Many of these groups run AP seminars or courses. Contact persons are given.

Australia: AVAA, c/o Ulrike Wurth, 88 Barrabool Rd., Highton, VIC 3220; Sheila
White, Veterinary School, Murdoch University, Murdoch, WA 6153
Austria: Austrian Vet AP Society, c/o Oswald Kothbauer, Windberg 2, 4710
Grieskirchen, Ober-Osterreich.
Belgium: BVDA, c/o Luc Janssens, 37 Oudestraat, 2610 Wilrijk.
Canada: c/o E.R. Clare Holmes, RR 4, Alliston, Ontario L0M 1N0.
Finland: Finnish Vet AP Society, c/o Jukka Kuussaari, 25460 Toija.

France: l'AVAF, Headquarters, 115 Rue d'Amiens, 60000 Beauvais; l'AVAF

Secretariat, 9 Rue des Ecoles, 92330 Sceaux.
Germany: contact Walter Greiff, Donaustrasse 39, Grenzhof, Memmingen,
Schwaben.
IVAS: International Vet AP Society, Secretary, David Jagger, 5139 Sugarloaf Rd.,
Boulder, CO 80302-9217, USA.
Japan: JVAS, c/o Kaoru Kitazawa, Faculty of Agriculture, Gifu University, Yanagido
1-1, 501-11 GIFU.
Netherlands: SNVA, c/o Emil Hovius, Heike 9, 5508 PA Veldhoven.
Norway: NVAS, c/o Are Thoresen, Leikvollgt 31, Sandefjord.
South Africa: c/o Jan Still, Vet School, MEDUNSA, Pretoria.
Sweden: SVAS, c/o Ritva Krokfors, Nasby Sodergard, S-59592 Mjolby.
Switzerland: Swiss Vet AP Society, c/o Konrad Zerobin, Vet School,
Winterhurerstrasse 260, ZURICH.
Taiwan: Contact Lin Jen-Hsou, Dept. Animal Husbandry, National Taiwan University,
Taipei, Taiwan
UK: c/o Eric Nelson, 32 Painshawfield Rd., Stocksfield, Northumberland, UK NE43
7PX.
USA: see IVAS

MEDICAL AP SOCIETIES AND SCHOOLS

Many Western countries have specialist AP schools (but whose teachers are not medically
qualified). They provide classical training in AP and usually accept vet and med professionals
but the courses are too long for most of those professionals.
Medical AP Societies and groups hold shorter AP courses and seminars. Most accept vets at
these meetings. Other Institutes arrange short or longer crash-courses, as needed by
professionals:

Austria: Ludwig Boltzmann AP Institute, Mariangasse 9, A-1090 Vienna

China: Special courses in Beijing for vets: contact IVAS.
Taiwan: Chinese AP Research Foundation (CARF), Box 84-223 Taipei, R.O.C.
UK: British Medical AP Society, Newton Lane, Lower Whitley, Warrington, Cheshire
WA4 4JA (Phone 092-573727)

AP SUPPLY HOUSES (NEEDLES, BOOKS, EQUIPMENT ETC)

Austria: Richter & Co., Feldgasse 19, A-4600 Wels

Hong Kong: Mayfair Medical Supplies, Rm 501-3, 5/F, Far East Consortium Bldg.,
204-206 Nathan Rd., KOWLOON (Fax 852-3-721-2851)
UK: Acumedic, 101-103 Camden High St., London NW1 7JN (Fax 01-387-5766)
UK: John Scarborough & Partners, Orchard Hse, West Bradley, nr Glastonbury,
Somerset BA6 8PB (Phone 0458-50491)

VETERINARY AP CHARTS
For practical purposes, most AP points in animals are located by transposition from human
positions, making allowances for differences in anatomy. Traditional charts and
accompanying booklets exist for horses, cattle, pigs, goats and camels. IVAS can supply

charts for many species. (See also the Vet texts below). Although this is an incomplete list,
other sources of animal AP charts are:
Primate/lab animal charts: by transposition from standard human texts

Horse charts:Traditional (Klide & Kung; Kothbauer; Rubin; Sobin; Weinstein;

Westermayer; Yu & Hwang; White) Transposition (Cain; l'AVAF (France);
Sutherland; White)
Cattle charts: Traditional (Klide & Kung; Rubin; Westermayer; Wheeler; Yu &
Hwang) Transposition (Kothbauer, Turnbull, Westermayer)
Pig charts: Traditional (Klide & Kung; Lin; Rubin; Yu & Hwang)
Dog/cat charts: Transposition method and in-vivo or post-mortem detection with
point-finders: Altman; Demontoy; Gilchrist; Janssens; Milin; Molinier; Still.
Earpoint charts: Horse (Hill; Hwang; McKibbin; Yu & Hwang) Cattle (Kothbauer)
Dog (l'AVAF; Jeannot; Sadowsky; Still)
Altman, S. 5647 Wilkinson Ave., N. Hollywood, CA 91505, USA.
l'AVAF, Headquarters, 115 Rue d'Amiens, 60000 Beauvais, France; Secretary, 9 Rue
des Ecoles, 92330 Sceaux, France.
Cain,M.J. Unison Rd., Molehill 20465, VA 22141, USA (Tel: 1-703-5541-8183).
Demontoy, A. c/o l'AVAF Headquarters, 115 Rue d'Amiens, 60000 Beauvais, France.
Gilchrist, D. c/o Ulrike Wurth, 88 Barrabool Rd., Highton, VIC 3220, Australia.
IVAS International Vet AP Society, Secretary, David Jagger, 5139 Sugarloaf Rd.,
Boulder, CO 80302-9217, USA.
Janssens,L.A.A., 37 Oudestaat, 2610 Wilrijk, Belgium.
Jeannot,R. 62 Cours Desbiey, 33120 Arcachon, France.
Klide,A. Dept. Anaesthesiology, Vet. School, 3800 Spruce St., Philadelphia, PA 19174,
USA.
Kothbauer,O. Windberg 2, 4710 Grieskirchen, Ober-Osterreich, Austria.
Lin,Jen-Hsou Dept. Animal Husbandry, National Taiwan University, Taipei, Taiwan
McKibbin,L. Wheatley Hall Farm, Box 28, Wheatley, Ontario, Canada
Milin,J. 95 l'Isle Adam, France.
Molinier,F. Ecole Veterinaire, 94 Maisons-Alfort, PARIS, France.
Rubin,M. (Vet AP Manual) c/o Maloine Publishers, Paris, France.
Sobin,J.M. (Sobin International), Sobin Park, Boston, Mass 02210, USA.
Still,J. Dept. Surgery, Vet School, MEDUNSA, South Africa.
Sutherland,E. POB 12009, Lexington, KY 40579-2009, USA.
Turnbull,J. N3653 U.S. HWY. 16, RR 2, La Crosse, WI 54601, USA.
Weinstein,W. Equine AP Monograph, c/o Eastwind Publishing Co., North Hollywood,
CA, USA.
Westermayer,E. The late Erwin's textbooks and charts on equine AP were published
posthumously in 1993 by Karl F. Haug Verlag, Heidelberg: Lehrbuch der
Veterinarakupunktur (Vol 1 (73 pp) and Vol 2 (302pp)).
Wheeler,A.J. Iowa State University, Ames, Iowa 50010, USA.
White,S. Veterinary School, Murdoch University, Murdoch, W. Australia 6153.

AP READING MATERIAL
BASIC TEXTS (those asterisked are suggested as essential texts)

1. Anon (1993). (*) Essentials of Chinese AP. (Coll. Trad. Chin. Med., Beijing,
Shanghai, Nanking) Foreign Languages Press, Beijing. 432pp.
1a. Cheng Xinnong et al (1987) (*) Chinese AP and Moxibustion. Foreign Languages
Press, Beijing. 432pp.
1b. Ellis,A., Wiseman,N. & Ross,K. (1989) (*) Grasping the Wind. Paradigm
Publications, Brookline, Massachusetts, 462 pp.
2. Anon (1977). (*) Basic AP: a scientific interpretation and application. Chinese
Acup. Res. Foundation, Box 84 - 223, Taipei, Taiwan.
3. Anon (1975, or later version) (*) Newest illustrations of the AP points (Charts and
Booklet). Medicine and Health Publishers, Hong Kong.
4. Anon (1978) Treatment of 100 common Diseases by new AP. Medicine and Health
Publishers, Hong Kong.
5. Anon (1977) Practical Ear needling therapy
6. Anon (1976) Anatomical Charts of the AP Points and 14 Meridians. Shanghai
People's Publishing House, Shanghai. (Alternative to (3) above).
7. Anon (1974) (*) The Barefoot Doctor's Manual. Running Press, Philadelphia.
948pp. Excellent, but for advanced students only.
7a. Altman,S. (1981) AP for animals (c/o 5647 Wilkinson Ave., North Hollywood, CA
91607, USA, 281pp. Excellent.
7b. Janssens,L. (1984) (*) Atlas of the AP points and Meridians in the dog (c/o
Oudestraat 37, Wilrijk 2610, Antwerp, Belgium).
7c. Demontoy,A. (Contact author at French address)
7d. Molinier,F. (Contact author at French address)
8. Brunner,F. (1980) AP fur Tierarzte: AP der Kleintiere. WBV Biologisch Med.
Verlag, Ipweg 5, D4070 Schorndorf, Germany, 320pp.
8a. Gilchrist,D. (1981) Manual of AP for small animals. Also: Greyhound AP (1984)
Published privately, c/o 219 Byrnes Street, Mareeba, Australia 4880.
9. Klide,A. & Kung,S. (1977) Vet AP. Univ Pennsylvania Press, Philadelphia, USA.
297pp.
10. Rubin,M. (1976) Manuel d'AP Veterinaire pratique moderne. Maloine Publishers,
Paris, 85pp (in French).
11. Westermayer,E. (1978) Atlas of AP for cattle. English and German versions. WBV
Biologisch Verlag, Ipweg 5, Schorndorf, Germany, 60pp. Excellent.
12. Westermayer,E. (1980) Treatment of Horses by AP. English version. Health
Science Press, Holsworthy. Devon, UK, 90pp. Excellent. German version: WBV
Biologisch Med. Verlag, Ipweg 5, D4070 Schorndorf, Germany.
12a. Kothbauer,0. (1983) AP in the ox, horse and pig (in German). (WBV Biologisch
Verlag, Ipweg 5, Schorndorf D4070, Germany). Excellent.
12b. White,S.S. (1984) Electro-AP in Vet. Med. Chinese Materials Centre, San
Francisco. 122 pages. Excellent.
12c. Yu Chuan & Hwang Yann-Ching (1990) Handbook on Chinese Veterinary AP and
Moxibustion. FAO Regional Office for Asia and the Pacific, Bangkok, 193pp.

CLASSIC CONCEPTS

13. Austin, Mary (1974) AP Therapy. Turnstone books, London. 290pp.

14. Wu Wei Ping (1973) Chinese AP. Health Science Press, Holsworthy. Devon, UK.
181pp.
14a. Mann, Felix (1973) (*) AP cure of many Diseases. Heinemann Medical Books,
London, UK.

15. van Nghi, Nguyen (1971) Pathogenie et Pathologie energetiques en medicine

chinoise. Imprimerie Ecole Tech. Don Bosco, Marseille, France.
15a. Connolly Dianne (1979) (*) Traditional AP: The Law of the Five Elements.
Centre for Traditional AP, American City Building, Columbia, Maryland 21944, USA.
197pp.
15b. Kaptchuk, Ted (1983) (*) The Web that has no Weaver. Congdon & Weed, New
York, USA.
15c. Porkert,M. (1983) The Essentials of Chinese Diagnostics. Acta Medicinae
Sinensis, Chinese Medical Publications Ltd., Zurich, Switzerland. 292pp.
15d. Wiseman,N. & Ellis,A. (1995) (*) Fundamentals of Chinese Medicine (English
translations and amendments of texts by the Beijing, Nanjing and Shanghai Colleges
of Chinese Medicine). Paradigm Publications, 44 Linden St., Brookline, Mass 02146,
USA, 532 pp.

OTHER TEXTS

16. Mann,F. (1977) (*) Scientific aspects of AP. Heinemann Medical Books, London,
UK.
17. Moss,L,. (1972) (*) AP and You. Paul Elek Books, London, UK. Excellent text on
Trigger-Point Therapy.
18. Fox,W.W. (1975) Arthritis and allied Conditions: a new and successful Approach.
Ranelagh Press, S. Hill Park, Hamsted, London, UK. Excellent text on Trigger-Point
Therapy.
19. Yau,P.S. (1977) Scalp Needling Therapy. Medicine and Health Publishers, Hong
Kong.
20. Kwong,L.C. (1978) Nose, Hand and Foot AP. Medicine and Health Publishers,
Hong Kong.
21. Shui Wae (1975) A research into AP and its clinical Practice. Commercial Press
Ltd., Hong Kong.
22. Chung,C. (1983) The AH SHIH Point. Illustrated guide to clinical AP (Chen Kwan
Books, 5-2, 1F CHUNG CHING SOUTH ROAD, Sect. 3, Taipei, Taiwan), 212pp.
23. Lee,J.F. & Cheung,C.S. (1978) Current AP Therapy, Med. Interflow Publ. House,
Hong Kong, 408pp.
24. O'Connor,J. and Bensky,D. (1983) AP - A Comprehensive Text, Shanghai College
of Trad. Med. (Eastland Press, Chicago), 750pp.
25. Ulett,G. (1982) Principles and practice of physiological AP. (Warren Green Inc.,
8356 Olive Blvd., Missouri 63132), 220pp.
26. Anon (1974) The Principles and practical use of AP Analgesia. Medicine and
Health Publishing Co., Hong Kong, 325pp.
27. Niboyet,J.E.H. et al (1973) L'anaesthesia par l'AP. Maisonneuve.
28. Travell,J. and Simons,M. (1984) Myofascial pain and dysfunction: the Trigger
Point Manual, Part 1. (Williams & Wilkins, Baltimore & London), 713pp.
29. Travell,J. & Simons,M. (1985) Myofascial pain and dysfunction: the Trigger Point
Manual, Part 2. (Williams & Wilkins, Baltimore & London).

MASTER POINTS FOR COS THERAPY

Taken together, the 66 Command/Su Points, plus the Shu, Mu, Luo, Xi, Test, Ryodoraku, HE,
Hour and SP21 Points are called the Master Points of AP.

1. In disorder of the associated Channel-Organ System (COS), there is usually tenderness on

palpation of the Yuan, Mu, Shu and Test points. The Test points may feel cold in Yin states
and hot in Yang states. The RYODORAKU points are electro-sensitive diagnostic points used
in Japanese diagnosis. Their readings are hypo- in Yin and hyper- in Yang states.
2. All Master Points, except Shu, Mu and HE points, are on their own Channels and lie
between the elbow and finger or between the knee and toe.
3. The Yuan-Luo combination uses the Yuan of the affected COS with the Luo of the PhaseMate COS, i.e in lung disease, LU09 (Yuan of LU) plus LI06 (Luo of LI).
4. SP21 is the Great Luo point (Luo point of all the Yin COSs).
The Five Phase Points
Tonic Sedat.
Affected COS
Wood Fire Earth Metal Water point point Yuan
LV (Wood-Yin )
01
02
03
04
08
08
02
03
GB (Wood-Yang)
41
38
34
44
43
43
38
40
HT (Fire-Yin )
09
08
07
04
03
09
07
07
SI (Fire-Yang)
03
05
08
01
02
03
08
04
PC (Fire-Yin )
09
08
07
05
03
09
07
07
TH (Fire-Yang)
03
06
10
01
02
03
10
04
SP (Earth-Yin )
01
02
03
05
09
02
05
03
ST (Earth-Yang)
43
41
36
45
44
41
45
42
LU (Metal-Yin )
11
10
09
08
05
09
05
09
LI (Metal-Yang)
03
05
11
01
02
11
02
04
KI (Water-Yin )
01
02
03
07
10
07
01
03
BL (Water-Yang)
65
60
40
67
66
67
65
64
XiRYODO
HE
Cleft HOUR
Test
-RAKU
(SEA)
Affected COS
Shu
Mu
point point point point
point
LV (Wood-Yin ) BL18 LV14
06
01
08
03
GB (Wood-Yang) BL19 GB24
36
41 33-39
40
GB34
HT (Fire-Yin ) BL15 CV14
06
08 07-09
07
SI (Fire-Yang) BL27 CV04
06
05 03-04
05
ST39
PC (Fire-Yin ) BL14 CV17
04
08
04
07
TH (Fire-Yang) BL22 CV05
07
06 04-10
04
BL53
SP (Earth-Yin ) BL20 LV13
08
03
09
02
ST (Earth-Yang) BL21 CV12
34
36 34-36
43
ST36
LU (Metal-Yin ) BL13 LU01
06
08
06
09
LI (Metal-Yang) BL25 ST25
07
01
11
05
ST37
KI (Water-Yin ) BL23 GB25
05
10
07
05
BL (Water-Yang) BL28 CV03
63
66 59-60
65
BL40

Luo
05
37
05
07
06
05
04
40
07
06
04
58

ROUGH GUIDE TO CHANNEL RELATIONSHIPS ON NECK, THORAX AND

ABDOMEN
This is a guide to the major functions of AP points on the neck, thorax and abdomen. THERE
IS CONSIDERABLE OVERLAP IN POINT FUNCTION ! It helps if you use good Channel
charts when studying the anatomical relationships between these points and their relationships
to vertebrae and spinal innervation.
GV
NECK

BL

FUNCTIONALLY RELATED Channel POINTS

ST
SP
CV
ORGAN/FUNCTIONS CONTROLLED

KI

15

10

THORACIC AREA
14
11-12

09

27

10-11

23
head/pituitary/parathyroid/
thyroid/neck/trachea/oesophagus

22
head/neck/thyroid/parathyoid/
upper limb/trachea/bronchi/
oesophagus
13
13
26
14
20
thorax/upper
limb/bronchi/lungs/thymus/heart /oesophagus
12
14
24
16
20
18
same
12
15
22
18
18
16
same
11
16
19
20
21/17
14
thorax/lungs/heart/oesophagus
10
17
17-18
22
16
12
diaphragm/stomach
09
18
16
24
16-15
10
stomach/liver/gallbladder
08
19
15
25
15
08
gastrointestine/spleen/pancreas
07-06
20
14
26
14
07-06
gastrointestine/spleen/pancreas/
urinary/reproductive/adrenal/
pituitary
LUMBAR AREA
06-04 21-23
13
27
14
06-04
gastrointestine/urinary/
reproductive/ adrenal/pituitary/
ovary/testis/tubes/kidney/hindlimb
04-03 23-26
12
28
13
04-03
intestinal/urinary/reproductive/ovary/
uterus/cervix/testis/prostate/bladder/hindlimb
l/s

26
12
29
13
03
intestinal/urinary/reproductive/uterus/
cervix/prostate/bladder/hindlimb

SACRAL AREA
02
27-30
11
30
12
02
intestinal/urinary/reproductive/cervix/

prostate/bladder/urethra/rectum/penis/
vagina/vulva/hindlimb
35
11
30
12
01
cervix/prostate/bladder/urethra/rectum/
penis/vagina/vulva
1.

SELECT the CORRECT CATEGORY for the Master Points KI04, SP04, HT05, LV05, TH05:
a. Yuan-Source
b. Xi-Cleft
c. Luo-Collateral
d. Hour
e. Shu-Back Association

2. SELECT the CORRECT CATEGORY for the Master Points KI03, HT07, ST42, TH04:
a. Yuan-Source
b. Xi-Cleft
c. Luo-Collateral
d. Hour
e. Shu-Back Association

3. SELECT the CORRECT CATEGORY for the Master Points KI05, SP08, HT06, LV06, TH07:
a. Yuan-Source
b. Xi-Cleft
c. Luo-Collateral

d. Hour
e. Mu-Front Alarm

4. SELECT the CORRECT Statement(s): The following are SHU-MU (Back Association-Front Alarm)
combinations:
a. GV combination=BL11 + CV22
b. CV combination=BL30 + CV23
c. LU combination=BL13 + LU01
d. GB combination=BL19 + GB24
e. (c + d)

5. SELECT the WRONG Statement as regards LULISTo / SPHTSI / etc as memory aid for the Channel Qi
sequence, with 0300-0500h being the time for the Qi High Tide in LU:
a. LU-LI, ST-SP, HT-SI etc are Husband-Wife pairs
b. The time for HT is 0900-1100h
c. LU, HT, PC are the three Arm Yin Channels. Their first point is on the chest & their last points near a
finger nail
d. TH, SI, LI are the three Arm Yang Channels. Their first point is near a finger nail & their last points are on
the face
e. GB, BL, ST are the three Leg Yang Channels. Their first point is near the eye & their last points near a
toe nail

6. SELECT the WRONG Statement:

a. A memory aid for the human Shu (Association, Back Reflex) points is: T3 to T7=Lung Constricts Heart
VeryGood Diana, T9 to T12=Live Gall SPlutters & Stutters, L1 to L5=THough KIdney Seas Colons Gate, S1
to S4=Small BLadder Midback White
b. A memory aid for the human Yuan (Source Points) is: Sex at 4, KIds at 5, HearTy LUnch of SILVca at 6
(etc)
c. A memory aid for the human Mu (Front Alarm) is: CV03, 04, 05 BLoody SIlly THeme, CV12, 14, 17 STuffed
HearTs Constrict, Lung & Liver First & Last (LU01, LV14), SP before LV (LV13), GB before KI (GB24, GB25),
LI=McBurneys Point (ST25)
d. A memory aid for the human Luo-Collateral Points is: 4 KISP, 5 HTLVTH, 6 LIPC, 7 LUSI (etc)
e. The Jing-Well (Ting, Tsing) point is always the most distal point on a main Channel. For Yang Channels,
it is the Metal point & for Yin Channels, it is the Wood point

7. SELECT the WRONG Statement:

a. Many AP texts use point names & alpha-numeric point codes that differ from other texts. Beginners are
advised to use one text as their basic reference work for point name & code & to check, point by point,
each new text against that reference, making appropriate adjustments to point names & codes in the
margins of the new book.
b. Because of modern telecommunications, it is easy to query supply houses on equipment, brochures &
prices
c. Because of the cost of air-freight & import taxes, Hong Kong supply houses are usually much more
expensive than European, US or Australian supply houses for AP needles & equipment
d. IVAS (founded in 1974) has a policy to run its full course (in English) in any country which can organise
enough participants to cover the cost of approved lecturers
e. The medical AP groups in most countries run week-end seminars on human AP. Vets are usually
welcome as associate members.

8. SELECT the WRONG Statement: The following are HOUR Points:

a. BL66
b. ST36
c. GB41
d. LU11
e. LI01

9. SELECT the WRONG Statement: The following are Luo-Collateral Points:

a. KI04
b. PC07
c. SP04
d. SI07
e. GB37

10. SELECT the WRONG Statement: The following are SHU-MU (Back Association-Front Alarm)
combinations:
a. SP combination=BL21 + LV12
b. KI combination=BL23 + GB25
c. LV combination=BL18 + LV14
d. HT combination=BL15 + CV14
e. LI combination=BL25 + ST25
1.

SELECT the CORRECT CATEGORY for the Master Points LI06, PC06, LU07, SI07:
a. Yuan-Source
b. Xi-Cleft
c. Luo-Collateral
d. Hour
e. Mu-Front Alarm

2. SELECT the CORRECT CATEGORY for the Master Points SP03, LU09, LI04, BL64:
a. Yuan-Source
b. Xi-Cleft
c. Luo-Collateral
d. Hour
e. Mu-Front Alarm

3. SELECT the CORRECT Statement(s): The Emotion or Spirit Points of the Five Zang [LU, HT, LV, SP, KI]
include:
a. BL13 - Feishu
b. BL20 - Pishu
c. BL23 - Shenshu
d. BL22 - Sanjiaoshu
e. BL52 - Zhishi

4. SELECT the WRONG Statement as regards BLaKI-PC / TriGallLV etc as memory aid for the Channel Qi
sequence, with 1500-1700h being the time for the Qi High Tide in BL:
a. BL-KI, PC-TH, GB-LV are Husband-Wife pairs
b. The time for GB is 2100-2300h
c. SP, KI, LV are Leg Yin Channels. Their first point is on the foot & their last points on the chest
d. ST, BL, GB are Leg Yang Channels. Their first point is near the eye & their last point is on the foot
e. The midline Vessels (GV-Dumai & CV-Renmai) are Qi Reservoirs, but are not in the diurnal Qi circulation
sequence

5. SELECT the WRONG Statement(s): The Emotion or Spirit Points of the Five Main Zang [LU, HT, LV, SP,
KI] include:
a. BL42 - Pohu
b. BL44 - Shentang
c. BL46 - Geguan
d. BL47 - Hunmen
e. BL49 - Yishe

6. SELECT the WRONG Statement:

a. In the Diurnal Qi Cycle, HT is the Qi Son of SP, & is Qi Mother & Wife of SI; GB is the Qi Son of TH, & is
Qi Mother & Husband of LV
b. Points SP01 & LV01 are on the big toe & LU11 is on the thumb
c. Points LI01 & ST45 are on the second finger & toe respectively
d. Points HT09 & SI01 are on the little finger & BL67 is on the little toe
e. Points TH01 & GB44 are on the middle finger & middle toe respectively

7. SELECT the WRONG Statement:

a. The only Yin Channel in the set: (LI, ST, SI, BL, KI, TH, GB, GV) is KI
b. The only Yang Channel in the set: (LU, SP, HT, KI, PC, TH, LV, CV) is TH
c. The Channel in the set: (LU, LV, ST, BL, GB, GV) which has least connection to the Eye is LU
d. The Channel in the set: (LU, LI, ST, HT, SI, PC, TH) which has least connection to the Arm is ST
e. The Channel in the set: (ST, SP, BL, KI, PC, GB, LV) which has most connection to the Leg is PC

8. SELECT the WRONG Statement: The following are HOUR Points:

a. KI10
b. SP03
c. LV01
d. CV09
e. HT08

9. SELECT the WRONG Statement: The following are Luo-Collateral Points:

a. LI06
b. PC07
c. HT05
d. ST40
e. BL58

10. SELECT the WRONG Statement: The following are SHU-MU (Back Association-Front Alarm)
combinations:
a. TH combination=BL24 + LV13
b. BL combination=BL28 + CV03
c. ST combination=BL21 + CV12
d. PC combination=BL14 + CV17
e. SI combination=BL27 + CV04

THE STUDY OF ACUPUNCTURE: POINTS AND CHANNELS IN

ANIMALS
SUMMARY
Successful acupuncture (AP) depends on a good knowledge of the location and functions of
the main AP points and Channel-Organ Systems (COSs). The Channels (which used to be
called Meridians) are the main pathways for transmission and storage of vital energy (Qi).
One may study the AP points and Channels in animals in two main ways:
a. The traditional Vet method and
b. the transposition method (from human AP).
Traditional Vet AP relies on texts translated from Chinese sources and does not describe
Channels in animals. Transposition AP relies on the study of human AP points/Channels and
their transposition to anatomically comparable positions in animals. Both are used in Vet AP
and will be discussed.
Advanced students use both systems but the transposition method has the following
advantages for beginners:
a. It is integrated and relatively easy to learn, whereas the traditional system is not integrated
and is more difficult to learn.
b. It is easily available through dozens of texts in European languages whereas the traditional
system has few texts in European languages.
c. Western Vet experience with the transposition system indicates that it is effective.
Transposition has some disadvantages, especially where anatomical differences between
species make some points difficult or impossible to locate. However, many of the
disadvantages can be overcome by choosing alternative combinations of points.
INTRODUCTION
More emphasis will be put on animal acupuncture (AP) by the transposition method (from
human AP) because it is easier to learn and it can be applied to all common species treated in
Vet practice. But first, we should discuss the characteristics of the AP) points.
THE CHARACTERISTICS OF AP POINTS
One of the most bewildering aspects of AP for beginners is the vast number of points which
are described in various human texts and the fact (which very quickly emerges from a
comparative study of any 10-20 textbooks on the subject) that many different combinations
of points can be used to treat any one condition. At first, this may suggest to the student (or
the sceptic!) of AP that the system is "unscientific", unstructured and almost a random

system. As we will see later, this is a very superficial view. We will also see why many
different combinations of points can exert the same effects.
AP points occur on all parts of the human body: the limbs, back, belly, head, ears, face, scalp,
nose, hands, foot zones etc. The Chinese name for the AP point is Hsueh which means "hole".
They saw the skin as the interface between the internal and external environment and the AP
points as entry and exit holes for external and internal energies and also as the means of
bringing these energies into balance.
AP points may coincide with AHSHI, AnShih, Trigger, "Ouch" or "Ah yes!" points. Many AP
points are over peripheral nerve. Needling should cause a sensation of paraesthesia, like an
electric shock running away from the needle. Other points are rich in proprioceptors, such as
near joints. These are mainly on the extremities. Others are rich in nerve endings. Needling
strongly stimulates the cerebral cortex and results in powerful reflex action, for instance the
response to GV26; LU11; A01 etc in shock, collapse).
Human and animal AP points have electrical properties which distinguish them from
surrounding skin. The electrical characteristics of the points have been well established in
human cadavers and in experimental animals. The bilateral symmetry of the points has been
established also.
AP points have high direct-current (DC) potential and low impedance (high conductivity)
relative to surrounding skin. Specially adapted voltmeters or resistance meters are used to
detect the points. Accuracy of electronic point detection is influenced by:
a. Probe application pressure must be constant. Readings vary with the pressure applied. In
practice, spring-loaded probes, applied at constant force, reduce this variation.
b. Skin lesions, sweat, serum etc can greatly alter the readings.
c. In animals the hair coat may interfere with readings.
The histological reality of the points has been shown in humans and laboratory animals.
Tissue around the points has more free nerve endings, vascular spirals, thickening of the
epidermis and more linear alignment of collagen fibres than tissue more distant from the
points.
Many major points are directly over peripheral nerves running in the subcutaneous tissue or
in the muscle. Needling of these points causes direct stimulation of the nerves. Other AP
points correspond with places where a peripheral nerve enters or leaves a muscle, the "motor
points" as known to physiotherapists. Still other points correspond with "trigger points
(TPs)", zones of referred pain and the AHSHI or pressure-sensitive points (pain points).
The histological properties of the points and their location vis a vis the peripheral nerves
explains the electrical characteristics of the points. The instruments used to locate the points
are very similar to neurometers, used to locate peripheral nerves.
Provocation experiments have been done on animals by Kothbauer (cattle), Kvirshishvili
(rabbits) and Schupbach (pigs). Irritant substances, such as Lugol's iodine or turpentine, were

injected into different organs, body regions or joints. The animals were observed closely to
see which points showed increased sensitivity after the challenge.
Kothbauer worked mainly on the reflex points of the abdominal viscera of cows (ovary,
uterus, kidney, cervix etc). He found that precise (and usually ipsilateral) points reacted when
the organ was irritated. Most of the points were in the lumbosacral area and coincided closely
with AP points (as transposed from the human BL Channel) known to be effective on these
organs. In later clinical use, he confirmed the therapeutic value of these reflex points (the
"pain points") in cows.
Kvirshishvili observed the ears of rabbits which had been injected with a blue dye. The ears
were shaved to make it easy to see vasodilation. Then he injected irritants into specific joints.
He confirmed that specific ipsilateral ear points reacted (vasodilated) to pain signals from
specific body regions. This reflex vasodilation is controlled by the hypothalamus.
AP points have other energetic characteristics, related to reflex vasodilation (hot-spots,
YANG, hyperactivity) or vasoconstriction (cold-spots, YIN, hypoactivity). Reactive AP
points can be detected by infra-red thermography.
For instance, Schupbach (Vet School, Zurich, 1985) injected irritant solution into the body or
horn of the uterus of minipigs. Using computer-controlled infra-red thermography, he located
specific zones on the skin of the lumbosacral area which became "Hot Spots" within 10-40
minutes (average 25 minutes) after irritation of the body or horn of the uterus. These "Hot
Spots" related well with classical AP points known to be related to the uterus and cervix
(points over the iliac wing, lumbosacral space, sacral foramina and anterior coccygeal area
(BL26.3, 27-34, PAIHUI, WEIKEN etc). In his experiments, Schupbach attempted to
correlate "Hot Spots" with points of low electrical resistance. The correlation was NOT
significant. Many low resistance points were found but infrared thermography was more
accurate at locating the reflex zones. In further experiments, he used electrodes implanted in
the uterus of minipigs to monitor myometrial activity following needling of the main "Hot
Spot" (BL26.3, over the iliac wing). AP stimulation caused definite increase in uterine
contraction.
Provocation experiments and stimulation of the reactive points suggest that the AP points
are terminals in a bi-directional reflex: viscerocutaneous and cutaneovisceral i.e. (IN =
OUT). They confirm the claim of TCM that AP has diagnostic and therapeutic uses.
DIAGNOSTIC CHARACTERS OF THE POINTS
There is some evidence (yet not complete) that the electrical properties of AP points which
are related to specific organs, regions or functions are changed when the organ, region or
function is diseased. In disease, the points are more sensitive to heat (Akabane test) and to
probing or palpation. In these cases, electrical conductivity and the DC potential of the
points usually increase. In deficiency of energy in a Channel, the measurement points may be
hyposensitive (decreased conductance).
Point sensitivity in disease may be unilateral (especially when the lesion is unilateral) or
bilateral. The location of the sensitive points is used by some acupuncturists to assist in
diagnosing the location of the disease. For instance, in vague abdominal pains, if the points on

the ST Channel and the Earpoint "stomach" were more sensitive than other points, this would
indicate that the lesion or problem was with the stomach or its functions.
In humans, Japanese (Nakatani, Motoyama), American and German (Voll) workers have
developed electronic diagnostic instruments which use this principle. These instruments are
very expensive and their value is not yet adequately proven. Many skilled acupuncturists can
locate the points and diagnose the energy imbalance without using these instruments.
In animals, Kothbauer's "Painpoint Detector" is of value in locating the sensitive points. It
delivers a small electrical current through a search-probe. (A reference electrode is placed on
a standard position). When the search probe reaches a sensitive point, more current passes
(because of greater conductivity) and the animal reacts by a pain-avoidance response.
However, it requires considerable time, patience and experience to use these instruments.
Some acupuncturists claim that they can locate the sensitive points faster by standard methods
of palpation or probing the skin with a blunt scissors or round-ended plastic test-tube.
Sensitive points can also be located quickly by psychic methods, such as by the reaction of a
pendulum (dowsing). Another method is to pass the hand slowly over the animal's body at a
distance of a few centimetres and to note the subjective sensations of prickling or tremor in
the hand as it passes over the sensitive points. A third method is to (mentally) visualise the
animal and to scan the body looking for the best points to treat, having programmed the mind,
in advance, to be drawn to these points.
These sensitive points are important not only to aid diagnosis, but also in therapy. Their use
in therapy will be discussed elsewhere.
The selective sensitivity which appears at certain points in disease is partly:
a. a reflex phenomenon associated with autonomic changes and
b. a "primitive nervous system" phenomenon, such as occurs in plants and lower animals
when tissues are damaged. As the disease process is controlled and/or eliminated by the body,
the point sensitivity returns to its normal baseline levels.
In the treatment of soft-tissue injuries or other disorders in which pain-points, AHSHI points
etc have been located on initial examination, disappearance of point sensitivity in the first few
treatment sessions is a good prognostic sign. This indicates that the condition is improving.
However, certain drugs (such as alcohol, mescaline, marijuana) and mental states (excitement,
fear, depression etc) may cause general alterations in all major AP points, probably by reflex
autonomic effects.
ALPHANUMERIC CODE, CHINESE NAME AND NUMBER FOR CHANNEL
POINTS, "STRANGE POINTS", "NEW POINTS" AND "HAND POINTS"
The alphanumeric code varies between European and American authors. For instance Lung
is coded LU, L, P (pulmon) etc by various authors. The code used here for the Channel points
is that used by IVAS (International Vet AP Society). The codes for the "Strange Points" (Z, Y,
X, A, L), "New Points" (NZ, NY, NX, NA, NL) and "Hand Points" (H) are my own).

Alphanumeric codes are very useful for rapid data storage and retrieval, for instance in
prescriptions, in case history files and in computerised records.
Chinese point name is that used by Wu Wei Ping and the Hong Kong sources. However,
European phonetic expression of the Chinese calligraphic symbols may vary between
textbooks and the beginner must be aware of this. Thus, point Hoku may be called Rokou,
HeGu (and other names!) in different textbooks. This causes great confusion to the beginner
and makes computerization by point names (between multiple authors) difficult or impossible.
The Chinese point codes are those used in "The Newest Illustrations of the AP Points",
Medicine and Health Publishing Co., Hong Kong (1973), the "Synopsis of Chinese AP"
(1974) and the "Principles and practical use of AP Anaesthesia" (1974) and the same
publishers. The "Strange", "New" and "Hand" points have no Chinese point codes.
Beginners should learn the location of the first and last point on each Channel. this helps to
orient the course of the Channel in their minds and, also, the direction of flow of Qi. Students
should also learn the position and functions of all the underlined points. These are the most
important points, according to the Chinese AP Research Foundation (Taipei, Taiwan): "Basic
AP - a scientific interpretation and application", (1977), C.A.R.F., Box 84-223 Taipei, Taiwan.
Students should validate the coding system used each new text. The codes used in this paper
are not the same as those used in the prescriptions for common diseases (see Appendix 1 of
the paper: The Choice of AP points for particular conditions).
AP CHANNELS
AP Channels are longitudinal lines connecting AP points with similar functional effects in
humans. Traditional Vet AP texts do not describe Channels, probably because Vet AP theory
was not as well developed as in humans.
TCM describes 12 pairs of Channels, which are bilaterally symmetrical in humans. These
Channels are Lung (LU); Large Intestine (LI) (sometimes called the Colon (CO); Stomach
(ST); Spleen/Pancreas (SP); Heart (HT); Small Intestine (SI); Bladder (BL); Kidney (KI);
Pericardium (PC) (also called Heart Constrictor (HC) or Circulation-Sex (CS); Triple Heater
(TH) (also called Triple Warmer or San Chiao); Gallbladder (GB); Liver (LV, sometimes
written as LI or Liv).
Each of these Channels has a specified number of points along its course. In general, all the
points on a Channel have some effect on the organ and its function e.g. any one of the BL
points influences the bladder, but some are more effective than others.
The number of points is as follows:
CHANNEL LU LI ST SP HT SI BL KI PC TH GB LV
No. Points 11 20 45 21 9 19 67 27 9 23 44 14
Each of the points on the left Channels has its mirror opposite on the right side.
As well as the bilaterally symmetrical Channels, there are 2 midline (single) Channels - the
Governor Vessel (GV) on the dorsal midline and the Conception Vessel (CV) on the ventral

midline. There are 28 GV points and 24 CV points. Thus, the total number of Channel points
= (2 x 309) + 52 = 670 points, or (309 + 52) = 361 positions (if one does not count mirror
opposites).
Evidence for the physical existence of Channels: In sensitive humans, a stimulus (needling,
pressure, electrical stimulus etc) applied to an AP point causes a sensation of paraesthesia
(numbness, "pins-and-needles" sensation, "electric-shock" sensation) to radiate proximally or
distally along the Channel. Very sensitive subjects can describe the superficial course of the
entire channel and may also identify sensations in the related internal organ. TCM uses the
term "Propagated Channel Effect" (PCE) to describe this effect.
The functional connection between AP points along the Channels has been demonstrated by
application of sonic (sound) stimuli which can be measured along the course of the Channel
by transducers which amplify and record the sound. More of the sound is detected along the
Channel than at other places.
ANIMAL AP POINTS AND CHANNELS BY TRANSPOSITION FROM HUMANS
The vast majority of western Vets who use AP study, choose and locate the points for therapy
by reference to the human system. Therefore, it is most important to learn this system
properly. In this talk we will discuss briefly the human point and Channel system. Details of
the course of the human Channels and the location of the AP points are in the paper "The
study of AP: Sources and Study techniques" (Rogers 1990).
The Channel points: Each AP point has a Chinese name, a western alpha-numeric code (e.g.
LI04; GB34; ST36), a position and a list of therapeutic indications, with some advice on
methods of needling. We will see later that it is not necessary to memorise all the points. For
general purposes a thorough knowledge of 60-90 points (in total) can give very valuable
results. (These points are underlined in Appendix 1 of this paper). In this seminar, I will retain
those codes (LU, LI, ST, SP, HT, SI, BL, KI, PC, TH, GB, LV, CV, GV) as the method of
Channel point description. There are many other methods in use and one must adopt one
convention to avoid confusion.
Other body points: As well as the Channel points, recent Chinese texts describe many other
points off the Channels. These points have been proved to be of value in clinical practice and
some of them should be studied. They include the "New Points", "Strange Points" and
"Hand Points" as listed in the "Newest Illustrations of the AP Points (Hong Kong, 1975).
Their names and codes (as used in the therapeutic prescriptions given in the paper on the
Choice of points for therapy) are included in Appendix 1 of this paper.
Scalp points: There are zones on the scalp for motor and sensory function, speech area,
reproductive function etc. These points are especially useful in treating the paralysis which
often follows cerebrovascular accidents. Face points, Nose points and Foot Zone points are
also described in recent texts.
The Chinese concept of the Macrocosm reflected in the Microcosm (the universe in the
atom, the whole in the part (Hologram) find its expression also in the fact that every organ,
joint, function and region of the body may "refer itself" to (i.e. influence and be influenced
by) other parts of the body such as the face, scalp, nose, foot zones etc. However, by far the
most well known (and best researched) example of this is in the Earpoints.

Earpoints: Nogier (France), discovered that certain specific points on the ear became
sensitive to palpation or showed physical changes (vascular hyperaemia, anaemia, flaky/scaly
skin, pustules or other reflex phenomena) in certain specific illnesses. He found that the
distribution of these points resembled an inverted human foetus or homonculus, with the head
downwards (at the ear lobe) and the back towards the posterior edge and the buttocks/feet at
the upper part of the ear.
Intensive Chinese research in human clinical and experimental trials confirmed Nogier's
findings. The result was the production of Ear maps which show the reflex earpoints for every
major organ, joint, region and function of the body.
In a paper called "An experimental evaluation of auricular diagnosis: the somatotopic
mapping of musculoskeletal pain" (1980), Oleson et al (Pain Management Clinic UCLA
School of Medicine, Los Angeles) reported good diagnostic accuracy of human earpoints. The
study was designed to evaluate the French and Chinese claims that the body is represented by
a somatotopic map on the external ear. Forty patients with musculoskeletal pain were
examined by one worker to determine the painful area. Each patient was then covered with a
sheet to conceal any visible physical problems. The physician conducting the auricular
diagnosis had no prior knowledge of the patient's medical history or condition. He simply
examined the ear to locate areas which were sensitive to probe pressure and to DC (electric)
current (increased conductivity). Using ear AP maps, he predicted the painful area. The
agreement between the established medical assessment and the ear-point diagnosis was 75%.
The results support the hypothesis that the body is represented by a somatotopic map on the
external ear. A copy of the abstract of that article is attached at the end of this paper.
However, the Chinese make even further claims for ear-point sensitivity in diagnosis. Texts
from Beijing (Outline of Chinese AP, 1975, Foreign Languages Press) and Hong Kong
(Practical Ear Needling Therapy, 1980, Medicine and Health Publishing Co) claim that
earpoint sensitivity can help in the diagnosis of the site of human cancer, inflammation and
other lesions in the internal organs, such as the lung, liver, uterus, stomach, intestines etc.
This is a most astonishing and revolutionary concept to orthodox workers! The EAR may be
used to assist in the diagnosis of the location of the condition (lesion, pain etc) and in the
therapy of that condition. However, there is controversy over the exact position of the points:
for instance, Nogier's ear charts are not identical to modern Chinese ear charts.
Kvirshishvili has already shown reflex points on the rabbit ear for the major joints. Still (Brno
Vet School), Jeannot (France), Hill (USA) and others have described Ear AP points in animals
but more work is needed to document the location and clinical uses of animal earpoints.
TRANSPOSITION FROM HUMANS TO ANIMALS
In animals, the transposition system has a number of difficulties and disadvantages:
a. Many of the important human AP points (the Command Points, see later) occur between
the elbow and digit or knee (stifle) and digit. However, few of our animals have 5 digits.
Thus, it can be difficult or impossible to locate anatomically comparable positions for these
areas in animals. Where would one locate point Shang Yang (LI01) or Hoku (LI04) in the
horse? Large animal Vet acupuncturists (Cain, Kothbauer, Thoresen, Westermayer etc) have
described locations for these difficult points.

b. Bladder Shu points (organ-associated points) occur along the paravertebral line, in relation
to intercostal spaces or the lumbar and sacral vertebrae. These are most important points for
therapy in some diseases. Humans have 12 pairs of ribs, 12 thoracic vertebrae, 5 lumbar
vertebrae and 5 sacral vertebrae, whereas few of our animal species fit this pattern. Thus, if
point Pi Shu (BL20) (the spleen/pancreas associated 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?
c. 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.
d. 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?
a. If one or more points can not be found, use other combinations. It is most important to
know that many combinations of AP points can produce the same result. For instance, in
man, headache might be treated by needling points Hoku (LI04). Lieh Chueh (LU07) and Tai
Chung (LV03), points which could easily be found in the dog but difficult or impossible to
find in the horse. However, points Feng Chih (GB20), Yin Tang (between the eyes), Tai Yang
(in the temple, lateral to the eye) could produce good success also and could be located in
most animals.
b. If there is doubt about the exact location of a transposed point, choose a number of
points along the nerve trunk or in the same or nearby dermatomal areas. Research
evidence most strongly suggests that AP effects are mediated via the nervous system and that
nerve points in the same dermatome, along the same nerve trunk or in nearby dermatomes can
exert very similar effects. Thus, although point Pi Shu (BL20) is nominally the associated
point for the spleen-pancreas, points BL19 or 21 (Tan Shu, Wei Shu) would also have some
effect. Similarly, although point BL13 (Fei Shu) is the Lung-associated SHU point (frequently
used in treating asthma and bronchitis) points BL12 and 14 (Feng Men and Chueh Yin Shu or
Pao Hsin Shu) would have similar effects. In fact, many of the massage, cupping, spooning
and cautery techniques would be applied over the whole area of BL12,13,14.
c. If the penis is in the way, deflect it to one side. If the exact location of the umbilicus is not
clear, make an estimate of its location and use this as the landmark to locate points above or
below it.
d. In the next few years, research on the points (and especially the Earpoints) will help to
define the position and functions of these points. Vet AP by the transposition method is a new
art-science and we must expect changes and improvements to be made in the future. It is our
privilege to be among the pioneers who will help to develop this most useful therapy in the
West.
POINT NOMENCLATURE
In China, each point in medical and Vet AP has a name which (to a Chinese reader) is in
some way descriptive of the function, location or character of the point. For instance point
Hsin Shu (BL15) translates as SHU point for the Heart; point Tsu San Li (ST36) translates as

Foot Three Miles (the point is 3 TSUN (Chinese inches) below the patella); point Lan Wei
(Hsueh) translates as Appendix (Point) etc. These meanings are lost to most Western
readers, as few texts give the translation of the point names.
AP texts in European languages may be based on originals from China, Korea, Japan, Taiwan,
Hong Kong etc. The European phonetic spelling of the original characters (calligraphic
figures) may vary widely for the same points. This may create great confusion for Western
readers who are trying to index points under the point 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!
Therefore, it is essential that students should adopt one convention, based on one
textbook which they will use as their basic reference work. Each new textbook or
reference must be checked point by point against the reference text and, if necessary, the
points in the new texts must be renamed and re-coded, if the student hopes to integrate the
new material with the old.
The codes used in this paper are the IVAS codes, as follows:
IVAS code
LU LI ST SP HT SI BL KI PC TH GB LV CV GV
Rogers old code LU CO ST SP HE SI BL KI HC TH GB LI VC VG
During this seminar and in all my papers, I will follow the IVAS convention. There is no
guarantee that the IVAS convention is identical to that of the other lecturers. This is because
there is no international standard of point coding and nomenclature established at this time. I
can not alter the Appendix to Paper 3 (on the Choice of AP Points), as it is not on disk. That
Appendix uses the old code (CO for Colon; HE for Heart, HC for Pericardium, LI for Liver
etc).
TRADITIONAL AP POINTS IN ANIMALS
Chinese Vet texts and their translations into European languages show the points used in
traditional Vet AP 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 the traditional Vet texts, AP points 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 alpha-numeric 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 instance, in the ox, the Chinese text ("Chinese Vet Handbook", Anon 1972, Lan Chou Vet.
Res., Institute, Ganshu, China), from which Klide and Kung prepared their section on the ox,
shows the following points: (see Table 1).
There are many difficulties in learning the traditional vet AP system:

1. The points are isolated (not on Channels) and bear little relationship to each other in
function. Thus, they have to be memorized in great detail. There is little possibility of busy
practitioners learning this system properly.
2. Between species differences occur in the symbols, names, codes, positions, functions and
method of stimulation. Thus, a Vet could know the points in the ox very well, yet not know
the traditional system as applied to other species.
3. Within species differences occur. The Chinese name, symbol and translation for a
particular point may vary between texts on the same species of animal. 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) 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).
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 Vet surgeons, their clients and their patients.
5. The system can not cater for many species because texts do not exist for them.
Over the next few years, Vets and scholars of the Chinese system will attempt to integrate the
existing traditional texts. If this is done, a single authoritative text for each species (for which
texts exist) may emerge. This should make it easier to study and use the traditional system.
Until then, however, most Vets will have to follow one particular school or text of the
traditional system. For those of you who wish to study the traditional AP system in animals, I
recommend the texts of Klide and Kung; Westermayer; Rubin; Yu & Hwang and any other
good translations of modern Chinese or Japanese Vet texts which may appear in the next year
or so.
CONCLUSIONS
AP points and Channels are real physiological and physical entities. General properties of AP
points and Channels and their association with peripheral nerves and other nervous structures
are discussed.
AP points become reactive (hyper- or hypo-sensitive) in disease in their related Channels,
organs, body functions on parts. They have diagnostic and therapeutic value.
Ear AP in animals is not as well developed at present as body AP but advances are expected.
Vet AP uses the traditional and/or transposition methods. Advantages and disadvantages of
both are discussed. Beginners are advised to base their study on the human AP system and to
include traditional Vet methods later.

Details of the course of the Channels and the location of the more important points in humans
are in the paper "The study of AP: Sources and Study techniques" (Rogers 1990).
FURTHER READING MATERIAL
Anon (1980) Essentials of Chinese AP. Foreign Languages Press, Peking 432pp.
Anon (1977) Chinese AP Research Foundation, Taipei: Basic AP - a scientific interpretation
and application. C.A.R.F., Box 84-223 Taipei, Taiwan 313pp.
Anon (1975) Newest illustrations of the AP points: booklet and charts. Medicine and Health
Publishing Co., Hong Kong 105pp.
Brunner, F. (1980) Akupunktur fur Tierarzte - Akupunktur der Klientiere. WBV Biologisch
Med. Verlag, Ipweg 5, D7060 Schorndorf, Germany 303pp.
Gilchrist, D. (1981) Manual of AP for small animals. Box 303, Redcliffe, Queensland 4020,
Australia.
Oleson, T.D., Kroening, R.J. and Bresler, D.E. (1980) Experimental evaluation of auricular
diagnosis: somatotopic mapping of musculo-skeletal pain at ear AP points. Report from Pain
Control Unit, Dept. Anaesthesiology UCLA School of Med., Los Angeles, California 90024.
(The UCLA group have valuable reports on AP research in many areas - clinical,
experimental and theoretical).
Klide, A.M. and Kung, S.H. (1977) Vet AP. University of Pennsylvania Press, Philadelphia,
297pp.
Rubin, M. (1976) Manuel d'AP veterinaire pratique moderne en Rep. de Chine. Maloine
Publishers, Paris. 85pp.
Schupbach, M. (1985) Thermographic proof of points with higher temperature after irritation
of the uterus in minipigs & the influence of these points on the viscera. Inaugural Dissertation
for the degree of DVM. Vet School, Zurich. 106pp.
Westermayer, E. (1978) Atlas of AP in horses. Health Science Press, Holsworthy, Devon,
U.K. (This is the English version of the original German version, which had 40 pages of
charts and text).
Westermayer, E. (1979) Atlas of AP in cattle. WBV Biologisch Med. Verlag, Ipweg 5, D7060
Schorndorf, Germany 62pp.
Yu Chuan & Hwang Yann-Ching (1990) Handbook on Chinese Veterinary AP and
Moxibustion. FAO Office for Asia and the Pacific, Bangkok 193pp.
QUESTIONS
1. One of the following statements is not correct. Indicate the incorrect statement:
(a) The Chinese name for an AP point is "Hsueh" or "Xue" which means "hole"

(b) AP points very seldom arise over a peripheral nerve and one should be very careful not to
needle a nerve
(c) AP points may coincide with AHSHI points, Trigger Points (TPs), Motor Points
(d) Some AP points are rich in proprioceptors, such as near joints; others are rich in nerve
endings. Needling strongly stimulates the cerebral cortex and hypothalamus and results in
powerful reflex action, for instance the response to GV26 in shock, collapse
(e) Needling should cause a sensation of paraesthesia, like an electric shock running away
from the needle.
2. One of the following statements is not correct. Indicate the incorrect statement:
(a) Tissue around AP points has more free nerve endings, vascular spirals, thickening of the
epidermis and more linear alignment of collagen fibres than tissue more distant from the
points.
(b) AP points have high direct-current (DC) potential and low impedance (high conductivity)
relative to surrounding skin
(c) Skin lesions, sweat, serum etc have no effect on the readings of electrical pointfinders.
(d) In animals (with hairy skins) the hair may interfere with readings of electrical
pointfinders.
(e) Spring-loaded probes, applied at constant force, improve the accuracy of electronic point
detection.

3. One of the following statements is not correct. Indicate the incorrect

statement:
(a) Reflex connections between AP points and organs/body parts were proven by
provocation experiments. Irritant substances were injected into different organs,
body regions or joints. The animals were observed closely to see which points
showed increased sensitivity after the challenge. Provocation experiments and
stimulation of the reactive points suggest that the AP points are terminals in a bidirectional reflex: viscerocutaneous and cutaneovisceral. They confirm the claim of
TCM that AP has diagnostic and therapeutic uses.
(b) Kothbauer worked mainly on the reflex points of the abdominal viscera of
cows. He found that specific ipsilateral points in the lumbosacral area reacted to
ipsilateral irritation of the ovary, uterus, kidney or cervix uteri.

(c) Kvirshishvili injected irritants into specific joints of rabbits. He confirmed that
specific ipsilateral Ear points vasodilated in response to pain signals from specific
body regions.
(d) Reflex vasodilation at AP points can be measured by thermography as coldspots.
(e) Schupbach injected irritant solution into the body or horn of the uterus of
minipigs. He located specific reflex zones especially over the iliac wing,
lumbosacral space, sacral foramina and anterior coccygeal area (corresponding to
BL26.3, 27-34, PAIHUI, WEIKEN etc)
4. One of the following statements is not correct. Indicate the incorrect
statement:
(a) The selective sensitivity which appears at AP points in disease is partly a reflex
phenomenon associated with autonomic changes and a "primitive nervous system"
phenomenon, such as occurs in plants and lower animals when tissues are damaged.
(b) As the disease process is controlled and/or eliminated by the body, AP point
sensitivity returns to its normal baseline levels.
(c) In the treatment of disorders in which pain-points, AHSHI points etc have been
located on initial examination, disappearance of AP point sensitivity in the first
few treatment sessions is a good prognostic sign.
(d) Certain drugs (such as alcohol, mescaline, marijuana) may cause general
alterations in all major AP points, probably by reflex autonomic effects.
(e) Mental state (excitement, fear, depression etc) has no effect on AP point
sensitivity.

5. One of the following statements is not correct. Indicate the incorrect

statement:
(a) Vet acupuncturists must know thoroughly at least 150 points before they can
expect good clinical results in animals.
(b) The 12 Main Channels are bilaterally symmetrical and the CV and GV
Channels are in the ventral and dorsal midline respectively
(c) There is a total of 361 point positions (if one does not count mirror opposites)
on the 14 main Channels of human AP

(d) Ear Points, "New Points", "Strange Points" and "Hand Points", Scalp points,
Face points, Nose points and Foot Zone points bring the number of point locations
to >1000.
(e) Earpoints are found in humans, represented as an inverted homonculus, with the
head at the earlobe, the back towards the posterior edge and the buttocks/feet at the
upper part of the ear. However, there is controversy over the exact position of the
points: for instance, Nogier's ear charts are not identical to modern Chinese ear
charts.
6. For each of the following Channels, indicate the letter (a to e) corresponding
with the correct number of points on the Channel:
#a #b #c #d #e
BL

61 63 65 67 69

CV

21 22 23 24 25

GB

44 46 50 52 54

GV

24 25 26 27 28

HT

09 11 13 15 17

KI

19 21 23 25 27

LI

18 20 22 24 26

LU

09 10 11 12 13

LV

13 14 15 16 17

PC

05 07 09 11 13

SI

19 20 21 22 23

SP

13 15 17 19 21

ST

39 41 43 45 47

TH

21 23 25 27 29

1=b

2=c 3=d

4=e 5=a

6: BL=d; CV=d; GB=a; GV=e; HT=a; KI=e; LI=b; LU=c; LV=b; PC=c; SI=a; SP=e;
ST=d; TH=b

THE CHOICE OF ACUPUNCTURE POINTS FOR AP THERAPY

This paper was written in 1980. For an update, see the attached paper on the Choice of
AP points for particular conditions

INTRODUCTION
One may use veterinary acupuncture (AP) by the transposition method (from human to
animal) or by the traditional vet method. It follows that the choice of points for therapy can be
based on either or both of these methods.
Some of the AP textbooks on man and animals have therapeutic indices (point prescriptions)
for specific disease conditions or symptoms. Other texts have not this facility. We have also
seen that many different combinations of points may be used in any one clinical condition.
The student is advised to study only a few AP texts initially. However, she/he should know
that one text (or even 3-4 texts) does not cover all conditions which may respond to AP.
Therefore, over a period of years, the serious student can expect to accumulate and study
dozens of different texts. Each of these texts will have to be integrated with material from
earlier texts. Therefore the student will need to make out personal prescription lists, using data
from many sources.
This paper discusses the choice of AP points based on the human transposition system but
first we must consider some differences between orthodox and unorthodox concepts of
disease.
DIFFERENCES BETWEEN ORTHODOX AND UNORTHODOX CONCEPTS OF
DISEASE
AP is frequently of great value in treating the pain and lameness associated with x-ray
evidence of severe osteoarthritis or "intervertebral disc prolapse syndrome", despite the
persistence of the lesion. Orthodox practitioners would suggest that this is impossible because
they assume that the pain and lameness primarily is caused initially by nerve stimulation from
the lesion, but which soon becomes a self-perpetuating system, (i.e., a vicious circle). They
claim that if the muscle spasm and tissue oedema is relieved, the locomotor function may be
restored despite the persistence of the x-ray lesion.
Severe gastric ulcers, even bleeding ulcers, may respond rapidly to AP, with no change in
dietary habits. Orthodox concepts would prescribe change of diet, drug therapy with antacids,
gastric sedatives, antispasmodics, Zantac or Cimetidine, etc. However, stimulation of certain
AP points, especially NeiKuan (PC06); TsuSanLi (ST36), ChungWan (CV12) and WeiShu
(BL21) has powerful effects on the autonomic nervous system (anti-nauseous effects), acid
secretion and regenerative power of the gastric mucosa. Thus, AP can combat the symptoms
of gastric ulcer and promote the ideal environment for self-healing, by reducing acid-secretion
and stimulating the defence systems of the body.
Similarly, AP can help patients who have lost motor function of an arm or leg following a
cerebrovascular accident, encephalitis etc. Orthodox medical concepts claim that damaged
neurons cannot regenerate. Acupuncturists agree with this but they claim that many types of
paralysis are due to functional rather than organic damage, (i.e.) that the motor-neurons are
"asleep but not dead", due to inadequate oxygen or blood supply. AP at certain points has
marked effect on brain microcirculation and, thus, can restore nerve function in such cases.
Also, the nervous system itself has considerable "plasticity" and new circuits can be
established to replace the functions of damaged circuits.

Another difference between orthodox and unorthodox concepts is in the importance of the
nature of the lesion. Orthodox clinicians would set great importance on the nature of a toe
pain (for example). Is it arthritis, sprain, gout, subluxation etc? To an acupuncturist, such
questions are of minor importance, as the point combination used covers all responsive
conditions of the toe and the Channel-Organ System (COS) related to the toes. For
pragmatic purposes, however, it is helpful to establish a firm diagnosis before attempting to
treat the condition.
Thus, AP claims to treat or help many conditions which, according to our western training,
should be difficult or impossible to treat successfully. How, then, do we go about choosing the
best points for therapy?
CONSTRUCTION OF AP POINT PRESCRIPTIONS
As one accumulates textbooks one may wish to construct a cumulative index of the points
recommended by the various authors for each condition. Each reference should be coded, in
order to avoid confusion as to the source and to avoid mistakes in the location of the points.
As new texts are studied, data can be added to the index, under a new reference code. For
example, suppose one were studying Klide and Kung in relation to AP in horses and one were
using the Sobin data (p 69 of Klide and Kung), one would find the following data under the
various points:
Point Indication
Head & Neck01 Tetanus, encephalitis, encephalomyelitis, encephaloedema
02 Purulent frontal sinusitis, cerebral hyperaemia
03 Cerebral hyperaemia, cerebral anaemia, neck rheumatism
04 Same as HN03
..
Tail 114 Over-exertion, heat stroke, common cold, bowel spasm
First, one would go through the data and pick out the complete list of key-words or
pathological conditions, mentioned in the text:
Tetanus, Encephalitis, Encephalomyelitis, Encephaloedema, Sinusitis (frontal, purulent),
Cerebral hyperaemia, Cerebral anaemia, Neck rheumatism, Overexertion, Heatstroke,
Common cold, Bowel spasm etc.
One would then go through the data again and enter the identity of each point under the
relevant conditions, giving a code (say) (K-S (for Klide/Kung-Sobin) before each point
combination and giving an appropriate alphanumeric code to each point, for example HN01
for Head and Neck 1, T114 for Tail 114.
Bowel spasm (K-S) T114 (T= Tail)

Cerebral hyperaemia (K-S) HN02,03,04

Encephalitis (K-S) HN01
Encephaloedema (K-S) HN01
Encephalomyelitis (K-S) HN01
Tetanus (K-S) HN01
.
.
.
.
etc
If a new reference, for example author X, had points under these headings, they would be
added later. For example:
Cerebral hyperaemia (K-S) HN02,03,04....
(X) 99, 112, 115...
Tetanus (K-S) HN01...
(X) 115, 119, 126...
etc
The problem with this system (traditional vet AP) is that there is no standard chart for any one
species. It is not possible to relate (K-S) HN02 with (X) 99 etc on the standard chart.
Therefore some major integration (referring back to the individual source charts) is necessary
either before the cumulative index is attempted or after it is done. Either way, it becomes
very time-consuming for the individual practitioner. However, one would expect that research
workers interested in vet AP will integrate all existing vet traditional texts into one "standard"
text for each species within the next few years.
Meanwhile, integration of human texts is much easier, as they are normally based on a
standard chart of the AP points (except for a few instances in which points such as BL36-54
and ST01-8 may have different alphanumeric coding in some texts:

Outer BL Points (IVAS BL40=WeiZhong, mid-popliteal crease)

IVAS 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54

Other 50 51 52 53 54 36 37 38 39 40 41 42 43 44 45 46 47 48 49
Inner line - - - - - --12 13 14 15 16 17 18 19 20 21 22 23 28 30
Codes for ST01-08
(IVAS ST08=TouWei, on temple)
IVAS 01 02 03 04 05 06 07 08
Other 08 07 06 05 04 03 02 01
These differences should be noted and adjusted by the student on the first comparison of
his/her "new" text with the reference text.
Thus, studying four texts, such as the Beijing text (2), Hongkong text (3), Taipei text (4) and
Barefoot Doctor's Manual (5), the student would prepare a therapeutic index in the same way
as above. Then, on checking the points listed for gastritis/gastric ulcer; toothache;
sciatica/lumbosacral pain, sprain, etc (for example) he/she would find:
Gastritis/Gastric ulcer
(Pek) ST20,21,25; SP05; CV12,13 (plus Earpoints and other points)
(Hkx) ST21,28,36; SP05; NL20,21; CV12,13 (plus earpoints and other points)
(TX) ST36,44; SP04; BL21; CV12; local points
(Bdm) ST25,36; BL20,21; PC06; CV06,08,12,13
Toothache
(Pek) LI02,03,04,05; ST03,05,06,07,42,44; SI18; Kl03; TH09,20; GB03,05,06,10,12,17;
CV24; GV27 (plus earpoints and other points)
(Hkx) LU02; LI01,02,04,05; ST03,05,06,07,42,44,45; SI18; TH09,20,21;
GB02,03,05,06,10,12,17; CV24; GV27,28 (plus earpoints and other points)
(TX) LI04,11; ST06,44; TH17
(Bdm) LU09; LI04; ST06,07; SI03; TH17,20
Sciatica, lumbosacral pain, sprain etc
(Pek) BL22,23,24,25,26,27,28,29,30,31,32,33,34,37,39,40,52,53,54,55,
57,59,60,63,64; GB30,31,34,39; GV02,03,04; AhShi, (plus earpoints and other points)
(Hkx) BL27,28,29,30,31,32,33,34,37,39,40,52,54,58,60; GB30,31,32,34,35,40; GV02,03
(plus earpoints and other points)

(TX) BL23,30,40,60; GB34; AhShi

(Bdm) BL23,37,40,52,60; GB30,34; AhShi (plus other points)
In the above examples (Pek), (Hkx), (TX) and (Bdm) refer to the Beijing, Hongkong, Taipei
and Barefoot Doctor's Manual Sources respectively.
Glancing down through the points listed under each condition, one could see some agreement
and some alternative point combinations. In choosing points for therapy, the student could
pick those which showed the greatest measure of agreement, for example:
Gastritis/gastric ulcer: Choose from CV12,13; ST36; BL21 (listed in 3-4/4 of the texts)
Toothache: Choose from LI04; ST06,07,44; TH20 (listed in 3-4/4 of the texts)
Sciatica/lumbosacral pain: Choose from AhShi; BL23,30,40,60; GB30,34 (listed in 3-4/4 of
the texts)
The therapeutic index is obviously a dynamic system, which is extended each time new
references are studied. Also, one may add data from the clinical experience of colleagues,
articles in the journals etc, as it becomes available.
The above approach is often called "Cookbook AP" by the purists and is regarded (especially
by classically trained members) as inferior AP. However, Cookbook AP works very well in
clinical situations with only one or a small number of signs or symptoms. Many recent
textbooks from China, Taiwan, Hongkong etc make no mention of classic AP in the old sense
and they rely very heavily on the Cookbook approach themselves. The Laws of the Five
Phases, the classic use of the Phase Points, Yuan-Source, Luo-Passage, Hour Points, the
Chinese Pulse Diagnosis etc are not mentioned in detail (if at all) in most of the modern texts
from China and its neighbouring countries.
Even if one has access to a comprehensive therapeutic index, one still needs a way to reduce
the number of points to a minimum. This is because many comprehensive prescriptions list far
more points than are needed to treat the case. In the final choice of points, one usually relies
on a few ancient Laws, choosing combinations from the following:
1. Sensitive points
2. TianYing points
3. Local points along affected and nearby Channels
4. Points along the affected Channels
5. Distant points on Channels through the affected area
6. Points on related Channels
7. Master points, including the Five Phase points, Mu/Shu points, Yuan/Luo points and XiCleft points

8. Combination of local and distant points

9. Selection of points according to the symptoms
10. Selection of points according to the innervation
11. Fore and Aft points
12. Earpoints
Cookbook AP can be improved greatly by choosing points from an extensive list (based on
many, if not dozens of, authoritative texts) so that at least 2 of the basic Laws of choosing
points are fulfilled (see example re elbow pain etc later in this paper).
DIAGNOSTIC, THERAPEUTIC AND PROGNOSTIC VALUE OF SENSITIVE POINTS
AND THE CHOICE OF POINTS FOR THERAPY
1. SENSITIVE POINTS
It is important to search for sensitive points. Sensitive points include the AhShi, Trigger
Points, motor points and any other points which show abnormal tenderness to palpationprobing. After taking the case history, the acupuncturist usually palpates the entire body,
probing the muscles, especially in those areas which the case history may suggest as likely to
be sensitive. In musculoskeletal conditions of the upper limb and neck one probes especially
the muscles of the upper limb, neck and thorax. In conditions of the lumbosacral area and
lower limb, these areas will be probed carefully. Occasionally, sensitive points may be found
far away from the problem area and a careful examination would include probing of the whole
body, irrespective of the more obvious areas likely to be affected. For example, SP06 may be
sensitive in menstrual disorder in women; KI03 may be sensitive in renal disorders; GB34
may be sensitive in cholecystitis; L 13 (LanWei = "Appendix Tail") may be sensitive in
appendicitis.
Wherever sensitive points are found, their locations are noted carefully for future reference.
These points may or may not be codified AP points. Their location can help in the diagnosis
and they are also useful in therapy and prognosis. Their disappearance, i.e. return to normal
sensitivity, during a course of treatment is taken as a good prognosis.
Sensitive points, when present, are always included in the point prescription. However,
occasionally a whole area, such as the rectus abdominis, gastrocnemius or gluteal muscles
may be sensitive and to needle all of this would require too many needles. In such cases, one
or two of the most sensitive areas in the muscle are chosen. If ultrasound or electrostimulation
equipment with a roller-electrode is available, the entire muscle can be treated.
One also probes scar tissue carefully. Wherever scar tissue is found, great care is taken to
check whether or not it may be associated with the symptoms (by reflex effects or by blocking
the flow of Qi in one or more Channels). Treatment of problem scars is very important. It is
discussed in the paper on "Techniques of stimulation of the AP points".
Other areas important to probe include the 66 Command Points (the 60 Phase Points + the 6
Yuan points of the Yang Channels (the Yuan points of the Yin Channels are the same as the

Yu points), see paper on the Study of Points and Channels), the front Mu points, the
paravertebral Shu Points" (BL13-30), also the outer line of the BL Channel (BL36-40, 4154)).
Sensitive points excluded from needling treatment include cancers, joint cavities, abscesses,
infected wounds, parasitized skin areas and ulcers. In the latter case, the use of TianYing
points is permitted in certain conditions (see next section).
In humans, practitioners who use the Earpoints pay particular attention to those points which
show abnormal sensitivity.
Point sensitivity can be detected objectively by electronic detectors, as mentioned in an earlier
paper.
2. TIANYING POINTS
In certain cases it is permissible to needle abnormal masses, such as goitre, synovial cysts,
indurated masses in muscle following intramuscular injections etc. The TianYing point is the
point of greatest sensitivity in the mass, cyst etc, It is focus of the problem a swollen or
enlarged area such as an inflamed muscle or joint or periosteum. One needle is put into the
TianYing point and occasionally, 3 or 4 more needles are placed around this one, from the
periphery, as in the diagram (a) and (b) below.
Cyst diagrams (a) and (b):
In the case of varicose leg ulcers, 3-5 needles are sometimes advanced underneath the base of
the ulcer as in diagram (c) below. Ulcer diagram (c):
In hip arthritis, for example, point GB30 (HuanTiao) is needled but the needle may also be
advanced to peck the periosteum of the femoral neck. The intramuscular lump which
sometimes follows injection in the biceps brachii or gluteal muscles can be dispersed quickly
by dry-needling the centre of the lump. In "Tennis elbow", the lateral epicondyle of the
humerus is often pecked with a needle.
In headache following epidural injection or lumbar puncture, the pain can be relieved by
injecting a needle into the original needle track. (A recent paper in a medical journal reported
extraordinary success in such cases by injection of 10 ml of the patient's blood back into the
puncture site. The author did not acknowledge the Chinese discovered that simple needling of
the same area could get the same result).
In general, however, cancer masses, joint cavities, infected wounds and infected abscesses
(non-sterile) and parasitised skin areas should not be needled except for biopsy or drainage
purposes.
3. LOCAL POINTS
In local problems, such as elbow pain, gastritis, tenesmus etc, one or two local points are
included in the prescription. For example, include:
neck pain: GB20; BL10; X 35 (HuaToChiaChi points);

shoulder pain: LI15; TH14;

elbow pain: LI11; HT03;
carpal (wrist) pain: LI05; HT07;
lumbosacral pain: BL23,25; GV03;
hip pain: GB30;
knee (stifle) pain: BL40; GB34; L 16 (HsiYen);
tarsal (hock) pain: BL60 penetrating to KI03;
gastritis: CV12 (CV12 is also the Mu point-for ST);
intestinal disease: ST25, CV04 (these are both local and Mu points for the large and small
intestine respectively);
bronchitis: BL13; CV17;
tracheitis: CV22,23.
Other examples of local points are in Table 1 (at the end of the paper).
4. POINTS ON THE AFFECTED CHANNEL
Where an organ or function controlled by a Channel is disturbed, one or more points on that
Channel are chosen. For example, ST36 in gastritis; LI04 in ulcerative colitis; LU09 in
pneumonia; SP06 in diabetes (Spleen- pancreas); HT07 in tachycardia; BL23,28 in bladder
disorders (these are also the Shu points for KI and BL respectively); KI points in KI
disorders; PC points in PC disorders etc.
Similarly, where aches or pains are located on or near the course of a Channel, points are
chosen on the Channel. For example in pain along the lateral thigh, points GB31 or 32 could
be included; for pain along the lateral chest, points GB22 or 25; SP17 or 18 or 19 or 20 or 21
could be included; for pain on the inner aspect of the leg, one might include one or two points
from: SP05,06,07,08,09; LV05,06,07; KI08,09,10.
5. DISTANT POINTS ON CHANNELS THROUGH THE AFFECTED AREA
In general, the most effective AP points are below the elbow and knee (the areas in which the
66 Command Points lie.
Problems at one end of the body may be treated by points at the other end. For example,
disorders of the head and its organs may be helped by points below the elbow or below the
knee (stifle). Points on the head may help problems below the waist.

Also, a local problem may be helped by needling a point above or below it on its Channel.
For example GB34 in hip, flank or lateral, thoracic pain; TH05 in elbow, shoulder and side of
neck pain; BL40 or 60 in lumbar pain; SP04 in genital pain etc.
A variation of this "Law" is that pain or other disorders at one end of a Channel may be
treated by points at the opposite end of the Channel. Examples are: GV20 in haemorrhoids,
tenesmus or rectal prolapse; GV26 in low back pain; KI01 in cerebral vascular accident,
apoplexy; LI04 in rhinitis, sinusitis, toothache of lower jaw; ST44 in toothache of upper jaw
or temporal headache; BL67 or GB37 in eye pain; LU01, HT01 or PC01 in pain in the palm
of the hand; TH23, LI20 or SI19 in pain in the dorsum of the hand; SI03, 04 or 05 in tinnitus
aurium; LI04, TH05 or SI03 in neck pain.
A Beijing text (9) advises that needles or moxa should not be applied to a wound, an ulcer or
scar. The nearest local points should be used instead. This is at variance with two well
established techniques: the treatment varicose leg ulcers (in Section 2 above) and the
treatment of scar tissue in the paper on "Techniques of stimulation of the AP points").
6. POINTS ON RELATED CHANNELS
The Phase-Mate Channels (Husband-Wife pairs, or Linked Pairs in the same Phase) are:
LU-LI; ST-SP; HT-SI; BL-KI; PC-TH; GB-LV. One member of each pair influences the
other. Disease along one member of a pair or of the main organ of a pair may be helped by
points on the other member of the pair. For example, gastric upsets or pain along the ST
Channel may be helped by needling points on the SP Channel. LI points influence LU
disorders. LV points are used in GB disorders (see below).
Also, points on nearby (anatomically related) Channels (for example SP, KI, LV in the leg
and thigh area; TH, LI, SI on the forearm etc) influence pain etc in the area. Example, pain
along LI Channel in the forearm should be helped by local or distal points TH or SI
Channels.
7. MASTER POINTS
In Classic AP the Five Phase Points (60 points in total) are very important but these are often
ignored in western and modern Chinese AP. They are discussed elsewhere, as are the Master
Points of AP.
The most important of the Master Points for therapy are the Shu-Back Association points,
Mu-Front Alarm points, Yuan-Source, Luo-Passage and Xi-Cleft points. Whether or not
these points are sensitive when their respective organs are upset), these points often are used
in therapy.
Combinations of Shu and Mu Points are prescribed frequently when an organ (or its
functions/correspondences) is abnormal:
Shu and Mu
BL13 and LU01 in disorders of the Lung
BL25 and ST25 in disorders of the Colon

BL21 and CV12 in disorders of the Stomach

BL20 and LV13 in disorders of the Spleen-pancreas
BL15 and CV14 in disorders of the Heart
BL27 and CV04 in disorders of the Small Intestine
BL28 and CV03 in disorders of the Bladder
BL23 and GB25 in disorders of the Kidney
BL14 and CV17 in disorders of the Pericardium, Circulation-Sex
BL22 and CV05 in disorders of the Triple Heater
BL19 and GB24 in disorders of the Gallbladder
BL18 and LV14 in disorders of the Liver
Combinations of Yuan-Source and Luo-Passage points. In disease of an organ or its
Channel, the Yuan point of the affected Channel is used with the Luo point of its PhaseMate Channel, for example in LU disorders (or disorders of the LU Channel), LU09 (Yuan
of LU) and LI06 (Luo of LI) could he used:
affected Yuan and Luo of Mate
in LU disorders: LU09 and LI06
in LI disorders: LI04 and LU07
in ST disorders: ST42 and SP04
in SP disorders: SP03 and ST40
in HT disorders: HT07 and SI07
in SI disorders: SI04 and HT05
in BL disorders: BL64 and KI04
in KI disorders: KI03 and BL58
in PC disorders: PC07 and TH05
in TH disorders: TH04 and PC06
in GB disorders: GB40 and LV05
in LV disorders: LV03 and GB37

The Xi-Cleft points are indicated mainly in acute diseases of their respective Channels or
organs. In haemoptysis: LU06 (Xi of LU); in acute colitis: LI07 (Xi of LI); in epigastric pain:
ST34 (Xi of ST); in acute lower abdominal pain at menstruation: SP08 (Xi of SP).
Various combinations of Master Points are possible. For example, in liver disease, or in
problems of the eyes or nails (which are controlled by LV), the LV Shu point (BL18,
KanShu), the LV Mu point (LV14, ChiMen), the LV Yuan point (LV03, TaiChung) and the
LV Xi-Cleft point (LV06 ChungTo) might be combined. In liver and gallbladder disease (or in
problems controlled by LV and GB Channels), the Luo points LV05 (LiKou) and GB37
(KuangMing) might be combined with the Mu, Shu and/or Xi-Cleft points for liver and
gallbladder (LV14, GB24; BL18, BL19; LV06, GB36).
8. COMBINATION OF LOCAL AND DISTANT POINTS
This is one of the most common methods of choosing points. Examples are:
Face and cheek disorders: local points (ST04,06) plus distant points on Channels to the
area (e.g.) LI04, ST44.
Eye disease: BL01; ST01 (local) plus SI06; GB37 (distant).
Ear disease: GB02; SI19; TH17 (local) plus SI03, GB43.
Hip arthritis: GB30 (local) plus GB34 (distant).
Other examples are shown in Table 1 (below).
The "Adjacent" point is another type of point, recommended in recent Chinese texts. This is
a powerful point, located 1-20 tsun from the local disorder or problem area. Examples are,
GB20 for head and eye; GV20 for forehead; GB25 for lower dorsal area and lumbar area;
LV13 in gastric pain. Other examples are given in Table 1 (below).
For best results, "Adjacent" points usually are combined with local and distant points as in
Table 1. Example: acute gastritis with gastric pain: ST36; PC06 (remote points on the leg and
arm) plus CV12 (local point plus Mu point) plus LV13 ("Adjacent point" and Mu of SP).
9. SELECTION OF POINTS ACCORDING TO SYMPTOMS
Symptomatic points: Certain points are known to be highly effective for common symptoms,
such as vomiting, nausea, fever etc. In treating a clinical syndrome, points are chosen for the
main problem and others may be added for the symptoms. For example, in gastritis: CV12
and ST36 might be chosen as the main points. If symptoms of nausea and fever were also
present, points PC06 and GV14 might be added. The Beijing text (2) lists the following
points for the common symptoms:
Cough; CV22; LU07; SP06
Diarrhoea: ST25,36; SP04; CV06
Difficulty swallowing: CV22,23; PC06

Dreams, nightmares: BL15; HT07; LV03

Excess mucus, cough: ST40.
Excessive-perspiration: HT06; KI07
Fever: LI04,11; GV14.
Hiccough, diaphragmatic spasm: BL17; ST36
Insomnia: HT07; SP06; KI03; CV24.
Nausea, vomiting: PC06; ST36.
Night sweats: SI03; HT06; Z 01
Pain in the cardiac area: PC06; CV17
Palpitation: PC06,04
Salivation: ST04; CV24,23
Shock: GV26; CV08,04; PC06,09
Other examples of points specific for symptoms are:
GB34 in acute, traumatic or muscular pain. (This is the pain point par excellence. It is usually
combined with one of two local points for the affected area).
ST36 in upper abdominal disorders;
SP06 in lower abdominal disorders;
GV26; KI01 in anaesthetic emergencies (collapse, apnoea, cardiac arrest);
PC06 in disorders of the heart, lungs, thorax;
Earpoint Lung in relieving the symptoms of narcotic or alcohol withdrawal.
10. SELECTION OF POINTS ACCORDING TO NERVE SUPPLY
For diseases in any region (head, neck, limbs, internal organs), one may select points from
areas supplied by the same spinal nerves, nerve plexus or nerve trunks as supply the problem
area. Often, direct needling of the nerve trunk or plexus is used. In this respect, the
paravertebral BL points and the paravertebral X 35 (HuaToChiaChi) points are especially
useful for many conditions which do not appear (on casual examination to have anything to
do with the back. This may be the explanation for the success of chiropractic and other
manipulative systems which concentrate on spinal massage and pressure manipulation. These
systems would concentrate on the same areas as the BL and X 35 paravertebral points.

11. SELECTION OF FORE AND AFT POINTS

In local disorders, such as knee pain, arm trauma etc, a combination of Fore and Aft points (in
front of and behind) are used. These are almost always local points. Examples are: Knee
pain: L 16 (HsiYen) and BL40; Forearm pain: PC06 and TH05. The Mu/Shu combination
is also an example.
12. EARPOINTS
Sensitive earpoints, plus other earpoints known to be related to the affected areas or functions
are used in Ear AP. The system is highly effective in man but needs much more development
before it can be recommended for routine use in animals.
FINAL SELECTION OF POINTSS
In the last two sections, we saw that points can be selected from therapeutic indices
(Cookbook Approach) or by reference to the Laws of AP. (There are other Laws not
discussed in this seminar). Ideally one should keep the number of points used in any one
session to a minimum. In practice, however, western acupuncturists may use up to 10 or often
20 points in certain cases. Usually, the number would be <10; Master acupuncturists usually
use <5 points. The ultimate aim of the Master is to cure with only 1 needle: few westerntrained practitioners attain that standard.
There is no hard and fast rule as to the choice of points. Various combinations are possible but
all combinations use the Sensitive (AhShi, Trigger etc) Points, when these are present.
Examples would be:
ORGAN DISEASES:
Sensitive Points (if present) + Mu + Shu points + points for symptoms
(or) Sensitive points + Yuan + Luo + Xi + points for symptoms
(or) Sensitive points + Earpoints
(or) Sensitive points + Local points + Distant points on the affected Channel
(or) many other combinations.
LOCAL DISORDERS (say elbow pain):
Sensitive points (if present) + Local points + Distant points on affected and related Channels
(or) Sensitive Points + Earpoints for Elbow + Earpoint ShenMen
(or) Sensitive Points + TianYing point + Fore and Aft points
(or) other combinations.

As mentioned earlier, the Cookbook approach, especially when it is based on a

comprehensive (cumulative) therapeutic index, may suggest dozens of points in specific
conditions. One way to make a final selection is to use only those points which are most
frequently recommended and to ensure that two or more of the AP Laws mentioned above are
included in making that selection. An example of this method is given below.
Example: In my files, based on a large number of textbooks and other sources, the following
points are recommended for the treatment of elbow pain, strain, trauma, arthritis, rheumatism,
etc. The various authors are coded (1) to (22). For the purpose of this exercise, only the
Channel points are noted.
Author Points Recommended as Effective
1 LU05,06; LI08,11,12,13,14,15; HT03; SI07,08,11; PC03; TH05,15; GB21,34; AhShi
2 LI11; HT03
3 LI10,11; HT03; SI09; BL10,20,23,37; GV04,12,14; LI11; TH05
5 LU05; LI11; TH05;
6 LU05; LI08,11,12,13; SI04,07,11; PC04
7 LU05; LI01,04,11; PC03; TH05,10; AhShi
8 LI11
9 LU05,06; LI08,12,13; SI04,07,11; PC03; TH01
10 LI10,11; BL40
11 LI10,11; SP04; HT04; SI04; PC06; TH01,03,05
12 LU05,07; LI04,06,11; HT01; SI08; PC03; TH10
13 LI04,10,11,12; HT03; TH05,10;
14 LI11,12; HT04; SI04; TH03,05,10; GB34; AhShi
15 LI02,04,05,10,11,13; SI04,08,10,11,12,13,14; BL42,43,44,45; TH04,06,13,14,16; AhShi
16 LI11; GB34; AhShi
17 LU05; LI04,11,14,15; HT03; SI03,06,07,08; TH05,15; GV14; AhShi
18 LI11; TH10
19 LI02,03,04,10,11; TH05; AhShi
20 LI10,11; HT03; GB21

21 LI11; AhShi
22 LU05; LI11; TH05; AhShi
Ranking these points in order of frequency, we find that in 22 text books, LI11 was listed 21
times. Then followed: TH05; LU05; LI10; AhShi points (in local area, shoulder area and
neck) 8-9 times; LI03,04,12; HT03; SI04,07,08,11; PC03; TH10 (4-6 times); LU06;
LI02,08,14,15; TH01,03,15; GB21,34; GV14 (2-3 times), Mentioned only once were: LU07;
LI01,03,05,06; SP04; HT04; SI03,06,09,10,11,12,13,14; BL10,20,23,37,40,42,43,44,45;
PC01,04,06; TH04,06,13,14,16; GV04,12.
Looking through these data, we can select the following points as those most frequently
recommended:
LI11,10; TH05; LU05; AhShi points. Let us call these the "Primary Points". Further down
the list (frequency 4-6/22) we have LI03,04,12; HT03; SI04,07,08,11; PC03; TH10. Let us
call these the "Secondary Points". Still further down the list (frequency 2-3/22), we have
LU06; LI02,08,14,15; TH01,03,15; GB21,34; GV14. Let us call these the "Tertiary Points".
Other points (listed above) are recommended by single authors but for the purpose of the
exercise they are ignored.
I would regard the Primary Points as the most important from which to choose the main
points. Local and distant points would be chosen from the primary, secondary and
(occasionally) tertiary points (or from other sources of information).
In the final prescription for elbow pain, sprain, arthritis, rheumatism etc, we could select the
points as follows:
MAIN POINTS (all cases): LI11; TH05 and AhShi points. LOCAL POINTS (depending
on the site of pain) from: LU05; LI10,12; HT03; SI09; PC03; TH10. For example, for pain
along the biceps tendon: PC03 or LU05 or HT03 would be added to the main points.
DISTANT POINTS (depending on the site of pain) from: LU06; LI02,03,04,08,14,15;
SI04,07,11; TH01,03,15; GB21,34; GV14. For example, in pain of the olecranon, distant
points (TH03 or SI07 or LI04) could be added to the main points for elbow (LI11; TH05;
AhShi) and local points near the olecranon (TH10 or SI08 and LI12).
This approach to the prescription would fulfil at least 3 of the Laws of choosing points and
would also choose the most frequently recommended points for the condition. It should be a
successful prescription for routine use and would be expected to give better results than if the
Cookbook approach alone was used.
The greatest weakness of Cookbook AP is that it is statistical rather than individual therapy.
The "best AP" is to adapt the Cookbook to individual cases and to fulfil at least 2 of the
LAWS on the choice of points. At the same time, one should also try to see the whole case
(not just the elbow pain) and to treat the patient as an integrated individual.
ALTERNATION OF POINTSS

In generalised or systemic conditions, points are often used bilaterally. Thus, if 20 points
appeared in the primary and secondary lists, one would have to needle 40 points if all were
used!
To limit needles to 6-12 per session, points may be alternated between sessions. For example,
primary points in the prescription for diarrhoea are: ST25,36,37; CV04,06,12; SP04,06,09;
BL20,25; LV13. One could alternate the points as follows: (bi = bilateral):
Diarrhoea: Session 1: ST25 bi (Local and LI Shu point); CV04 (local and SI Shu point)
SP06 bi (symptom point and used in low abdominal disorders); BL20 bi (SP Shu, frequently
recommended in diarrhoea). Total 7 needles.
Session 2: ST36 bi (symptom point ); CV06 (Local and in an appropriate neural segment);
CV12 (ST Shu; ST is often upset in diarrhoea); SP04 bi (distant point on SP Channel, which
traverses affected area and is also appropriate for the symptom); BL25 bi (LI Shu). Total 6
needles.
Session 3: ST37 bi (symptom point); CV04 (SI Mu and local point); SP09 bi (distant point
on an appropriate Channel); LV13 bi (SP Mu and on the appropriate Channel). Total 7
needles.
These combinations reduce the number of needles to 7 or 8 per session and meet the major
requirements for choosing points. They should be successful. In acute diarrhoea, a response is
usually evident after one or two sessions over a 24 hour period. Further sessions are seldom
required but may be given over the following days to ensure that the symptoms do not recur.
POINT SELECTION BY PULSEE
In classic human AP, the Laws listed above are used in choosing points. However, the Five
Phase Points are said to be very important also. Their choice in each case is based on (a) the
symptom picture (which may indicate imbalances between the Phases and within one or more
Phases) and (b) the CHINESE PULSE DIAGNOSIS. In Western AP the CHINESE PULSE
method is largely ignored, mainly because of lack of expertise. Modern texts from China,
Taiwan and Hongkong also ignore it, or give it very brief discussion. Furthermore, high
therapeutic success rates are reported by physicians who ignore the Pulse system. However, in
skilled hands, Pulse Diagnosis can be extraordinarily accurate but I believe it to be a psychic
rather than a physical, objectively demonstrable phenomenon. Those who wish to study Pulse
Diagnosis will find details in Wu Wei Ping, Mary Austin or Nguyen van Nghi (see
references).
In vet AP, even if one wished to use the PULSE system, this would be impossible to
transpose directly because of anatomical differences in the arteries and also because the Five
Phase Points are located on those parts of the limbs which show the greatest anatomical
differences from Homo sapiens, with his/her five digits. (Some traditional vet texts, including
Klide and Kung, report that the CHINESE PULSES may be taken in animals on the carotid or
other accessible arteries but few of the vet colleagues whom I know use this system. Other
psychic methods of Pulse assessment include taking a "surrogate pulse", possibly one's own
or the client's or to use dowsing/divining method (pendulum etc). These methods are rarely
used.

CONCLUSIONS
The choice of points in vet AP depends on which system (traditional or transpositional) is
being followed. It also depends on one's depth of AP knowledge. Novices usually use the
Cookbook Method of point selection but they should try to fulfil some of the Laws and to
choose points which help the "whole patient", not just the more obvious symptoms.
In the transposition method a therapeutic index can be consulted in one or more human
textbooks, or the student may make a personal cumulative therapeutic index from many
sources and may rank the points by citation frequency. This will enable him/her to draw up
lists of primary, secondary and tertiary points. From these lists one may select 1 to 12
(occasionally more than 12) points but one should ensure at least 2 of the following Laws are
fulfilled in each point combination used:
1. Sensitive points (AhShi, Trigger Points etc). Be careful to examine for sensitive areas on
surgical or other scars. If these are related to symptoms, treat the scar. (See the paper on
"Methods of stimulating the AP points").
2. TianYing points (focus of a swelling etc).
3. Choose local points along affected Channels or nearby Channels.
4. Choose points along the affected Channels choose points on related Channels
5. Distant points on affected Channels
6. Points on related Channels
7. Some of the MASTER POINTS, especially Mu, Shu, Yuan, Luo and Xi points. Mu and
Shu are often combined, as are the Yuan for the affected Channels and the Luo for the
Phase-Mate Channel.
8. Combination of local and distant points on relevant Channels
9. Points according to the symptoms
10. Points according to the innervation
11. Fore and Aft points
12. Earpoints
In vet AP, few vets are expert enough to use the classical method of balancing the Channels
by using the Five Phase Theory and the 66 Command Points. French colleagues are
probably the most expert in this area, as they study the classic concepts in very great depth.
Although vets in USA and other countries learn this system, few of them study it deep enough
to be really familiar with it. Do not let this deter you!
One old Law of AP states that points on one side of the body may be used to treat
problems on the opposite side. This is one aspect of the "Law of Opposites". However, it is

more usual to use points on the same side as a local problem unless the problem is in the
midline (or near it), in which case points are needled bilaterally.
In certain cases, contralateral points may be used. For example, in motor paralysis, Motor
Points (on the Scalp) are needled on the side opposite to the paralysis. In toothache, left LI04
may be used to treat pain in the right jaw (although, more commonly, ipsilateral LI04 is used).
It may be desirable to alternate the points between different sessions if the student is unhappy
with his first selection or if the results are not satisfactory.
In other cases of paralysis, contralateral body points (on the "good" limb) are used as well as
ipsilateral points. In the Appendix to this paper a list of AP prescriptions is given.
Vets using the traditional AP system may use the therapeutic index in a suitable textbook or
may construct their own index from many sources. However, there is a major difficulty of
integration of various sources because of differences in point location, nomenclature and
alphanumeric coding between various texts and even within texts.
FURTHER READINGG
1 Veterinary AP (1977). by Klide, A.M. and Kung, S.H. University of Pennsylvania Press,
297 pp.
2 Outline of Chinese AP (1975). by Academy of Traditional Medicine. Foreign Languages
Press, Beijing, 305 pp.
3 Newest illustrations of the AP points (1973). by Medicine & Health Publishing Co., Hong
Kong, 100 pp.
4 Basic AP: a scientific interpretation and application (1977). by Chinese AP Research
Foundation. C.A.R.F. Box 84-223 Taipei, Taiwan, 311 pp.
5 Barefoot Doctor's Manual (1977). American translation of official Chinese Manual by U.S.
Dept. Health & Education. Running Press, Philadelphia, 948 pp.
6 Chinese Acupuncture (1973). by Wu Wei Ping. Health Science Press, Wellingborough,
Northants, U.K., 181 pp.
7 Acupuncture therapy (1972). by Mary Austin. Turnstone Books, London, 290 pp.
8 Pathogenic et Pathologic Energetiques en Medicine chinoise. (1971). by Nguyen van Nghi.
Imprimerie Ecole Technique Don Bosco, 78 Rue Stanislas Torrents, 13 Marseille, France, 699
pp.
9 Essentials of Chinese AP (1980). by Beijing, Shanghai and Nanking Colleges of Traditional
Medicine, with the Acad. Trad. Chinese Med. Foreign Languages Press, Beijing, 432 pp.
Reissued 1993: Essentials of Chinese AP. (Coll. TCM, Beijing, Shanghai, Nanking) Foreign
Languages Press, Beijing 432pp.

Table 1
Examples of point selection using Local, Adjacent and Distant points.
Diseased

Local points

Adjacent

area
limb
ST08

Distant points on

points

Thoracic limb

Pelvic

GB20

LI04;

BL40;

Head
ST36

GV20,24;

Face/forehead
BL60

ST08;

GV23

Temple

GB08;

ST08;

Z 09

GB20

Eye

BL01;

TH23;

ST01

GV23;

Ear

GB02;

TH17;

SI19

SI17

TH03

GB41

Nose

LI19,20

BL07

LI04,11

ST45

Mouth/cheek/jaw

ST04,06

SI17

LI04

ST44

GV15

LU11;

GV20;

Throat/front of neck CV22,23

BL10

GB20

LU07

SI03,09

ST43;

TH05;

LI04

GB43

SI06;

LI04

GB37

LI04,11

KI06

Neck and nape

GV16;

GB20;

BL10

BL11

SI03

BL66

Shoulder area
ST38

SI11;

GB21;

LI15

LI14

LI11;

TH05

BL59;

Upper arm

LI11

Forearm

TH05;

Chest area
ST40

CV17;

LU05

GB34;

TH05;

LI15

LI11

SI03;

LI04

AhShi T1-T7

ST19

PC06;

BL18

TH06

GB34

BL10

SI03

BL60

Ribs/axillary area SP17;

LV14

Dorsum, upper

GV14;

Dorsum, lower

BL18,21

GB25

SI03

BL40

Lumbar area

BL18,23

GB25

SI06

BL40

GB30

SI06

BL40

Lumbosacral area GV04;

BL43

BL25

Hypochondrium

GB26,27

LV14

PC06

GB38

Abdomen, upper

CV12;

AhShi T9-L2

CV16

PC06

ST36

Abdomen, lower

CV04;

AhShi L2-S4

ST25

TH06

SP06

Rectum

GV01;

BL35

BL30

BL57

Inguinal area
GB38

GB26,27

LV14

LV03;

Hip/thigh area

GB30,31;

GV03

GB34

BL36

Knee area

ST36;

L 16

Ankle area

KI03;

BL60;

GB31

GB39

ST41; BL59

ST44

GB40

APPENDIX
ACUPUNCTURE PRESCRIPTIONS
1980
(See Appendices 1-3 of the paper "Choice of AP points for particular conditions" for a later
Cookbook)
INTRODUCTION
These prescriptions have been compiled by the frequency ranking method for points and
prescriptions in more than 30 textbooks and many other articles on human AP. Prescriptions
are available from such sources for more than 800 human disorders and symptoms, of which
less than 10% are listed in this Appendix. This material is presented to students as a guide to
the selection of points in the more common conditions.
The prescriptions concentrate mainly on the Channel points and some of the more commonly
used "Strange", "New" and "Hand" points. They ignore the "Scalp points", "Earpoints", "Foot
Zone points", "Nose points", "Face points" and other valuable reflex points. (Students
interested in these methods should consult the relevant texts).
AP therapy is not a panacea, nor is it equally effective for all conditions listed below. Certain
condition, such as muscular lameness, vomiting, diarrhoea, anaesthetic apnoea, hormonal
infertility and convulsions are said to respond quickly and successfully. Others, such as
lameness in severe spinal trauma, osteoarthritis, chronic bronchitis etc require longer courses
of AP therapy man may have failure rates of 30-40%. Still other conditions, such as
peripheral nerve paralysis, paraplegia, paralysis after cerebrovascular accident, urinary
incontinence, severe arthritis (especially polyarthritis) are even more difficult to treat
successfully.
Acute conditions often respond in 1-4 sessions at intervals of 12-14 hours. Chronic and more
difficult conditions may require up to 14 or more sessions at intervals of 3-7 days. As a
general rule, if some improvement is not seen by the 6th session, the probability of success
becomes less and less with each subsequent non-responding session.
AP is frequently combined with other forms of therapy, such as hyperbaric oxygen and
physiotherapy in nerve paralysis; antibiotic therapy in acute, progressive infections, artificial
respiration, transfusion and vasodilator therapy in severe toxaemic shock (Chinese Medical
Journal, Beijing, November 1978 p.497); herbal medicine in cough and many other
conditions. However, concurrent use of large doses of sedatives, narcotics, opiate antagonists,
corticosteroids and analgesics is unwise according to some authorities. These drugs may
antagonise the effects of AP at the level of the specific or non-specific receptors in the brain,
spinal cord or other target areas. If possible, patients should be weaned off these drugs before
AP is used. However, other authorities dispute this claim. Therefore, at this time, the question
remains unresolved. In emergencies and in very serious conditions, AP is given despite the

concurrent use of "antagonistic drugs". Examples are GV26 + KI01 in narcotic- induced
apnoea and the use of Earpoint "Lung" to prevent withdrawal symptoms in narcotic addicts
being detoxified by intravenous naloxone injections.
Channel codes used in the Index are: LU= Lung; LI= Large Intestine, colon; ST= Stomach;
SP= Spleen-Pancreas; HT= Heart; SI= Small Intestine; BL= Bladder; KI= Kidney; PC=
Pericardium, Circulation-Sex, Heart Constrictor; TH= Triple Heater; GB= Gallbladder;
LV=Liver; GV=Governing Vessel (Du, dorsal midline); CV=Conception Vessel (Ren, ventral
midline).
Z 01-31; Y 01-19; X 01-35; A 01-44; L 01-42 are the "Strange Points" for Head & Neck;
Thorax and Abdomen; Loin and Back; Upper Limb and Lower Limb respectively.
NZ01-35; NY01-06; NX01-16; NA01-15; NL01-36 are the "New Points" for Head &
Neck; Abdomen; Loin and Back; Upper Limb and Lower Limb respectively, H are the
Hand points".
In this system, ST08 (TouWei) is on the temple and BL40 (WeiZhong) is in the popliteal
crease.
Thus, the point identification system used in these prescriptions is that adopted by IVAS. The
name of each point is listed in the Appendix to the paper on the Study of the Points and
Channels.
CHOOSING POINTS FROM THE INDEX
These prescriptions are usually in the format of a Primary + Secondary + Tertiary list. The
Primary (P) list is the most important. They are regarded as the Main Points. Points in the
Secondary (S) and Tertiary (T) lists are added only if the symptoms dictate. For example, in
chronic debilitating diseases, Primary (P) points are: BL43; ST36; X 18. Secondary (S) points
are: BL17,20,23; CV06; PC06. If abdominal pain or uterine pathology is present: add CV06;
if kidney disease is present: add BL20 (or BL21) etc.
In short prescriptions, the Secondary (S) list could be added as a routine. For example in skin
diseases involving malignant pustules, the Primary (P) point is GV12 and the Secondary (S)
points (LI04; BL40) could be added routinely.
The Laws governing the choice of Points (see the preceding paper) should be kept in mind
and at least two of them should be fulfilled by the points used. Also consider alternating the
choice of points between sessions.
AP PRESCRIPTIONS IN ANIMALS
(Transposition Method)
The convention x to y means a needle penetrating from point x to point y (for example GB39
to SP06); the convention x-y means any or all points between point x and point y (for
example SI10-14).
GENERAL CONDITIONS

To stimulate immune reaction (antibody production (immunostimulant effect), leucocytosis,

phagocytosis in infections or leucopenia) P: LI04,11; GV14; ST36; GB39 to SP06; S: In
localised infections add points for the region or organ affected.
Chronic disease (slow convalescence; to improve constitution after debilitating diseases) P:
BL43; ST36; X 18; S: BL17,20,23; CV06; PC06.
Weak constitution (fatigue, poor general health, general weakness (as a tonic) P: CV03,04;
ST36; SP06; LI11; BL20,43; S: PC06; SP21; CV12; LI04; HT09; BL10,11; LV03; GV14;
GB34,38; X 18.
Fever, hyperthermia P: LI04,11; GV14; S: ST36,44; LU10; Bleed Earpoint "Apex";
Dehydration, thirst: add KI07.
Allergies, hypersensitivities (immunosuppressant effect) P: LI04,11; ST36; GV14; LV03;
GB39 to SP06; S: Local allergies: add local and distant points for the region or affected
organ; Urticaria: add SP10.
Anaemia P: GV14; ST36; BL17; CV04,06; LI11; S: GV04; CV12; BL18,20,22,23; T:
PC06; SP06,10; LI04; KI01; GV20
Anaesthetic emergencies (apnoea, respiratory and cardiac arrest), neonatal asphyxia P:
GV26; S: KI01; T: strong stimulation of ear canal.
Recumbency, downer-cow syndrome: Injection of 2% procaine solution into BL22,23,24,28
(bilateral), GV03; 5 ml per point, at a depth of 35-40 mm. Alternative is 250 ml 1%
methylene blue solution (i/v) into jugular vein. (Take great care not to allow perivascular
leakage !)
Muscle cramp, poor finish in racing animals P: AhShi points in muscles; Forelimb: search
forelimb, neck, thoracic muscles. Hindlimb: search hindlimb, lumbosacral and abdominal
muscles). Add main points for cramping region; (Hindlimb, esp. BL23,40,57; GB30,34;
Lowback especially BL23,25,27,31; GV02,03,04; X 35 (L1-S4); S: BL40,60; GB30,34;
Forelimb especially GB21; LI11,15; TH05,14; BL11,12,41; X 35 (C1-T6 area)).
Paralysis of peripheral motor nerves, spinal paralysis P: Stimulate nerves (bilaterally),
with strong stimulation on affected side. Use local points for the region or affected limb,
especially a chain of points over affected nerves. Use AhShi points, if present (but they are
seldom present). Use the Scalp points (on the opposite side) for the Motor Areas; S: Massage
and physiotherapy, if possible. If cerebral anaemia is suspected, add GV26. Consult textbooks
for further details.
DISORDERS OF THE SKIN
Neurodermatitis, dermatitis, eczema, urticaria, pruritus P: LI04,11; SP06,10; KI09;
ST36; S: LI04,15; GV14; BL13,17,23,25,40; PC07; GB20; ST25; SI03.
Malignant-pustules, carbuncles, furuncles, boils, folliculitis (anywhere on the body) P:
GV12; S: LI04; BL40.

Abscess, felon, whitlow (nailbed) P: GV10; S: BL40.

NERVOUS DISORDERS
Epilepsy, during attack P: GV26; KI01; LU11; SI03; BL62; Between attacks P: GV14,20;
PC06; HT07; ST36,40; BL15; CV12; Y 29; S: GV06,08,13,24; PC05; HT05; GB20: CV15;
SI03; BL62; T: GV01,12,15,16,17; KI06,09; SP01; PC07,08; GV06,17; LI04,11;
BL03,05,61,63,64,65; GB09,13,15; ST41,42,45; SI08; TH17; LV02,03; A 01; Z 01.
Convulsions, during attack P: KI01; GV26; Between attacks P: LI04; LV03; SI03; BL20;
ST36; S: LU11; LI11; SP01; BL60,63; GB20; LV02; CV04,06,12; GV12,14,21,22.
Hysteria, during attack P: KI01; GV26; Between attacks P: PC06; HT04,07; SP06;
GV08; KI01,05: LI04; BL15,22; CV12; GV13,26; ST36,40; SI03; GV14,20.
Unconsciousness, coma P: GV26; KI01; LU11; A 01; S: GV20; PC06,08,09; LV03; HT09;
T: LI01,04; ST36; CV06; GV24,25.
DISORDERS OF THE NECK AND THORACIC LIMB
Neck pain, sprain, rheumatism, spasm, arthritis, slipped disc, wry neck and paralysis P:
GB20,21,39; BL10,11; GV14,16; SI03,07; X 35 (C2-T4); A 23; AhShi; S: BL12,41;
SI06,14,15; LI04,11; LU07; TH05,15; BL40,43,60,64,65; SI10,11,16; GB34,36; GV13,18;
CV24; TH10,12,16; HT07; LI15; KI01; A 22.
Upper limb pain, sprain, rheumatism, spasm, arthritis P: LI04,11,15; TH05; AhShi
(neck, back, shoulder area and arm) and local points; S: SI03,06,08; BL11; LI10; T:
TH07,14; BL18,40,62; GB34; ST44; NZ23; A 30,32.
Upper limb paralysis P: LI15; LI11 to HT03; TH09 to TH10; TH05 to PC06; LI04 to
PC08 (or LI04 to SI03); S: LI09,10; SI09; A 30; NX04; SI06; GB21; TH03,04.
Shoulder, pain, cramp, rheumatism, stiffness, arthritis, bursitis P: TH14,15; LI11,15,16;
BL11; SI09,11; AhShi; S: TH10; SI03,10,13; GB21; T: TH03,06,11,13; GV12,14;
SI12,14,15; LI04,10; BL13,41,44; A 42.
Shoulder, Shoulder muscles and thoracic back pain, spasm etc P: LI11,15;
SI09,10,11,12,13,14; GB21; TH14; AhShi; S: BL11; SI03,08,15; LU02,09; LI02; T:
TH03,11,13,15; SI06; LI04; BL12,13,41,42,44; GB20; HT02.
Shoulder and arm muscles: pain, cramp, rheumatism P: LI04,11,15; TH05,14; AhShi; S:
LI10; TH06,15; GB34; ST36; T: LI07,16; TH10,11,13; SI11.
Elbow pain, sprain, arthritis, rheumatism P: AhShi; LI11 to HT03; LI12; LU05; TH05;
S: LI04,10; GB34; SI04; T: LI08,12,13,14; SI07,08,11; PC03; TH01,10; LU06; GB21;
HT01,04.
Wrist, carpal pain, sprain, rheumatism, arthritis P: (Choose according to the affected
Channel and side): AhShi (local and shoulder girdle); LI04,05,06; SI04,05; TH04,05;

HT05,07; PC07; LU07; S: SI06,11; TH06; LU08; A 09,22; T: SI03,05,08,10-14; LU06,09;

LI03; HT06; PC04; TH02,03,13,14; BL12-17; BL41-46.
Metacarpal pain, sprain, rheumatism P: LI03,04; LU01,07; PC01,07,08; HT01,07; A 22;
SI04; TH04; AhShi; S: LI05,06,11,20; LU05,08; SI03,07; TH02,03,05,23.
Finger (digital, upper limb) pain, sprain, rheumatism, arthritis P: AhShi; A 22; PC07;
LU07; LI03,04; SI03,04,07; S: LI05; HT07; TH03,04,05; local periosteal AP (Thumb: esp.
LU07 and periosteal local AP; Index: especially LI03,04,05; PC07; Middle: especially
PC07,08; Fourth finger: esp. TH03; HT07; Little finger: especially SI07; TH03; HT07; T:
LI06; HT03; TH06,13,14; A 09,17; PC04,06,08; GV14; SI06,08,10-14; BL12-17,41-46.
DISORDERS OF THE THORACIC AREA, HEART, LUNGS, TRACHEA
Pain, trauma, rheumatism, stiffness, spasm, arthritis, slipped disc in thoracic spine and
thoracic back muscle area P: Spinal AhShi; X 35; GV points esp. 09,12,13,14; GB30; S:
GV05,06,08,11; BL23,46,49,50; GB21,26; SI11,14; T: GV01,02,03,07,10,15,16;
KI01,02,03,04,08; CV04,06,12,22; ST13,37,39,41; BL40,56,60,64; LI05; GB20,25; LU02;
LV13.
Palpitations, atrial fibrillation, functional cardiac disorders P: HT05,07,09; PC06,07;
BL15; S: HT06,08; PC03,05; BL10,14; CV14; T: HT03; PC04; BL11,12; LU04; LI04;
ST36; LV01,03; GB20; CV06,12,17; GV24.
Bronchitis P: LU05; BL11,12,13,43; CV17,22; S: LU01; LI03; ST13,14,15,40; SI15;
BL42,44; KI22,23; PC06; CV18,19,23; GV10,12,14; NX04; T: LU09; ST36; BL08,14,17;
CV14; X 01; Acute P: LU05; BL13; CV22; LI04; GV14; S: PC06; TH05; BL12; ST40;
GB20; T: LU07,08,09; LI06; SI17; BL10; SP06; GB21; CV17; GV16; Chronic P: LU05;
BL13; CV22; ST40; CV12,17; BL12; S: PC06; BL08,20; LU06,07; CV06; GV12; LI04; T:
LU01; ST36; BL11,17; CV18; NX04.
Asthma, bronchospasm, functional emphysema P: CV17,22; NX04; X 01; BL13; PC06;
ST40; S: LU01,02,05,07,09,10; ST36; LI04; CV06,12; BL11; GV14; T: LU03,06,08;
ST09,10,12,13,16; KI04,27; CV04,16,18,23; GV10,12; SI15; GB19,23,35,44; SP06.
Chronic rhinitis, sniffles P: LI04,20; Z 03,14; GB20; GV23,25; S: LI11,19; GV14,20,24; Z
15,16; BL07,08; LU05; GB04.
Soft moist cough, excess phlegm P: ST40; CV12; S: LU07; BL20; LI18.
Cough P: BL13; LU05,07; CV17,22; ST40; S: LU02,06,08,09,10,11; LI04; ST36; KI03,27;
CV21; T: LU01,04; LI18; ST16; SP18; BL11,12,43; KI24,25,26; PC02; CV12,16,20;
GV11,14.
Tracheitis (see laryngitis) P: CV22; BL11,13; S: LI04; GV14; ST40; LU05,07.
DISORDERS OF ABDOMINAL AREA, DIGESTIVE, REPRODUCTIVE, URINARY
SYSTEMS AND LOW BACK; DISORDERS OF THE DIGESTIVE TRACT

Malabsorption, ill-thrift, weight loss P: ST36; BL20,21; CV06; bleed A 09; S: CV12;
KI03; LV13; BL17.
Anorexia, total inappetance P: ST36, KI17; CV12; S: CV10; GV07; ST21,22; SP04;
HT07; BL20.
Poor appetite, inappetance P: BL20; ST36; S: KI17; CV12; GV07; ST22; SP06; HT07;
BL18,21; LI04.
Digestive upsets, indigestion P: ST36; CV12; S: BL21; SP06; ST25; CV10; T: ST45;
BL20,22,47,49; LV13,14; GV05,11; SP04,05,16; PC06; T: GV06,13,14; BL66; LI04;
ST21,23; SP15,21.
Vomiting P: ST36; PC06; CV12; S: ST25; SP03,04; BL20,21; KI20; GV18;
CV11,13,14,18,22; T: BL45,46,49,50; KI20,21,25,26; TH19; GB23; CV06,08,15,16; SI04;
LV03,13; LI04; Neurogenic, nervous vomiting P: ST36; PC06; CV12; BL17.
Nausea P: PC06; CV12; ST36; S: HT03; BL21; CV02,03,13,14; Continuous: add KI01;
Neurotic: add BL17; ST21.
Gastritis P: PC06; ST21,36; CV12,13; BL21; S: BL18,20; ST20,25; CV06; T: BL17,19,22;
SP04,05,06; ST19,23,37.
Colic, gastric: see vomiting.
Enteritis P: BL22,25,29,53; GV05; S: ST25,36,37,39; BL21,27; CV06,08,10; GV03; SP05;
Chronic: add Moxa CV08.
Gastroenteritis P: PC06; ST25,36; S: BL21; SP04; CV12; moxa CV08; needle points 0.5"
near CV08; A 09 (4 points 1" near umbilicus)).
Ulcerative colitis, colic, spasm P: ST25,36; SP15; CV06; BL25,27; S: CV12; BL20,21;
LI04; HT07. T: LI10; ST17,28,37,40,44; HT03; BL22,24,31; PC06; GB28,34; LV03;
CV03,04,08,13.
Diarrhoea P: ST25,36,37; CV04,06,12; SP04,06,09; BL20,25; LV13; S: ST34; moxa CV08;
SP03,14,15; BL21; KI07; GV05,06; T: LI03,04: KI08,13,14,20,21; GV01,03; LV14;
Chronic: add moxa CV08.
Constipation P: TH06; KI06; SP15 (or) ST25,26; CV06; BL25; SP03; KI16; S: CV12;
BL27,28,33,36,38,50,51,57; SP03,16; GV01; GB34; T: ST40,44; CV03; LV01,02; LI02,11;
GB28.
Colic (intestinal) P: ST25,36; CV06; moxa CV08; S: LI04; BL25; CV12; LV03; T: ST37;
LV02,05; SP14.
Paralytic ileus P: ST25,36; SP15; BL25,27.
Anal/perineal pruritus, pain P: GV01,20; BL57; SP10; S: BL25,32; TH06.

Tenesmus, anal ptosis, protrusion P: GV01,20; BL57; CV08 (moxa); S: GV02,06; CV06;
ST25,36.
DISORDERS OF REPRODUCTIVE SYSTEM
Pseudopregnancy (to terminate); to induce birth near term, misalliance (to abort) P:
SP06; ST36; BL32; CV05,06; LI04; KI08; "labour points" (in human, 2" lateral and 2"
below umbilicus, bilateral; S: ST25; CV02; SP09.
To facilitate calving, relaxation of pelvic ligaments in dystocia P: GV02,03,04; BL32,53;
S: BL23,24,26,31,33,34,54.
To facilitate reposition of prolapsed uterus P: GV02,03,04; BL23,26,31,53; S:
BL24,32,33,34,54.
Placental retention P: CV03; BL60,67.
Uterine inertia, failure to regress postpartum P: CV02,04; GV20; SP06; Y 16 to Y 18; S:
ST29,36; CV03,06.
Lochiorrhoea P: CV07; Y 15.
Vaginal discharge, leucorrhea P: CV03,04,06; SP06; ST25; LV03; GB26; S: CV02,05;
BL27,31-35; KI10,12; ST29; LV11; T: CV07; BL23,30; GV04; SP10; ST36; LV04.
Metritis P: BL30; SP12; GB26,27; S: BL27,28,31,32; GV04; CV07; GB28,29; T:
BL25,33,35; SP06,10; ST29,36; LI04; CV02,03,04; Y 18.
Anoestrus, cystic ovaries, repeat breeders in cows, infertility P: Main point is 4" from
mid-line in L5-L6 space (bilateral); use also AhShi points in lumbosacral area (i.e. in area
BL23 to BL34); S: points from GV02,03,04; BL23,24,26,31-34,44,53.
DISORDERS OF URINARY SYSTEM
Urinary tract disorders P: CV03,06; ST25; BL31-34; AhShi; S: CV04,05; SP06; LV08;
BL23; GV04; X 35 (Sacral 1-4).
Bladder disorders P: CV03,06; SP06; BL23,28; S: BL32; CV04; SP09.
Cystitis P: BL28,38,58; CV03,04; KI02,03; ST28; S: BL23,25,26,31-33,54; GB26,29;
SP06,09; CV02; T: ST27.
Bladder pain, spasm (in obstruction, calculi, colic) P: BL23,28; SP06; S: SP09;
BL24,25,27,31,33; CV03,04,06; ST30,36
Dysuria, pain or difficulty on urination P: SP06,09; CV03,04; BL32; S: HT08;
BL23,27,28,31,33,34,52; SP11; CV02,05,06,09; LV05,08; KI01,04,05,11; ST28,36; GV20.
Haematuria P: BL23,27; CV04,06; S: SP06; LV03; BL28; KI07.

Spastic bladder P: SP06; CV04; S: BL23; KI10; CV06; LV03.

Polyuria, diabetes insipidus P: BL23; CV04; S: GV04; BL21,22,24; LV13; CV03,06;
SP06; KI07.
Urinary incontinence P: CV03,04; GV04; SP06; BL22,23; X 35 (L2-S5); S: CV02,06;
GV20; BL25,27,28,67; LV01,02,03; KI02
Bladder paralysis P: CV02,03,04; S: GV03; LV02; KI11; BL23,28,40.
Urine retention, postoperative urethral stricture, sphincter spasm; to evacuate bladder
in cerebrovascular accident, stroke etc P: SP06; CV04; S: SP09; CV03; BL28; T:
BL23,32,43; CV02; ST28
Anuria, retention with coma, unconscious P: KI01; S: GV26
DISORDERS OF LUMBOSACRAL AREA
Lumbar, loin, renal area, sacral area pain, rheumatism, stiffness, lowback syndrome,
arthritis, spondylitis P: AhShi; X 35; BL23,25,27,31,40,52,60; GB30,38; GV02,03,04; S:
BL22,24,26,32,37,57; SI03; LV09; GV01; GB26,29,34; T: BL33,34,36,39,54,63,64,65;
KI03,07; SP08; ST31; GB27.
Lower limb paralysis, posterior paralysis, paraplegia P: X 35; GB30,31,39; ST36; local
points for region; GB34 to SP09; S: ST31,32,38,39,41,42; BL11,37,40,54,57,60; KI03;
GB33; T: ST33,37,40; SP03,04,06; BL23,25,32,38,39,55,61,62; GB37,40,43; LV03,11;
KI07,08; GV02,03; L 24.
Hip, thigh pain/rheumatism, arthritis etc P: AhShi; GB30,31,34; BL23,24; LV08,11; S:
GB28,29,32,39; BL30,60; KI03.
Hip dysplasia (dogs) Prevention: Avoid breeding from carriers. Treatment P: GB30,34;
Peck periosteum of femoral trochanter; S: GB29,31; BL40,60. (Lumbar pain add BL21,23;
GV03). Alternative: under anaesthesia, implant 5-8 gold beads around acetabulum (anterior,
dorsal and posterior ridge). This method is safe and highly effective
Knee (stifle) pain, rheumatism, arthritis etc P: AhShi; GB34 to SP09; GB33 to LV08; L
16 to L 16; GB30,38,39; ST33,35; BL40; S: ST34,36; LV07; BL57,60.
Ankle (hock) pain, strain, spavin, arthritis, rheumatism etc P: AhShi; BL60 to KI03;
GB39,40; ST41; S: BL59,62,63; SP05,06; GB37
Metatarsal pain, rheumatism, sprain, inflammation P: AhShi; BL60; ST42,43; L 05; S:
BL57; ST41,44; KI03; LV03; T: GB34,39,41; SP04,05; KI06; LV02.
Toe (hind digit) pain, arthritis, rheumatism etc P: AhShi; L 08; SP04; LV03; S: ST41,43;
GB34,40; BL60; KI03.
AP ANALGESIA

Abdominal surgery in large animals: LU01 with TH08 to PC04.5 (i.e. between PC04 and
PC05). See the paper on AP Analgesia.
Abdominal surgery in small animals: BL23 (bilat) with ST36 (bilat) (or) SP06 to BL59
(bilateral).
Thoracic, head and upper limb surgery in small animals: Needle penetrating through the
limb at level of PC06 and TH08 (both bilateral).
Inguinal and lower limb surgery in small animals: SP06 to BL59 (bilateral) +\- BL23
(bilateral).
QUESTIONS
1. One of the following statements is not correct. Indicate the incorrect statement:
(a) The TianYing Point is a point in an abnormal mass, such as a goitre, synovial cyst etc. It
is the point of greatest sensitivity in the mass. One needle is put into the TianYing point and
occasionally, 3 or 4 more needles are placed around this one, from the periphery.
(b) In varicose leg ulcers, 3-5 needles are sometimes run underneath the base of the ulcer
(c) In hip arthritis, GB30 is needled but the needle may also be advanced to peck the
periosteum of the femoral neck.
(d) The intramuscular lump which sometimes follows injection in the biceps brachii or gluteal
muscles can be dispersed quickly by dry-needling the centre of the lump. In "Tennis elbow",
the lateral epicondyle of the humerus is often pecked with a needle. In headache after epidural
injection or lumbar puncture, the pain can be relieved by needling the original needle track
(e) AP needles are inserted routinely into cancer masses, joint cavities, infected wounds and
infected abscesses (non-sterile) and parasitised skin areas.
2. In local problems, 1-2 local points are included in the prescription. For example, in
Lumbago include lumbar points (from BL22,23,24,25). One of the following sets of
points are not local points. Indicate the incorrect set:
(a) neck pain : local points include GB2O; BL10; X 35 (HuaToChiaChi points)
(b) shoulder pain: local points include LI15; TH14
(c) elbow pain : local points include LI11; HT03
(d) carpal Pain : local points include LI05; HT07
(e) hip pain : local points include GB3O
(f) knee pain : local points include BL40; GB34; L 16 (HsiYen)
(g) hock (tarsal) pain: local points include BL60 penetrating to KI03

(h) tracheitis : local points include CV22 or 23

(i) earache : local points include ST07, SI19, GB02, TH17,21
(j) eye pain : local points include ST09, SI16, LI18, GB21, BL12

3. One of the following statements is not correct. Indicate the incorrect statement:
(a) Problems at one end of the body may be treated by points at the other end. For example,
disorders of the head and its organs may be helped by points below the elbow or below the
knee (stifle).
(b) A local problem may be helped by needling a point above or below it on its Channel. For
example GB34 in hip, flank or lateral, thoracic pain; TH05 in elbow, shoulder and side of
neck pain; BL40 or 60 in lumbar pain; SP04 in genital pain etc.
(c) A variation of this "Law" is that pain or other disorders at one end of a Channel may be
treated by points at the opposite end of the Channel. Examples are: BL67 or GB37 in eye
pain; LI04 in rhinitis, sinusitis, toothache of lower jaw; ST44 in toothache of upper jaw or
temporal headache; LU01; HT01; PC01 in pain in the palm of the hand; TH23; LI20; SI19
in pain in the dorsum of the hand; SI03,04 or 05 in tinnitus aurium; GV20 in haemorrhoids,
tenesmus or rectal prolapse; GV26 in low back pain; KI01 in cerebral vascular accident,
apoplexy; SI03 in neck pain
(d) The Phase-Mate Channels (LU-LI; ST-SP; HT-SI; BL-KI; PC-TH; GB-LV) influence
one another. Disease along one member of a pair or of the main organ of a pair may be helped
by points on the other member of the pair. For example, gastric upsets or pain along the ST
Channel may be helped by needling points on the SP Channel
(e) Points on anatomically related Channels (for example SP, KI, LV in the leg and thigh
area; TH, LI, SI on the forearm etc) have little or no influence on pain etc in the area.
Example, pain along LI Channel in the forearm should not be helped by local or distal
points TH or SI Channels.

4. One of the following statements is not correct. Indicate the incorrect statement:
(a) Important immunostimulant points include LI04,11; GV14; ST36; GB39 to SP06
(b) Important points in fever, hyperthermia include LI07; GV16; ST30.
(c) Important points in chronic disease include BL43; ST36; X 18; BL17,20,23; CV06;
PC06.
(d) Important points for weak constitution (general tonic) are CV03,04; ST36; SP06; LI11;
BL20,43; CV06; PC06.

5. One of the following statements is not correct. Indicate the incorrect statement:
(a) Important points for anaemia are GV18; ST31; BL25; CV22; LI15
(b) Important points for allergies, hypersensitivities (immunosuppressant effect) are
LI04,11; ST36; GV14; LV03; GB39 to SP06.
(c) SP10 is an important point for urticaria.
(d) Important points for anaesthetic emergencies (apnoea, respiratory and cardiac arrest),
neonatal asphyxia are GV26; KI01
(e) Important points for recumbency, downer-cow syndrome are: Injection of 2% procaine
solution into BL22,23,24,28 (bilateral), GV03; 5 ml per point, at a depth of 35-40 mm.

6. One of the following statements is not correct. Indicate the incorrect statement:
(a) Important points for muscle cramp, poor finish in racing animals are AhShi points in
muscles. Add main AP points for cramping region: Forelimb especially GB21; LI11,15;
TH05,14; BL11,12,41; X 35 (C1-T6 area)); Hindlimb, especially BL23,40,57; GB30,34;
Lowback especially BL23,25,27,31; GV02,03,04; X 35 (L1-S4); BL40; GB30,34.
(b) Important points for paralysis of peripheral motor nerves and spinal paralysis are:
Stimulate nerves (bilaterally), with strong stimulation on affected side. Use local points for
the region or affected limb, especially a chain of points over affected nerves. Use AhShi
points, if present (but they are seldom present). Use the Scalp points (on the opposite side) for
the Motor Areas; S: Massage and physiotherapy, if possible. Add GV26 if cerebral anaemia is
suspected.
(c) Important points for neurodermatitis, dermatitis, eczema, urticaria, pruritus are:
LI06,09; SP07,13; ST41; GV24; GB30.
(d) Important points for malignant-pustules, carbuncles, furuncles, boils, folliculitis
(anywhere on the body) are: GV12; LI04; BL40.
(e) Important points for abscess, felon, whitlow (nailbed) are: GV10; LI04; BL40.

7. One of the following statements is not correct. Indicate the incorrect statement:
(a) Important points for epilepsy are: during attack: GV26; KI01; LU11; SI03; BL62;
between attacks: GV14,20; PC06; HT07; ST36,40; BL15; CV12; LI04; LV03.
(b) Important points for convulsions are: during attack: KI01; GV26; between attacks:
LI04; LV03; SI03; BL20; ST36; GB20; CV04,06,12.

(c) Important points for hysteria are: during attack: KI01; GV26; between attacks: PC06;
HT07; SP06; GV08; KI01: LI04; BL15; CV12; ST36,40; SI03; GV20.
(d) Important points for unconsciousness, coma are: LU01; LI06; ST30; SP09; BL11; KI03;
PC01; TH15; GB21; LV11; GV22; CV22.
(e) Important points for neck problems are: GB20,21,39; BL10,11; GV14,16; SI03,07; X 35
(C2-T4); AhShi

8. One of the following statements is not correct. Indicate the incorrect statement:
(a) Important points for upper limb paralysis are: LI20; TH23; SI19; GB31.
(b) Important points for other upper limb problems are: LI04,11,15; TH05; AhShi (neck,
back, shoulder area and arm) and local points; SI03,06,08; BL11; LI10; GB34.
(c) Important points for shoulder problems are: TH03,06,10,11,13,14,15; LI04,10,11,15;
BL11,13; SI03,09-15; AhShi; GB21; GV12,14.
(d) Important points for elbow problems are: AhShi; LI04,08,11,12,13,14; LU05,06;
TH01,05,10; SI04,07,08; PC03; GB21,34; HT01,03,04.
(e) Important points for wrist problems are: choose according to the affected Channel and
side: AhShi (local and shoulder girdle); LI03,04,05,06; SI03,04,05,08,10-14; TH04,05,06;
HT05,06,07; PC07; LU07; SI06,11; LU06,08,09; PC04; TH02,03,13,14; BL12-17,41-46.

9. One of the following statements is not correct. Indicate the incorrect statement:
(a) Important points for metacarpal problems are: AhShi; LI03,04,05,06,11;
LU01,05,07,08; PC01,07,08; HT01,07; SI03,04,07; TH02,03,04,05.
(b) Important points for finger (digital, thoracic limb) problems are: AhShi; local points;
PC07; LU07; LI03,04; SI03,04,07
(c) Important points for problems in thoracic spine and thoracic back muscle area are:
spinal AhShi; X 35; GV07-16; GB20,21,30; BL23,40,46,49,50,60; SI11,14.
(d) Important points for functional heart disorders are: HT05-09; PC03-07; BL10-15;
CV06,12,14,17; LU04; LI04; ST36.
(e) Important points for lung problems are: CV03; BL28; GB25; BL23

10. One of the following statements is not correct. Indicate the incorrect statement:

(a) Important points for rhinitis are: LI04,11,19,20; GB20; GV14,23,25; LU05.
(b) Important points for tracheitis are: CV01; GV01; ST25; BL25
(c) Important points for malabsorption, ill-thrift, weight loss, inappetance, anorexia are:
ST21,22,36; SP04,06; BL17,18,20,21; LI04; KI03,17; LV13; CV06,10,12; HT07; GV07.
(d) Important points for indigestion are: PC06; ST36; CV08,10,12; BL20-22,25,27; SP06;
ST25; LV13,14
(e) Important points for vomiting are: ST36; PC06; CV12; BL21
1 = e 2 = c 3 = a 4 = b 5 = c 6 = b 7 = e 8 = b 9 = h 10 = b 11 = c 12 = d 13 = d 14 = a 15 = a

SUMMARY
1. Veterinary acupuncture (AP) is based primarily on human AP principles and the choice of
points for particular conditions is very similar to the choice for similar human conditions.
2. Using a Hewlett-Packard Minicomputer, data from over 55 textbooks and clinical articles
were stored. Frequency-ranked prescriptions for >1100 clinical conditions were generated
from the computer database.
3. The Top Twenty Points from each prescription were extracted from the database summary.
From this list, the most important points for major body regions (head, neck, thoracic limb,
thorax, nose, throat, shoulder, elbow, lung, stomach, etc) and common symptoms (shock,
nausea, vomiting, diarrhoea, fever, etc) were extracted.
4. Appendix 1 comments on the use of the point Index, the structure of the Index and the code
and name of each point. Appendices 2 and 3 list the points. Examples of methods of point
selection for specific conditions and for more complex syndromes (combinations of
symptoms) are given in the text.
5. Advantages and disadvantages of the COOKBOOK METHOD of point selection are
discussed in relation to holistic (traditional) AP.
INTRODUCTION
Western veterinary AP is based primarily on transposition of human AP principles to animal
patients. To select effective points for therapy, one makes appropriate adjustments for
differences in anatomy, location of peripheral nerves, and temperament of the animal (Rogers,
1980b; Molinier, 1983; Westermayer, 1981). There are some texts on traditional veterinary
AP and some Western experts have produced texts which are based on traditional points.
Others have written texts on the transposition method. Advantages and disadvantages of the
transposition method have been discussed elsewhere (Rogers, 1982b).
Studies of the electrical resistance of skin in dogs, horses and cattle have confirmed the
existence of REPP (reactive electropermeable points) at locations predictable from the human
AP system (Janssens; Krueger; Greiff; Kothbauer). In AP research with primates, laboratory
animals (mice, rats, guinea pigs, rabbits) and larger species, the human transposition system is
the one used routinely to locate points such as LU01; LI04,11,15,20; ST09,25,36; SP06,09;
HT07; BL points; PC06; TH05,08,14,17; GB20,30,34; LV03,14; GV26 etc. The clinical and
experimental effects of stimulating these points have been confirmed worldwide in the past 10
years in many animal species (laboratory, farm, domestic and zoo).
Uses of the computer in AP and the advantages and disadvantages of computer -generated
prescriptions were discussed elsewhere (Rogers 1984 a, b). Many professionals still refuse to
use a computer. I believe that this refusal stems from fear (that they will not be able to master
it) and ignorance of what a modern computer can and cannot do. Traditionally-trained
acupuncturists may scorn the idea of cookbooks (although they use their own favourite
prescriptions - a poor Cookbook). They would be horrified at the idea of computerising AP.

COOKBOOK AP: Many have told me that "prescription AP", especially the free availability
of prescriptions, do AP a disservice. They assume that the cowboys (quacks, charlatans, getrich-quick merchants) will proliferate and thrive if such information is freely available. I do
not believe this. I would prefer to see AP develop rapidly. This will not happen if we must
wait for a high percentage of the professions to develop to Master Acupuncturist status. The
use of AhShi therapy and cookbooks brings more professionals into the active AP field than
any other method that I know.
This paper discusses computer-based AP prescriptions for selected areas and symptoms under
3 main headings
: computer AP databases
: prescriptions for major body areas, functions, subregions
: prescriptions for common symptoms
It has taken me more than 11 years to amass these data. Therefore I ask each of you to treat
the material as copyright. You are welcome to use it for clinical, study and research purposes,
but not for commercial publication in text, computerised, microfiche form, etc. You are free
to make personal copies for friends or colleagues, but only on condition that they also agree to
respect the copyright.
The Channel and Point coding used throughout this text is: LU, LI, ST, SP, HT, SI, BL, KI,
PC, TH, GB, LV, CV, GV; ST08 (TouWei) is on the temple, BL41 (FuFen) is at T2 and
BL40 (WeiZhong) is in the popliteal crease. This is the same as that used by IVAS. The
alphanumeric code and name of each point is shown in Appendix 1. As there is no
internationally accepted coding system to-date, you are urged to check my coding system
(Appendix 1) at this stage and to compare it with the one which you use. This is most
important to prevent confusion and error.
COMPUTER AP DATABASES
The larger the database, the more points are filed under any given region, symptom or
condition. However, the first 6-10 points listed (in order of descending citation score) are the
most important for routine use. For example, in the most recent summary of the database, 401
points were listed from a base of 44 texts for the treatment of sequelae (hemiplegia,
paralysis) of CVA or polio. The Top Ten points were:
Ranking
Point
Score

10

LI04 LI11 ST36 GB34 ST06 GB30 ST04 LI15 TH05 GB39
.86

.79

.77

.74

.73

.72

.68

.66

.62

.62

The Maximum score possible was .964. The bottom 10 points were:
Ranking

392

393

394

395

396

397

398

399

400

401

Point
Score

CV13 CV17 BL65 LI01 ST23 BL07 KI20 GB06 GB43 LV06
.02

.02

.02

.02

.02

.02

.02

.02

.02

.02

The scores have been rounded up or down to the second decimal place. Clearly, the first list
would be expected to give better therapeutic results than the second list above.
However, selection of the Top Ten points in the above list would not necessarily be the best
selection for a CVA sequel which was primarily mutism or aphasia. For such cases, the top
10 points are:
Ranking
Point
Score

10

CV23 GV15 HT05 LI04 Z 21 TH03 GB02 TH17 NZ32 SI19

.82

.72

.44

.37

.27

.23

.23

.21

.20

.18

(From a total of 71 possible points listed by 27 texts, maximum possible score was .952)
The differences between the Top Ten points for CVA and the Top Ten points for aphasia
underline the need for formulating specific questions for the computer search. Where
possible, one should search the database for general data (CVA), general region (head, neck,
thoracic limb etc), specific region (arm, leg, hip, etc), specific nerve (mandibular,
hypoglossal, radial etc). Where specific symptoms are marked (aphasia, incontinence, etc)
they should also be searched.
The greatest volume of data refers to the abdomen and its organs/functions. Although there
are points listed for "abdomen", "digestive upsets", "reproductive disorders" etc, these lists
should be used as guidelines for general study or general consideration. In specific cases, it is
preferable to search under the most relevant symptom or condition, such as "vomiting",
"diarrhoea", "constipation" etc, rather than "digestive upset" or "metritis", "infertility",
"impotence", "oligospermia" etc, rather than "reproductive disorders".
The database covers >1100 headings (regions, organs, conditions, symptoms, etc). The
printout of the complete listing for the Top Twenty points runs to some 160 pages of fullwidth (132-character) computer paper. In one hour, it is not possible to cover these data.
Therefore, I have chosen to list the Top Twenty points for about 130 of the major body
regions and their subregions and organs (Appendix 2). The Top Twenty points for about 130
of the more common symptoms are also listed (Appendix 3).
PRESCRIPTIONS FOR MAJOR BODY AREAS, FUNCTIONS, SUB-REGIONS AND
COMBINATIONS OF SIMILAR CONDITIONS
In the database (see Appendices 1,2,3) points are filed under separate condition codes such
as:
040201 Shoulder area (unspecified conditions)
040202 Clavicle: APA for fracture reduction
040203 Shoulder: APA for dislocation reduction

040205 Shoulder, scapula : pain .. ache.. .arthritis etc

040211 Shoulder, scapular: paralysis
040219 Deltoid: myofascial syndrome
Using the computer, it was possible to combine information to retrieve all points used in, for
example, all conditions of "shoulder, clavicle and scapular area" (a total of 181 points from 45
references). In this way, the entire database was summarised by amalgamation of data for
major body areas, functions, subregions and combinations of similar conditions.
The Top Twenty points and their scores are listed in Appendix 2. These lists should prove
useful in the study of AP and as reference material for teaching seminars. They do not,
however, supplant the lists of points for specific symptoms but should be seen as general
guidelines in the choice of points.
PRESCRIPTIONS FOR COMMON SYMPTOMS
The database was searched for a cross-section of common symptoms, especially those relating
to the musculoskeletal system (pain, paralysis) and to major body functions. The Top Twenty
points and their scores for some 130 symptoms or conditions are listed in Appendix 3. It must
be remembered that only the Top Twenty points are given here. There are many other points
which could be considered, especially if a number of symptoms occur together. In
complicated cases, for example, neurogenic vomiting and dehydration in the dog, points for
the main symptom (vomiting: PC06; ST36; CV12; ST25) could be combined with supportive
therapy (fluid replacement).
In cases of anaesthetic emergency or respiratory arrest, main points (GV26, KI01) could be
combined with artificial respiration (though the latter is seldom needed if the points are
stimulated strongly). In cases where cardiac arrest has also occurred, point PC06 (very
powerful on heart and lungs) could be added to GV26, KI01, and open or closed heart
massage, defibrillation or other methods would be added.
Please scan Appendices 1, 2 and 3 now, and then return to the discussion which follows.
MASTER POINTS FOR CHANNEL THERAPY
Apart from the 66 Command Points, there are other powerful points to redistribute Qi
between imbalanced Channels. These are the Shu-Back Association (Reflex) Points, the MuFront Alarm Points, the Luo-Passage (Connecting Points between the Phase-Mate Channels
within one Phase), the Xi-Cleft Points, the Test Points, the Ryodoraku (Japanese Points), and
the HE (Sea Points). The latter points are not the same as the HO points on the Channels. In
addition there is an Hour Point (the Phase point of a Channel, for example the Earth Point
of SP, the Water point of BL etc). SP21 is the Great Luo point (Luo point of all the Yin
Channels).
Taken together, the 66 Command/Su Points, plus the Shu, Mu, Luo, Xi, Test, Ryodoraku,
HE, Hour and SP21 Points are called the Master Points of AP.
The Five Phase Points

Tonic Sedat.

Affected COS

Wood Fire Earth Metal Water

point point

Yuan

Luo

LV (Wood-Yin )

01

02

03

04

08

08

02

03

05

GB (Wood-Yang)

41

38

34

44

43

43

38

40

37

HT (Fire-Yin )

09

08

07

04

03

09

07

07

05

SI (Fire-Yang)

03

05

08

01

02

03

08

04

07

PC (Fire-Yin )

09

08

07

05

03

09

07

07

06

TH (Fire-Yang)

03

06

10

01

02

03

10

04

05

SP (Earth-Yin )

01

02

03

05

09

02

05

03

04

ST (Earth-Yang)

43

41

36

45

44

41

45

42

40

LU (Metal-Yin )

11

10

09

08

05

09

05

09

07

LI (Metal-Yang)

03

05

11

01

02

11

02

04

06

KI (Water-Yin )

01

02

03

07

10

07

01

03

04

BL (Water-Yang)

65

60

54

67

66

67

65

64

58

Xi-

RYODO

HE

Cleft

HOUR

Test

-RAKU

(SEA)

point

point

point

point

point

Affected COS

Shu

Mu

LV (Wood-Yin )

BL18

LV14

06

01

08

03

GB (Wood-Yang)

BL19

GB24

36

41

33-39

40

GB34

HT (Fire-Yin )

BL15

CV14

06

08

07-09

07

SI (Fire-Yang)

BL27

CV04

06

05

03-04

05

ST39

PC (Fire-Yin )

BL14

CV17

04

08

04

07

TH (Fire-Yang)

BL22

CV05

07

06

04-10

04

BL53

SP (Earth-Yin ) BL20

LV13

08

03

09

02

ST (Earth-Yang) BL21

CV12

34

36

34-36

43

ST36

LU (Metal-Yin ) BL13

LU01

06

08

06

09

LI (Metal-Yang) BL25

ST25

07

01

11

05

ST37

KI (Water-Yin ) BL23

GB25

05

10

07

05

BL (Water-Yang) BL28

CV03

63

66

59-60

65

BL54

1. In disorder of the associated Channel-Organ System (COS), there is usually tenderness

on palpation of the Yuan, Mu, Shu and Test points. The Test points may feel cold in Yin
states and hot in Yang states. The RYODORAKU points are electro-sensitive diagnostic
points used in Japanese diagnosis. Their readings are hypo- in Yin and hyper- in Yang states.
2. All MASTER points, except Shu, Mu and HE points, are on their respective Channels
and lie between the elbow and finger or between the knee and toe.
3. The Yuan-Luo combination uses the Yuan of the affected Channel with the Luo of the
Phase-Mate Channel, i.e in lung disease, LU09 (Yuan of LU) plus LI06 (Luo of LI).
An examination of most of the listings in Appendices 2 and 3 shows that the Top Ten points
obey the basic laws of choosing AP points. In summary, these laws suggest a choice of points
from:
a. AhShi points (including Trigger Points, tender scars, fibrositic nodules etc)
b. Local points (which also meet condition (d)).
c. Distant points on the Channel through the affected area or on the Channel of the
affected organ. A chain of points on the affected Channel is said to be specially powerful.
d. Points on the affected nerve, the nerve supply related to the affected organ or area, or in
the same or a nearby spinal nerve segment.
e. Encircling the problem area; "Fore and Aft" points; combination of Yin side and Yang
side points (medial/lateral; anterior/posterior).
f. Combination of Mu and Shu (Front Alarm + Back Association) points.
g. Combination of affected Yuan and Luo of Mate (Source Point of the affected Channel
plus Passage point of its Phase-Mate Channel (LU-LI; ST-SP; HT-SI; BL-KI; PC-TH;
GB-LV).
h. Xi-Cleft point of affected Channel.
i. One or more of the Five Phase Points (Energetic balancing points).
j. Symptomatic points (traditionally known to have marked effect for the specific symptoms,
for example, GV26 in shock, emergencies; PC06 in nausea or vomiting).
k. Extra-Channel points ("New" or "Strange" points, points not on the Main Channels),
especially those effective for the condition, e.g. NX04 (TingChuan) in asthma.
l. Points on the Phase-Mate of the affected Channel (e.g.) ST points in spleen diseases; SP
points in stomach diseases.
m. TianYing point (OT02, centre of the goitre etc).

n. One point on each of the 4 limbs (e.g. LI04 and ST44, both bilateral, in tonsillitis or
toothache).
Let us examine the Top Ten points from some prescriptions (Appendices 2,3) in detail under
three basic headings:
1. Local conditions or regions
2. Conditions of specific internal organs or their functions
3. Generalised conditions and complex syndromes.
In each of these conditions, codes (a) to (n) mentioned above are used to show the laws
observed by the points in the Top Ten list.
1. LOCAL CONDITIONS OR REGIONS: Let us pick problems of the eye, nose, neck,
shoulder, elbow, lowback, hip and knee (stifle) as examples from Appendix 1:
EYE: BL01 (b); LI04 (c, as the LI Channel connects to ST Channel at the eye); GB2O
(c);also Wood (GB,LV) controls the eyes; ST01 (b); Z09 (b, k); BL02 (b); ST02 (b); GB14
(b,c (Wood)); TH23 (b); BL18 (liver controls eyes. BL18 is Shu point of liver, b). The
combination BL01, ST01, Z 09, GB14 meets law (e) above and is very useful in eye diseases.
7/10 of these points are local points.
NOSE: LI04 (c,g,i,j); LI20 (b); GB20 (j); GV23 (c); LI11 (c,i,j); GV14 (c,j); Z 03 (b,k);
BL07 (c); LI19 (b); ST02 (b). The combination LI20, Z 03, ST02 also meets law (e). 4/10 of
these points are local points.
NECK: GB2O (b); GV14 (b); LI04 (c,g,i); BL10 (b); SI03 (c,i.j); LI11 (c,i,j); OT01 (AhShi
point - a); GB21 (b,c depending on site of problem); GB39 (c,j); SI15 (b). The combination
GB20,21, BL10, GV14, SI15 also meets law (e). 5/10 of these points are local.
SHOULDER area: LI15 (b,j); LI11 (c,i,j); TH14 (b,j); Sl11 (b); Sl09 (b); LI04 (e,g,j); OT01
(a); Sl10 (b); OT05 (local points, b); BL11 (d ,j ). A combination of SI09, LI15 and a new
point l" above anterior axillary crease is known as the "shoulder triplet". The combination
meets law (e) above and has powerful effects in shoulder conditions. 6/10 of these points are
local points.
ELBOW: LI11 (b,i,j); TH05 (c,j); LI04 (c,g,i); HT03 (b,i); LU05 (b,i); LI10 (b); OT01 (a);
LI12 (b); TH10 (b); SI07 (c). 6/10 of these points are local.
LOWBACK: BL23 (b,j); BL40 (c,i,j); GB30 (c, linked to lowback via BL Channel, d,j);
BL60 (c,i,j); GB34 (c (via BL link), i,j); BL25 (b); BL37 (c); GV04 (b); BL57 (c); BL31 (b).
4/10 of these points are local.
HIP: GB30 (b,j); GB34 (c,i,j); GB29 (b); GB31 (c); BL40 (c via link to GB Channel, i,j);
BL60 (c,i,j); OT01 (a); GB39 (c,i,j); ST36 (d,i); LV08 (-). Although only 2/10 of these points
are local, 2 of the top 3 points are local.

KNEE: GB34 (b,i,j); BL40 (b,i,j); L 16 (b,k); ST35 (b); SP09 (b); ST36 (c,i); ST34 (b);
LV08 (c); OT01 (a); GB31 (c). The first05 of these points are the most commonly used
combination (obeying law e) and all are local points.
In the eight local conditions discussed above, seven have a local point as the first in the list
(the 8th has a local point as second on the list).
2. CONDITIONS OF INTERNAL ORGANS AND THEIR FUNCTIONS: Let us consider
the Top Ten points in five of the conditions in Appendix 2. Close examination of other lists in
the appendices will show that they follow similar logic.
PLEURA: BL42, BL47, BL43, KI23, KI22, BL13, GB32 (7/10 points) are on the thorax or
dorsal paravertebral area (local). Two of the other three (ST12, BL11) are at the thoracic inlet
and the 10th point (GB44) obeys law (c).
HEART, PERICARDIUM: Only 3 of the Top Ten (BL15, BL14, CV17) are over or near the
organs. They obey laws (b), (d), (e) and (f). Six of the remainder (PC06, PC07, HT05, PC05,
PC07, PC04) are on the HT or PC Channel (laws c, i, j). The 10th point (ST36) is a Master
Point, with many functions, including effects on HT and PC.
COUGH, GENERAL: BL13, CV22, GV12, BL12, CV17 (5 of the top 10 points) are over
the thorax, trachea or dorsal paravertebral area. They obey laws (b), (d), (e), (f), (j). Three
points (LU05,07, 10) are on the LU (lung) Channel (laws c, i). The remaining two points
(ST4O, GV14) meet laws c and i.
LIVER: 6/10 points (BL18,19,20,48; GV09; LV13) are over or near the liver. They obey
laws b, d, e, f, j. The remaining four points (LV03, ST36, GB34, SP06) are master points.
They obey laws c, g, i, j.
GENITALIA FEMALE AND REPRODUCTION: 6/10 points are in the lumbosacral
innervation area (low abdomen or l/s paravertebral area). They are: CV03,04,06; GV04;
GB26; BL32. They obey laws (b), (d), (e), (j). The four remaining points (SP06,10; LV03;
ST36) are Master Points with major effect on low abdomen and its functions. They obey laws
(c), (i), (j).
2a. IF AN ORGAN OR FUNCTION HAS NO NAMED CHANNEL, points can be
chosen from combinations relating to the nearest organs, or Channels, or functions. For
example, suppose there were no entries for the following organs:
Thymus: consider points from combinations for heart, lungs, stomach (nearest organs) and
immunity (a closely allied function).
Diaphragm, oesophagus: consider heart, lung, stomach combination.
Appendix: consider lower right abdomen and large intestine combinations + immunity.
Adrenal (beside kidney): consider kidney combinations.
Ovary, tubes, uterus: consider kidney, bladder, low abdominal and large intestinal
combinations.

Vagina, vulva, scrotum, testicles, penis: these are controlled by the 3 Leg Yin Channels
(SP, LV, KI). Consider points on these Channels + points for low abdomen, bladder.
3. GENERALISED CONDITIONS AND COMPLEX SYNDROMES: Generalised
conditions include metabolic, hormonal, toxic, general autonomic upsets, etc (such as gout,
diabetes, food poisoning, shock, neurasthenia, etc). Although one symptom may be dominant,
it is usual to have a number of symptoms and abnormalities occurring together.
For example, in gout, the presenting symptom may be pain in the big toe (or other joint), but
other symptoms could include liver enlargement + pain; headaches; irritability; blurred vision;
tiredness, etc. The comprehensive treatment would entail dietary advice (possibly involving
food allergy/intolerance testing) and increased fluid intake. AP would be aimed at the more
severe symptom (say toe pain) but other points (especially LV and GB) would be aimed at the
other symptoms. The liver is central in gout and many allergies. Treat the liver.
In diabetes mellitus, polyuria, neuropathy and other signs can arise. Dietary advice, together
with points for diabetes (see Appendix 2) the local regions affected by neuropathy and the
kidney (Appendices 1 and 2) would be indicated.
In food poisoning, vomiting and diarrhoea would be tackled by points such as CV12, PC06,
ST25,36,37 but other symptoms (dehydration, prostration etc) would best be tackled by fluid
replacement. Medication (kaolin, chlorodyne) can assist the gastrointestinal symptoms.
In shock, points like GV26, KI01, ST36, PC06 can be of immediate help but accurate
diagnosis of the pathology is essential and would indicate other interventions (surgery, if
severe internal bleeding; fluids, stimulants, warmth, etc where indicated).
In neurasthenia, insomnia, excitement etc, the HT and PC Channels control these
functions in traditional belief. Consider HT, PC points.
DISCUSSION
1. IN MOST LOCAL PROBLEMS (joint, muscle, superficial organ etc) the best
prescription combines AhShi points and local points + distant points on the affected or
related Channel. It is important to check the location as regards the nerve supply and the
Channel. For example, the best combination for pain in the medial epicondyle of the humerus
will not be identical to the best combination for the lateral epicondyle. However, in traditional
AP, it is not enough to pick any local point. (Some local points are better than others, or, at
least, are more frequently recommended than others).
Modern neurophysiological concepts of AP stress that adequate stimulation of the affected or
related NERVES will produce results as good as the traditional method but adequate clinical
or research testing of the traditional versus modern (nerve theory) methods has not been done.
For the moment, I give the benefit of the doubt to the traditional system, which has stood the
test of time.
2. IN DISEASE OF INTERNAL ORGANS, the most important points lie near the organ in
the thoracoabdominal area or in the paravertebral area (the Mu, Shu and Huatochiachi (X 35)
points, CV and GV points). Where the organ has a named Channel (LU, LI, ST, SP, HT, SI,
BL, KI, PC, GB, LV) it is common to include one or more points on that Channel (distant as

well as local points). Also, the course of the Channel is important. For example, the liver,
kidney and spleen Channels traverse the inner thighs and groin area. Distant points on these
Channels are important in genital and lower abdominal conditions.
In general, if a symptom or abnormal function can be traced to a specific COS, treat that
COS. If more than one symptom/organ system is involved, choose a combination of
points which will influence all the major symptoms or upset organs.
3. IN ACUTE SERIOUS CONDITIONS, WITH MULTIPLE SYMPTOMS AND
PATHOLOGY, it is unwise to rely solely on AP. AP can often give considerable help (using
points as indicated by the main symptoms and pathology) but conventional or unconventional
(complementary) therapies may need to be used as well.
4. IN CHRONIC COMPLICATED CASES, where immediate life-threatening symptoms or
pathology are absent, one can rely more on AP as the main therapy (in cases amenable to
treatment). At all times, however, the aim of good medicine is to help the patient to the
greatest extent, with the minimum of side effects. Therefore, it is good practice to use
whatever complementary therapies seem best indicated.
Analysis of the database indicates that points from the list: LI04,11;
ST25,36; SP06; HT07; BL23,40; PC06; TH05; GB20,34; LV03; CV06,12;
GV04,12,14,20,26 arise in a high proportion of cases. In complex cases, if one has difficulty
in deciding on a prescription, it is advisable to include a few points from that list.
LIMITATIONS OF COOKBOOK AP: How would one treat the following syndrome? The
patient had the following symptoms (at different times) during a period of 6 years, beginning
two years after radical right lung surgery: recurrent haemorrhagic nephritis; cystitis; rightsided sciatica; right- sided paravertebral pain (C6 - T4 area); right-sided headache and bouts
of acute conjunctivitis (right); right ear tinnitus; waking at night with severe pain along the SI
Channel of the arm to the little finger, with the arm in spasm.
To try cookbook prescriptions in such a case would be second-rate AP. There was obviously a
connection between all these symptoms (all relate to SI, BL, KI) and most were right sided
symptoms. On examination, the patient's thoracotomy scar was badly twisted, with adhesions
on the right BL line. This was the clue. Blockage of the Qi flow (traditional concept) or
reflex irritation effects (Western concept) could cause all of these symptoms via the Chinese
SI-BL-KI energy cycle. Treatment was physiotherapy + injection of the scar plus a few
AP sessions using BL points. All symptoms were successfully cleared. Cookbooks have their
limitations and Chefs do not need them.
CONCLUSIONS
Cookbooks or computerised prescribing is very valuable for beginners and for those working
in a clinic. However, one should not rely too much on machines or computers. Computers
need electrical power. In national disaster and warfare, and in many of the developing
countries, electrical power, batteries etc may be unavailable where they are needed most.
Therefore, it is important for the development of medicine and veterinary medicine that as
many professionals as possible should study the basics of AP. This learning process can be
accelerated by interaction with a computerised database (Rogers 1984a). Adequate knowledge

of AP will enable it to be used more widely in field work (large animal work, medics and
paramedics in the bush).
Although the data reported here (Appendices 1,2,3) are but a small fraction of the database, it
is obvious that for most conditions, the Top Ten Points usually will be worth considering.
However, in some complicated cases, points not in the Top Ten may be most relevant. The
statistical method is very useful for population medicine, but it may be disastrous for the
unfortunate patients who need individually designed care.
As a general rule, if a Cookbook prescription does not produce definite results by 2-3
sessions, it is necessary to (a) change the choice of points, or (b) consider other therapies, or
(c) regard yourself as unable to assist.
The enthusiastic amateur AP practitioner will get useful results with the COOKBOOK but
more complicated or deeply rooted problems require more holistic (traditional + modern +
complementary + intuitive) therapy. Therefore, I strongly encourage you to continue your
study of Chinese AP in depth. To get the best results, use the cookbook as the first-line of
attack (in conditions amenable to AP) but be prepared to fall back on traditional and other
methods if results do not follow quickly (Rogers 1984b). This assumes that the user is trained
in basic AP and is able to interpret the point selections.
When using the prescriptions given in this paper, please note (a) the number of references in
the prescriptions, (b) the maximum possible score, (c) the score of each point in the list
(calculated by ratio to the maximum possible score), and (d) the variation in scores between
points. If there are few references, the prescription may be of doubtful value. If the maximum
possible score is (say) .90 and the max. score for any point is (say) less than .40, the
prescription may be doubtful. If there is little variation between the scores and all scores are
greater than .40, various combinations of points should be equally effective.
Remember that the best prescriptions usually combine AhShi points, LOCAL points,
DISTANT points and (if internal organs are involved) Mu + Shu + Yuan + Luo
combinations. Thus, the wheel turns full circle. The traditional methods of point selection
were best after all. Modern technology has merely re-invented the wheel !
REFERENCES
Greiff, Walter; Janssens, Luc; Kothbauer, Oswald (1970-1983). Verification of AP point
locations in nimals by electrical methods and by experimental and/or clinical results.
Kothbauer, Oswald ( 1983). Veterinary AP - Ox, Swine and Horse. Verlag Welsermuhl, Wels,
Austria, 334 pp.
Krueger, C. (1976). AP point topography in the horse. Am. J. Acup. 4, 276-.
Molinier, F. ( 1983). Localisation of veterinary AP points. Rev. d'Acup. Vet. (Paris), No. 17
(4), 6-.
Rogers, P.A.M. (1982a). The study of AP: Sources and study techniques IVAS Annual
Congress, Cincinnati, Ohio (33pp + appendix).

Rogers, P.A.M. (1982b). The study of AP: Points and Channels in animals. Ibid. (23 pp).
Rogers, P.A.M. (1982c). The choice of points for AP therapy. Ibid. (26 pp).
Rogers, P.A.M. (1984a). Computer applications in the study and clinical use of AP. IVAS
Annual Congress, Austin, Texas, 13 pp.
Rogers, P.A.M. (1984b). Traditional versus cookbook AP. Ibid. 40 pp.
Westermayer, E. (1981). Channels and ancient points, especially in cattle. IVAS Annual
Congress, Cincinnati, Ohio, 21 pp.
Yu Chuan & Hwang Yann-Ching (1990) Handbook on Chinese Veterinary AP and
Moxibustion. FAO Regional Office for Asia and the Pacific, Bangkok, 193pp.
ABSTRACT
Backpain is only a sign or symptom. It may be primary, secondary, or as part of a generalised
disorder. In practice, it may be difficult to make a specific diagnosis of the cause of human
backpain, unless X-ray, myelography and other tests are carried out routinely. The practitioner
may be satisfied with clinical remission.
In hospitalised patients, AP is successful in treating post-operative pain and complications. It
can be successful also in backpain which has not responded to surgery.
AP therapy is by stimulation of relevant reflex points in the skin and muscles. Points of
tenderness to palpation are important. They are the AhShi or TRIGGER points (TPs).
Stimulation is given to the TPs, paravertebral (Shu) points, and points related to specific
areas, organs or functions, e.g.local and distant points on Channels through affected area.
Data from over 66 textbooks and clinical articles were stored on a Hewlett Packard
Minicomputer. Frequency-ranked prescriptions for >1100 clinical headings were generated
from the database. Some of those, of relevance to backpain (primary and secondary), were
analyzed. Pain of central origin is not included. The "Top Twenty" points for selected body
regions/organs related to the neck and back are given. Points for certain common
signs/symptoms (thoracalgia, lumbalgia, sciatica etc) are given.
Appendix 1 comments on the use of the point index and its structure. It lists the codes and
names of all the points. The points for regions and signs are in Appendices 2 and 3. Examples
of methods of point selection for simple and more complex conditions (syndromes) are given.
Advantages and disadvantages of "Cookbook AP" are discussed in relation to traditional AP
concepts.
The following combinations are useful guides to pain control:
Neck: TPs, GB20,21,39, GV14, LI04,11, BL10, SI03,15, ST38 (or GB34)
Thoracic back: TPs, GV09,12,13,14, X 35, BL40,60
Lowback/leg: TPs, GV04, BL23,25,31,37,40,60, GB30,34.

Other methods of point selection (Earpoints, Newpoints, Handpoints etc) must be regarded as
experimental at this time.
INTRODUCTION
Traditionally-trained acupuncturists generally scorn the idea of Cookbook acupuncture (AP),
although they often use their own formulae (poor cookbooks! ). They would be horrified at
the idea of computerising AP. They claim that the free availability of prescriptions do AP a
disservice, allowing it to fall into the hands of untrained, unqualified people. I do not accept
this. There is one medicine. The best people to practice AP would be those trained in
conventional medicine as well as AP. TP therapy (see below), even without any knowledge
of AP, may give 60-70% clinical success. If one adds classical AP points, the success rate can
increase by 10-20%. The use of TP therapy brings more professionals into the active AP field
than any other arguments or demonstrations. Storage of data on computer makes its analysis
and retrieval very easy. Databases can be updated and re-analyzed periodically. Computers do
not forget (assuming that files are copied and backed up every time they are updated).
Advantages and disadvantages of computer-generated prescriptions are discussed in detail
elsewhere (Rogers 1984 a,b).
Backpain may be primary (paravertebral muscle pain, thoracolumbar disc disease, vertebral,
sacroiliac or arthrotic), secondary (referred from irritation of thoracic or abdominal organs),
or as part of a generalised disorder.
This paper deals with the selection of points for human backpain, using Cookbook methods,
based on computer analysis of textbook and other data. If other symptoms or organs are
involved, the selection of points must take these into consideration.
It has taken me more than 11 years to set up the database. I ask each of you to treat the
material as copyright, not for commercial publication in text, computerised, microfiche form.
You are welcome to use it for your own professional purposes and to give it to colleagues, if
they agree to respect the copyright.
THE BASICS OF AP
The alphanumeric code and name of each point is shown in Appendix 1. As there is no
internationally agreed coding system, you should check my codes (Appendix 1) with the
codes which you use, to prevent confusion and error. In human AP, the paravertebral Shu
(reflex points for all major thoracic and abdominal organs) are located on the inner line of the
bladder (BL) Channel as follows:
Lung (LU), Pericardium (PC), Heart (HT), Governor Vessel (GV), Diaphragm = BL13-17, in
area T3-T7 respectively; Liver (LV), Gallbladder (GB), Spleen-pancreas (SP), Stomach (ST)
=BL18-21, in area T9-T12 respectively; Triple Heater (TH), Kidney (KI), CHIHAISHU,
Large Intestine (LI), KUANYUANSHU = BL22-26, in area L1-L5 respectively; Small
intestine (SI), Bladder (BL), CHUNGLUSHU, PAIHUANSHU = BL27-30, in area S1-S4
respectively. These points have diagnostic value (when tender). They help to identify the
affected organ. They also have therapeutic value in treating the affected organ and local
problems near the points. However, local muscle strain or trauma can also cause Shu point
tenderness. Thus, Shu point tenderness need not always indicate disorders of the related
organs. Points on the outer line of paravertebral BL points (BL41-54) have similar functions

to the related points on the inner line. Irritation of the thoracic or abdominal organs can refer
pain to related skin and muscle segments, especially in the paravertebral area. This can
establish TPs, as detailed by Travell and Simons (1984) and in the TP Therapy Symposium
(1981). Long after the visceral pain has gone, the TPs can remain active. Unless TPs in the
thoracosacral muscles are "removed" by AP or other physiotherapy, the function of the back
muscles is impaired and performance is impaired.
In human AP, the AhShi point is defined as a point, usually in muscle, which is tender on
palpation. AhShi means Ouch! or Ah Yes! There are two kinds of AhShi points: those from
which palpation elicits only local tenderness and those which radiate pain to the problem area
(the area in which the patient complains of pain). The latter type is the true TP of western
medicine. It is the most important point in AP therapy and the patient may unaware of TP
tenderness until the point is pressed. TPs may occur almost anywhere in muscle. Scars may
also act as TPs. TPs in the paravertebral area often correspond with organ Shu points. For
example, in coronary disease, patients may have TPs in the area T3-T6. Patients with kidney
or ovary problems may be touchy in the area L1-L3 (BL22-24). The reflex point for the ovary
and kidney is BL23.
REFERRED PAIN: Pelvic limb lameness is often due to pain referred from thoracolumbar
or lumbosacral nerves, as in sciatica. It may arise also in pain referred from abdominal
viscera, such as in a painful kidney, ovary, uterus or colon. Thoracic limb lameness may arise
in pain referred from cervical or upper thoracic nerves or from pain in thoracic organs (lung,
pericardium, heart). Thus, neck- and back-pain often manifest as pain in the thoracic- or
pelvic- limb.
ASSESSMENT OF PATIENTS BEFORE TREATMENT
A complete history is taken, together with any findings of previous investigations. In the
clinical examination, attention is paid to any lesions or signs related to all major systems or
functions. One tries to identify the primary problem(s) and the location(s) of pain. It is
essential to probe or palpate the muscles from head to toe, to locate any TPs. Particular
attention is paid to the paravertebral muscles and the large muscles of the neck and limbs. The
joints and tendons are also palpated. Patients with signs of pain, stiffness or lameness are
seldom free of TPs. Their detection is indicated by an expletives or groans or "Ah Yes! "
when they are palpated.
Always check for diagonal relationships. Cain stresses that fore-lameness is often
accompanied by tenderness at contralateral lumbosacral or hind-limb points in the horse.
Also, hind-lameness is sometimes associated with TPs on the contralateral side of the neck.
Be careful to check the paravertebral Shu points in relation to the location of limb pathology,
for example BL25 (L4-5, large intestine Shu) in radial forearm pain and BL21 (behind last
rib, stomach Shu) in anterolateral pain in the pelvic limb etc. In all local problems (neck,
shoulder, elbow, back, thoracolumbar, lumbosacral, hip, knee etc), the TPs must be found.
They are recorded and marked as they are located. This helps rapid reassessment of the case
on later visits. It also makes it easy for the patient to locate them for massage or other
physiotherapy (ultrasound, LASER etc) between AP sessions.
DATABASE OR COOKBOOK AP

AP points listed under various symptoms, body parts etc were stored on file. Data under
sections on point functions were also stored. The data base was sorted and duplicate entries
from specific sources were eliminated. Points were scored by a weighted citation frequency
method. Prescriptions were generated for each part and symptom and were output with the
highest-scoring points first and the lowest-scoring last.
The larger the database, the more points are filed under any given region, symptom or
condition. However, the first 6-10 points listed (in order of descending citation score) are the
most important for routine use. For example, in the most recent summary of the database, 401
points were listed from a base of 44 texts for the treatment of sequelae (hemiplegia,
paralysis) of CVA or polio. The Top Ten points were:
Ranking
Point
Score

10

LI04 LI11 ST36 GB34 ST06 GB30 ST04 LI15 TH05 GB39
.86

.79

.77

.74

.73

.72

.68

.66

.62

.62

The Maximum score possible was .964. The bottom 10 points were:
Ranking
Point
Score

392

393

394

395

396

397

398

399

400

401

CV13 CV17 BL65 LI01 ST23 BL07 KI20 GB06 GB43 LV06
.02

.02

.02

.02

.02

.02

.02

.02

.02

.02

The scores have been rounded up or down to the second decimal place. Clearly, the first list
would be expected to give better therapeutic results than the second list above.
However, selection of the Top Ten points in the above list would not necessarily be the best
selection for a CVA sequel which was primarily mutism or aphasia. For such cases, the top
10 points are:
Ranking
Point
Score

10

CV23 GV15 HT05 LI04 Z 21 TH03 GB02 TH17 NZ32 SI19

.82

.72

.44

.37

.27

.23

.23

.21

.20

.18

(From a total of 71 possible points listed by 27 texts, maximum possible score was .952)
The computer allows one to COMBINE data, to retrieve ALL points used for ALL conditions
of (say) the "thoracic back" or "abdomen" etc. In this way, the entire database was
summarised by amalgamation of data for major body areas, functions, subregions and
combinations of similar conditions. Appendix 2 gives examples. Regional points, however, do
not supplant the need to consider points for specific symptoms. For example, in the selection
of points for FACIAL PARALYSIS (OPTIC NERVE), one could search under "Head",
"Face", "Facial paralysis", "Facial paralysis, optic branch"(see below). Many of the points are
common to all those headings, but the specific heading is probably the best source.

020000 HEAD, ITS ORGANS AND FUNCTIONS

LI04 GB20 ST06 ST07 ST36 LI20 TH17 LI11 TH05 LV03
.946 .927 .896 .896 .852 .787 .-779 -.7-77 -.7-77 .-758
(54 references, 458 possible points, max possible score .963)

020-500 FACE, CHEEK (GENERAL POINTS FOR)

LI04 ST06 ST04 ST07 ST02 LI20 BL02 GB14 TH-17 ST03
.860 .86-0 .780 -.780 .595 .581 .547 -.532 .513 .487
-(49 references, 198 possible points, max possible score .963)

020507 FACE:
NUMB

FACIAL N.

PARALYSIS;

BELL'S PALSY;

FACIAL HEMIPLEGIA;

ST06 ST04 LI04 ST07 TH17 ST02 LI20 GB14 SI18 ST03
.886 .829 .803 -.717 .606 .586 .-529 .529 .4-43 .414(36 references, 111 possible points, max possible score .972)

020508 FACE:

FACIAL N.

PARALYSIS;

BELL'S PALSY, UPPER (OPTIC) BRANCH

LI04 LI20 ST04 ST07 ST06 TH17 GB14 SI18 BL02 Z 09

.664 .664 .588 .580 .504 .504 .504 -.420 .336 -.24-4
(12 references, 46 possible points, max possible score .992)

020509 FACE:

FACIAL N.PARALYS-IS;

BELL'S PALSY, MIDDLE (MAXILLARY) BRANCH

ST04 ST06 CV24 ST07 ST03 GV26 SI18 LI04 LI20 Z 09

.645 .645 .526 .513 .395 .355 .263 .250 .250 .250
( 8 references, 24 possible points, max possible score .950)

020510 FACE:
BRANCH

FACIAL N.

PARALYSIS;

BELL'S PALSY, LOWER (MANDIBULAR)

ST06 CV24 LI04 ST04 ST07 ST03 ST05 TH17 ST18 LI02
.743 .527 .500 .365 .338 .257 .216 .203 .135 .122
( 8 references, 25 possible points, max possible score .925)

The CVA (aphasia) and Head (optic area paralysis) examples show the necessity of specific
(as well as general) searches of the database. Where it is possible, one should search the
database for general region (neck area, thoracic back, lumbar area etc), specific region
(shoulder, hip, knee, etc), specific nerve (where applicable, e.g. radial, sciatic). Where
specific symptoms are marked, they should be searched (e.g. insomnia, dysmenorrhoea,
polyuria etc).
The data base covers >1100 headings. Only a few are given here, mainly relating to neck,
back, associated parts and common symptoms. Appendix 2 covers the parts and Appendix 3
the symptoms.
The data base has 452 headings under abdomen/functions/organs/symptoms. The major
headings are listed below.
06---- ABDOMEN AND BACK, ITS ORGANS AND FUNCTIONS
0601-- ABDOMEN GENERAL
060101 ABDOMEN:

GENERAL POINTS FOR ABDOMEN AREA AND ORGANS

060102 ABDOMEN:

APA FOR SURGERY OF ABDOMEN AREA AND ORGANS

0602-- THORACOLUMBAR SPINE AND AREA

060201 BACK, POSTERIOR TRUNK:
060202 THORACOLUMBAR:

GENERAL POINTS

(AREA, SPINE AND SPINAL CORD) GENERAL POINTS

0603-- LIVER (INFLAMMATION, CALCULI, JAUNDICE, ACETONAEMIA ETC)

060301 LIVER:

GENERAL POINTS

060302 LIVER:

HEPATITIS;

PAIN

0604-- SPLEEN
060401 SPLEEN:

GENERAL POINTS

060402 SPLEEN:

(AREA) APA FOR SURGERY OF

0605-- GASTROINTESTINAL TRACT:

GENERAL SYMPTOMS

060501 STOMACH, INTESTINE AND GASTROINTESTINAL FUNCTION:

060502 MALABSORPTION:

WEIGHT LOSS**XS;

0606-- STOMACH AND DUODENUM

EMACIATION etc

GENERAL POINTS

060601 STOMACH:

GENERAL POINTS

060602 STOMACH:

(AREA) APA FOR SURGERY OF

0607-- SMALL INTESTINE, APPENDIX, CAECUM, COLON, RECTUM

060701 INTESTINE:

GENERAL POINTS

060702 INTESTINE:

OBSTRUCTION;

P-AIN;

VOLVULUS;

PAIN##ADHESIONS

0608-- UROGENITAL (GENERAL CONDITI-ONS)

060801 URINARY-GENITAL FUNCTION:

GENERAL POINTS

060802 URINARY-GENITAL FUNCTION:

PAIN OR PAIN REFERRED FROM

0609-- URINARY TRACT AND FUNCTIONS

060901 URINARY TRACT:

GENERAL POINTS FOR URINARY TRACT FUNCTION

060902 URINARY TRACT:

(AREA) APA FOR SURGERY OF

0610-- GENITALIA FEMALE AND REPRODUCTION

061001 GENITAL-IA, FEMALE:

GENERAL POINTS

061002 GENITALIA, FEMALE & MALE:

etc

PAIN;

NEUR-ALGIA;

SENSATION**BURNING

0611-- PREGNANCY
061101 PREGNANCY:

FORBIDDEN POINTS;

MAY INDUCE MISCARRIAGE

061102 PREGNANCY:

MORNING SICKNESS;

NAUSEA;

VOMITING;

FAINT

0612-- MAMMARY FEMALE

061201 BREAST, MAMMARY GLAND, NIPPLE:
061202 MAMMARY GLAND, NIPPLE:

GENERAL POINTS

APA FOR MASTECTOMY OR COSMETIC SURGERY

0613-- MENSTRUAL CYCLE, CONTRACEPTION

061301 REPRODUCTIVE FUNCTION & GENITALIA (FEMALE):
tc
061302 MENSTRUATION:

PSYCHOGENIC UPSETS DUE TO;

MENSTRUAL DISORDE-RS ePREMENSTRUAL SYNDROME

0614-- REPRODUCTION MALE (IMPOTENCE, SPERMATORRHOEA ETC )

061401 REPRODUCT-IVE FUNCTION & GENITALIA (MALE):
061402 ERECTION:

POOR OR ABSENT;

IMPOTENCE;

GENITAL PROBLEMS etc

PREMATURE EJACULATION etc

0615-- GENITALIA MALE

061501 GENITALIA, MALE:
061502 GENITALIA:

(REPRODUCTIVE FUNCTION) GENERAL POINTS

(AREA) APA FOR SURGERY OF

CHOICE OF POINTS IN AP THERAPY

The points for treatment depend on the organs and parts involved. In classical AP, there are
many Laws or guides to the choice of points. An examination of most of the listings in
Appendices 2 and 3 shows that the Top Ten points obey the basic laws of choosing AP points.
In summary, these laws suggest a choice of points from:
a. AhShi points (including Trigger Points, tender scars, fibrositic nodules etc)
b. Local points (which also meet condition (d)).
c. Distant points on the Channel through the affected area or on the Channel of the
affected organ. A chain of points on the affected Channel is said to be specially powerful.
d. Points on the affected nerve, the nerve supply related to the affected organ or area, or in
the same or a nearby spinal nerve segment.
e. Encircling the problem area; "Fore and Aft" points; combination of Yin side and Yang
side points (medial/lateral; anterior/posterior).
f. Combination of Mu and Shu (Front Alarm + Back Association) points.
g. Combination of affected Yuan and Luo of Mate (Source Point of the affected Channel
plus Passage point of its Phase-Mate Channel (LU-LI; ST-SP; HT-SI; BL-KI; PC-TH;
GB-LV).
h. Xi-Cleft point of affected Channel.
i. One or more of the Five Phase Points (Energetic balancing points).
j. Symptomatic points (traditionally known to have marked effect for the specific symptoms,
for example, GV26 in shock, emergencies; PC06 in nausea or vomiting).
k. Extra-Channel points ("New" or "Strange" points, points not on the Main Channels),
especially those effective for the condition, e.g. NX04 (TingChuan) in asthma.

l. Points on the Phase-Mate of the affected Channel (e.g.) ST points in spleen diseases; SP
points in stomach diseases.
m. TianYing point (OT02, centre of the goitre etc).
n. One point on each of the 4 limbs (e.g. LI04 and ST44, both bilateral, in tonsillitis or
toothache).
Let us examine the top ten points for some of the prescriptions in the database (Appendices 2
and 3) in detail, under 3 categories:
1. Local areas or regions
2. Conditions of specific organs or their functions
3. Generalised conditions and complex syndromes.
In each of the following prescriptions, codes (a)-(n) above are used to show the Laws
observed by the "Top Ten" points in the database.
1. LOCAL AREAS OR REGIONS (Examples from Appendix 2).
NECK: GB20 (b); GV14 (b); LI04 (c, g, i); BL10 (b); SI03 (c, i, j); LI11 (c, i, j); OT01 (TP,
a); GB21 (b, c, depending on site of pain); GB39 (c, j); SI15 (b). Combination GB20,21,
BL10, GV14, SI15 also meets Law (e). 5/10 of the points are LOCAL.
SHOULDER AREA: LI15 (b, j); LI11 (c, i, j); TH14 (b, j); SI11 (b); SI09 (b); LI04 (e.g.j);
OT01 (TP, a); SI10 (b); OT05 (Local points, b); BL11 (d, j). Combination of SI09, LI15 and
a New Point 1" above the anterior axillary crease is known as the "Shoulder Triplet" (e). That
is a powerful combination in shoulder pain. 6/10 points are LOCAL.
ELBOW: LI11 (b, i, j); TH05 (c, j); LI04 (c, g, i); HT03 (b, i); LU05 (b, i); LI10 (b); OT01
(TP, a); LI12 (b); TH10 (b); SI07 (c). 6/10 points are LOCAL.
THORACIC SPINE, BACK AREA: GV14 (b); BL40 (c); OT01 (TP, a); GV12 (b); OT05
(Local points, b); GV13 (b); X 35 (b, k); GV09 (b); BL60 (c); OT06 (c). 6/10 points are
LOCAL.
DORSOLUMBAR SPINE AND AREA: BL40 (c, j); BL23 (b, j); X 35 (b); BL60 (c); OT01
(TP, a); BL37 (c); GB30 (c- via BL link); GV14 (b, c); OT05 (Local points, b); OT06 (c).
4/10 points are LOCAL (2 out of the first 3).
LOWBACK: BL23 (b, j); BL40 (c, i, j); GB30 (c- linked to lowback via BL Channel, d, j);
BL60 (c, i, j); GB34 (c- via BL link-, i, j); BL25(b); BL37 (c); GV04 (b); BL57 (c); BL31
(b). 4/10 points are LOCAL.
COCCYGEAL AREA: BL34 (b); BL40 (c, j); SI06 (g, j); BL30 (b); OT01 (TP, a); BL37
(b); X 35 (b, k); OT05 (Local points, b); OT06 (c); BL35 (b). 6/10 points are LOCAL.

HIP: GB30 (b, j); GB34 (c, i, j); GB29 (b); GB31 (c); BL40 (c- via GB30 link-, i, j); BL60
(c, i, j); OT01 (TP, a); GB39 (c, i, j); ST36 (d, i); LV08 (g). Although only 2/10 points are
LOCAL, 2 of the top 3 are LOCAL.
THIGH, FEMUR: GB30 (b, j); GB31(b); GB34 (c, j); LV08 (c); ST36 (c); BL23 (j); LV11
(b); BL40 (b, c); BL37 (b); SP06 (c, l). 5/10 points are LOCAL.
KNEE AND POPLITEAL AREA: GB34 (b, i, j); BL40 (b, i, j); L 16 (b, k); ST35 (b); SP09
(b); ST36 (b, c, i); ST34 (b); LV08 (c); OT01 (TP, a). 9/10 points are LOCAL. The first 5
points are the most commonly used and obey Law (e).
In most local problems (joint, muscle, superficial organ etc), as in the 10 examples above, the
best prescription combines TPs plus LOCAL points plus DISTANT points on the
affected or related Channel. It is important to check the location as regards the nerve supply
and the Channel. The best points for the anterior of the shoulder may not be the best ones for
the posterior of the shoulder. Furthermore, some local points are more often recommended
than others.
2. CONDITIONS OF SPECIFIC ORGANS OR THEIR FUNCTIONS (Examples from
Appendix 2).
PLEURA: 7/10 points (BL13,42,43,47, KI22,23, GB32) are on the thorax or
dorsal/paravertebral area (e.g. are LOCAL points). Two of the other 3 (ST12, BL11) are at the
thoracic inlet and one (GB44) obeys Law (c).
HEART, PERICARDIUM: Only 3 of the top 10 (BL14,15, CV17) are over or near the
organs. They obey Laws (b, d, e, f). Six more (PC04,05,06,07, HT05,07) are on the PC or
HT Channel (Laws c, i, j). The 10th point (ST36) is a master point, with many functions,
including effects on PC and HT.
COUGH, GENERAL: 5 of the top 10 points (BL12,13, CV17,22, GV12) are over the
thorax, trachea or dorsal paravertebral area. They obey Laws b, d, e, f, j. Three points
(LU05,07,10) are on the LU (lung) Channel (Laws c, i). The last two points (ST40, GV14)
obey Laws c, i.
LIVER PROBLEMS: 6/10 points (BL18,19,20,48, GV09 LV13) are over or near the liver.
They obey Laws b, d, e, f, j. The other four (LV03, ST36, GB34, SP06) are master points.
They obey Laws c, g, i, j.
FEMALE GENITALIA/REPRODUCTION: 6/10 points (CV03,04,06, GV04, GB26,
BL32) are in the lumbosacral innervation area (low abdominal or lumbosacral paravertebral
area). They obey Laws b, d, e, j. The other 4 points (SP06,10, LV03, ST36) are master points,
with major effects on the low abdomen and its functions. They obey Laws c, i, j.
In disease of internal organs, the most important points lie near the organ. The
paravertebral points (Shu and X 35), local GV points, the abdominal Mu points and local CV
points are the most important. If the organ has a named Channel (LU, LI, ST, SP, HT, SI,
BL, KI, PC, GB, LV), one or more local and distant points on that Channel are included. In
genital and lower abdominal conditions, distant points on LV, KI, SP Channels can be added,
as these Channels pass the inner thighs and the groin area.

If the organ or function has no named Channel, points can be chosen from combinations
relating to the nearest Organs/Channels. For example, if there were no data for Thymus,
Appendix, Oesophagus, Adrenal etc, one could construct combinations of points:
Thymus, oesophagus: points for heart, lungs, stomach (nearest organs) and immunity (a
thymus-related function).
Appendix: points for lower right abdomen, large intestine, immunity.
Ovary, tubes, uterus: points for kidney, bladder, low abdomen, large intestine etc.
Vagina, vulva, scrotum, testicles, penis: points for low belly. Also, the 3 YIN Channels of
the feet (SP, KI, LV) pass near the groin- use distant points on them.
3. GENERALISED CONDITIONS AND COMPLEX SYNDROMES
Generalised conditions include metabolic, hormonal, toxic, autonomic upsets (as in gout,
diabetes, food poisoning, shock, neurasthenia etc). Although one symptom may be dominant,
it is usual for a number of signs or symptoms to occur together. For example, in gout, the
presenting symptom may by PAIN IN THE BIG TOE, but on examination, liver enlargement,
headaches, irritability, blurred vision, tiredness etc may be present also. The comprehensive
treatment would entail advice on diet (possibly involving food allergy/intolerance tests),
alcohol and fluid intake. AP would be aimed at the more severe symptom (say toe pain) but
the prescription should also help the other symptoms.The LIVER is central in gout and many
allergies. Treating LV and GB points (LV03,14, GB34, BL18,19, GB14,20) would help ALL
the symptoms.
Neurasthenic patients often complain of backache. Their symptoms may include depression,
headache, generalised aches and pains, insomnia, weakness etc. The PC and HT Channels
control the spirit, in Chinese belief. Symptoms of neurasthenia can be helped by LOCAL
points plus PC/HT points (HT07, PC06, BL14,15) and general points like ST36, LV03,
LI04.
In treating complex cases, choose point combinations which influence all the major
symptoms and the affected organs. If symptoms or signs can be traced to a Channel
function, treat that Organ/Channel. In complex cases other methods (conventional
medicine, homoeopathy etc) may be needed also.
Analysis of the entire database for all parts and functions shows that certain points are very
commonly cited. They are:
LI04,11, ST25,36, SP06, HT07, BL23,40, PC06, TH05, GB20,34, LV03, CV06,12,
GV04,12,14,26. These are Master Points in traditional AP. In complex cases, if one has
difficulty in selecting points, it may help to include a few points from the master list.
Example of syndrome related to scar tissue/Channel block
Beginning 2 years after right pulmonectomy, the following symptoms occurred intermittently,
or in combinations, over a 6-year period:

recurrent haemorrhagic nephritis and cystitis (BL, KI)

right-sided sciatica (BL)
right-sided paravertebral pain (C6-T4) (BL)
right-sided headache (BL)
right-sided bouts of acute conjunctivitis (BL)
right-ear tinnitus (SI)
waking up at night with right arm in spasm and severe pain along SI Channel to the 5th
finger (SI)
Cookbook prescriptions would have been as futile as western medicine in that case. All
symptoms related to BL Channel or the Channels upstream (SI) or downstream (KI) from
BL in the Channel circuit. All were right-sided, except (possibly) the nephritis/cystitis.
There was an obvious connection. The thoracotomy scar was badly twisted, with adhesions on
the right BL line. Blockage of "Channel energy" flow in the BL channel could be related to
the signs. In western terms, reflex irritation effects could be involved. Treatment was
procaine injection of the adhesed part of the scar plus a few sessions of AP on BL points,
plus physiotherapy. All symptoms were successfully cleared and did not recur. Cookbooks
have their limitations! But cookbook recipes must include TP- (and scar-) therapy.
POSTOPERATIVE PAIN
Janssens (see Rogers 1987) reported that AP has controlled pain in dogs which did not
respond to surgery for disc disease. He has also used AP successfully to control pain and
other complications arising after abdominal and other surgery. Papers by Russian workers, in
press to Scandinavian J. Acup., confirm that AP has similar effects in humans.
Points used in post-operative pain/complications are chosen by the same principles as any
other AP point combinations. In addition, one may run long needles subcutaneously, parallel
to the wound.
CONCLUSIONS
In practice, it is difficult to make a specific diagnosis of the cause of backpain, due to the
difficulty of routine X-ray, myelography and other tests. Many patients presenting with
backpain also have other signs or symptoms. One aims to help the patient towards selfhealing, not to "heal the backpain". The general practitioner may be satisfied with clinical
remission.
Palpation of the muscles, to locate TPs is an essential part of the clinical examination.
The combination of TPs, GB20,21, GV14, BL10, SI15 covers most neck pain. LI04,11,
SI03, ST38 (or GB34) are useful distant points.

The combination of TPs, GV09,12,13,14, X 35 covers most thoracic backpain. Local BL

points can be used instead of GV points. BL40,60 are useful distant points.
The combination of TPs, GV04, BL23,25,31, covers most backpain below the ribs, including
radiating sciatic pain. BL37,40,60, GB30,34 are useful distant points.
The most common combination of points is: all TPs, plus 1-2 LOCAL points (near the
affected organ or part). If an organ is thought to be involved, its Shu point is used, whether
tender or not. To this can be added the Mu (abdominal alarm) point. This includes the use of
Shu points in superficial problems which may not have direct organic involvement. For
example, BL13 and 25 (Shu points for the LU and LI Channels) as part of a prescription to
help resolve pain of an inside-forearm pain (in the Channel area of LU and LI). Similarly,
BL23,28 (Shu of KI and BL) would be indicated in Achilles/heel pain (Channel area of KI
and BL). One or two DISTANT points on a Channel passing through or near the problem
area, on the Channel of the affected organ, or a CHAIN of points along an affected Channel
or nerve are also helpful.
Many point combinations are possible. Points with special or general action may be
considered. Useful points are:
Neck GB34, LU07
Thoracic limb LI04,11,15, TH05,15, GB21
Spinal column BL16
Lumbosacral and pelvic limb BL21,23,40,60, GB30,34, ST36
Muscles, tendons TH15, GB34, BL19,20
Bones, joints BL11,23
General effects LI04, ST36, BL23
Immunostimulation LI04,11, GV14, ST36
Lung BL13,43
Liver BL18, GV09
Stomach, appetite BL21, ST36
Hind gut BL25,30
Adrenal, stress conditions, urogenital, bones BL23,52, GV04
There are other methods of point selection (Earpoints, Face points etc) but these methods are
not as well documented as bodypoint AP. They must be regarded as experimental until
adequate documentation and comparative clinical trials are available.

Meanwhile, the database method gives points very similar to those which traditional AP
would suggest. The computer has merely re-invented the wheel.
The use of other physiotherapies (massage, ultrasound, LASER etc) on the points (between
sessions) helps to ensure high success rates.
ACKNOWLEDGEMENTS
I thank Dr. Pekka Pontinen, Tampere, Finland and the organisers of the Nordic Acupuncture
Congress for financing my trip to the Congress.
REFERENCES
ANON (1974) The Barefoot Doctor's Manual. Running Press, Philadelphia. 948 pp.
ANON (1975) Newest Illustrations of the AP points. (Charts and booklet). Medicine and
Health Publishers, Hong Kong.
ANON (1980) The Essentials of Chinese AP. College of Trad. Chin. Med., Beijing, Shanghai,
Nanking. Foreign Languages Press, Beijing. 422 pp. Reissued 1993: Essentials of Chinese
AP. (Coll. TCM, Beijing, Shanghai, Nanking) Foreign Languages Press, Beijing 432pp.
CHUNG, C. (1983) The Ah Shih Point. Chen Kwan Books, 5-2 1-F Chung Ching South
Road, Section 3, Taipei, Taiwan, R.O.C. 212 pp.
PONTINEN, P. (1982) AP Seminar for Swedish Physicians. Contact AP and Pain Research
Dept., University of Tampere, Finland.
ROGERS, P.A.M. (1984a) Computer applications in the study and clinical use of AP. IVAS
Annual Congress, Austin, Texas. 13pp.
ROGERS, P.A.M. (1984b) Traditional versus Cookbook AP. Ibid 40 pp.
ROGERS, P.A.M. (1987) Treatment of backpain in the horse and dog by AP. Nordic
Acupuncture Congress, Oslo, Norway, September 1987.
TRAVELL, J.G. & SIMONS, D.G. (1984) Myofascial pain & dysfunction: the TP manual.
Part 1. Williams & Wilkins, London & Baltimore, 713pp.
TRIGGER POINT THERAPY: Symposium on myofascial TPs (1981) Arch. Rehabilitation
Med., March, 97-117; Dorrigo et al (1979) Pain, 6, 183-; Kajdos (1974) Amer. J. Acup., 2,
113-.; Kellgren (1939-42) Clinical Sci., 4, 35-; Khoe (1979) Amer. J. Acup., 7, 15-; Lewit
(1979) Pain, 6, 83-.; Melzack et al (1977) Pain, 3, 3-.; Macdonald (1983) Annals of Royal
Coll. Surg. Eng., 65, 44-,; Rogers, C. (1982) Amer. J. Acup., 10, 201-.
COPYRIGHT
Philip A.M. Rogers MRCVS

These prescriptions are published as a micro-computer software package. They may not be
published or used for commercial purposes without written permission from the author !!
However, colleagues are most welcome to use them for their own clinical or research
purposes.

Point convention used in the computer outputs :

The Channel Points are coded as follows: LU=Lung; LI=Large Intestine; ST=Stomach;
SP=Spleen-Pancreas; HT=heart; SI=Small Intestine; BL=Bladder; KI=Kidney; PC=Heart
Constrictor, Pericardium, Circulation-Sex; TH=Tri-Heater; GB=GallBladder; LV=Liver;
CV=Conception Vessel (Ren Mo) ; GV=Governor Vessel (Du Mo). In this system, the second
branch of the BL Channel has BL41 (FuFen) at the T2/scapular area and BL40 (WeiZhong)
at the popliteal crease, as in the "Essentials of Chinese AP" 1993 (Coll. TCM, Beijing,
Shanghai, Nanking) Foreign Languages Press, Beijing 432pp. The ST Channel has ST01
(ChengChi) infraorbital and ST08 (TouWei) on the meeting of the vertical and the horizontal
hairline on the forehead.

Channel Code LU LI ST SP HT SI BL KI PC TH GB LV CV GV
no. of points 11 20 45 21 9 19 67 27 9 23 44 14 24 28

The New, Strange & Hand Points are ordered as in the "Newest Illustrations
of the AP points" (Med. & Health Publishers, Hongkong, 1973) :

NZ=New Head & Neck; NY=New Abdomen; NX=New Loin & Back; NA=New Upper
Limb; NL=New Lower Limb;

Z =Strange Head & Neck; Y =Strange Thorax & Abdomen; X =Strange Loin & Back; A
=Strange Upper Limb; L =Strange Lower Limb; H =Hand points.

New Points Strange Points

Point code NZ NY NX NA NL Z Y X A L H
no. of points 35 6 18 15 36 31 19 35 44 42 18

Category OT (Other) codes :

01=AhShi; 02=TianYing; 03=Segmental nerve; 04=Haemorrhoid point; 05=Local
points for region; 06=Distant points for region; 07=points on Channel through area;
08=Periosteal AP; 09=Periincisional pts.; 10=Chieh Kou (Cut ends)

Trigger Points (categories TP, TQ, TR):

Trigger Points are located as in "Myofascial Pain and Dysfunction" by
Travell & Simons (Williams & Wilkins, Baltimore & London, 1983). Their coding is
summarised in the index of point locations, which is appended.

Point code OT TP TQ TR
no. of points 10 99 99 3

The total number of points (Channel, New, Strange etc plus Trigger Points) in the database is
871.

The 12 basic laws of selecting points:

1. Treat the main contradiction, adding 1-2 points for the more serious symptoms.
2. Points according to the innervation or in same dermatome as the problem area or function.
(The paravertebral and HuaToChiaChi (X 35) points are especially important).
3. AhShi (tender) points (trigger, myalgic, fibrositic, motor, REPP points).
4. Local points or points locally on nearest Channels.
5. Distant points on Channels controlling problem area.
6. Combination of local & distant points or Yin and Yang points (e.g. the YUAN (Source)
point of the problem part/organ/Channel and the LUO (Passage) point of its linked Channel).
7. Points "Fore & Aft", "Above & Below", "Left & Right", encircling the problem area.
8. Points well known for their symptomatic effects.

9. Back & Abdomen combination: SHU (BL Reflex) and MU (Front Alarm) or points near the
SHU and MU.
10. The XI (Cleft) point of affected organ/Channel in acute diseases.
11. Scar therapy; improving electrical conductivity of scars and soft tissue injury by needling,
injection, laser, physiotherapy etc.
12. The TianYing point - under the ulcer base, into the cyst etc.

!! Always seek the tender (trigger) points !!

Final selection of points from this index :

1. High scores with multiple authors indicate the most important points. If the first point listed
has a score <.40, this indicates poor agreement between authors and may indicate a
prescription of doubtful value.

2. The first 4 to 6 points in each prescription list are the most frequently cited points.
Additional points may be added from those remaining, if other symptoms indicate a need for
them.

3. Prescriptions with less than 2 authors or with little variation in point scores may be of
doubtful value !!

4. When needling, always provoke TehQi (needle sensation). Expect poor results if poor
needle sensation is reported !!

5. The number of needles per session should normally be less than 12 (use as few as possible).

6. Alternate prescriptions if in doubt or if result is not satisfactory after 1-2 sessions.

7. Research workers seeking "non-active" points for "placebo" or "control" groups of subjects
should not use any point listed in these prescriptions. As "active" points, they should consider
points in the Top Ten of each list.

8. The most common prescription for local or organ problems is: local points + AhShi
points + distant points.

!! Always seek the tender (Trigger) points !!

AMALGAMATED DATA: TOP 10 POINTS FOR MAJOR BODY FUNCTIONS,

ORGANS & PARTS

The Point Index for body organs, parts and functions is laid out in a regional sequence as
follows:

01xxxx Emergencies and First Aid

02xxxx Head, its organs and functions
03xxxx Neck, thyroid
04xxxx Thoracic limb
05xxxx Thorax, its organs and functions
06xxxx Abdomen, its organs and functions
07xxxx Pelvic limb
08xxxx Skin and hair
09xxxx General, immunity

When searching for, say the sacral area, search under 06xxxx (Abdomen)
When searching for, say the heart area, search under 05xxxx (Thorax )

The main headings of the index are :

010100 EMERGENCIES
010200 FIRST AID
020100 PSYCHE AND MENTAL DISORDERS
020200 ADDICTIONS
020300 BRAIN, ITS FUNCTIONS & PARTS, MENINGES, POLIO, CONVULSIONS,
020323 MEMORY: LOSS OF;AMNESIA;FORGETFUL
020349 BRAIN, MENINGES
020350 CVA, POLIO, PARALYSIS, HEMIPLEGIA
020351 CONVULSIONS, EPILEPSY, TETANUS, TREMOR
020353 SPINAL CORD
020400 HEAD, FOREHEAD, VERTEX, OCCIPUT, TEMPLE, HEADACHES,
020433 FOREHEAD, FRONTAL SINUSES
020434 VERTEX
020435 OCCIPUT
020436 TEMPLE
020500 FACE, CHEEK
020600 EYE, EYELID, VISION ETC
020700 NOSE, NOSTRIL, NASAL SINUSES, OLEFACTION
020800 THROAT, PHARYNX, LARYNX, TONSIL, VOICE
020900 EAR, HEARING, MENIERES DISEASE, EUSTACIAN TUBE, MASTOID ETC
021000 LIP, ORAL MUSCLES
021014 MOUTH
021100 TOOTH, GUM

021124 TOOTH, UPPER

021125 TOOTH, LOWER
021200 TONGUE, SPEECH
021222 SALIVA, SALIVARY GLANDS ETC
021300 MAXILLA
021313 CHIN
021315 MANDIBLE
021316 TEMPORO-MANDIBULAR JOINT, MASSETER
021317 MAXILLA, MANDIBLE
030000 NECK AND CERVICAL SPINE
030129 THYROID, PARATHYROID
040000 THORACIC LIMB, ITS ORGANS AND FUNCTIONS
040200 SHOULDER, SCAPULA, CLAVICLE
040300 AXILLA
040400 ARM, HUMERUS
040500 ELBOW
040600 FOREARM, RADIUS, ULNA
040700 WRIST, CARPUS
040800 HAND, PALM
040900 FINGER
050000 THORAX AND BACK, ITS ORGANS AND FUNCTIONS
050001 THORAX, CHEST, RIBS, STERNUM
050002 THORACIC SPINE, BACK AREA
050200 HEART, PERICARDIUM
050228 CIRCULATION, BLOOD PRESSURE

050229 ARTERIES, VEINS, ARTERIOSCLEROSIS, ISCHAEMIA

050300 OEDEMA, FLUID RETENTION, ASCITES
050400 BLOOD, BODY DEFENCES, HAEMORRHAGE, THYMUS ETC
050500 RESPIRATORY SYSTEM (TRACHEA, BRONCHI, LUNG, COUGH, ETC
050541 PLEURA
050543 TRACHEA
050544 BRONCHI, LUNG, PNEUMONIA, ASTHMA
050545 COUGH GENERAL
050600 OESOPHAGUS
050700 DIAPHRAGM
060000 ABDOMEN AND BACK, ITS ORGANS AND FUNCTIONS
060141 ABDOMEN UPPER, EPIGASTRIC, HYPOCHONDRIAC AREA
060142 ABDOMEN MIDDLE, PERIUMBILICAL AREA
060143 ABDOMEN LOWER
060200 DORSO-LUMBAR SPINE AND AREA
060228 COCCYGEAL AREA
060231 LOWBACK (LUMBO-SACRAL, RENAL, SACRO-ILIAC), LUMBAR, SACRAL)
060232 WAIST, FLANK AREA
060300 LIVER (INFLAMMATION, CALCULI, JAUNDICE, ACETONAEMIA ETC)
060323 GALLBLADDER, BILEDUCTS (INFLAMMATION, CALCULI, OBSTRUCTION)
060400 SPLEEN
060410 PANCREAS, DIABETES MELLITUS, HYPO- & HYPER- GLYCAEMIA
060500 GASTROINTESTINAL TRACT
060503 INDIGESTION, INAPPETANCE, NAUSEA, VOMITING
060542 PAIN, COLIC, SPASM IN ABDOMEN OR ITS ORGANS, PERITONITIS

060543 DIARRHOEA, DYSENTERY, CONSTIPATION

060600 STOMACH AND DUODENUM
060700 SMALL INTESTINE, APPENDIX, CAECUM, COLON, RECTUM
060752 ANUS, TENESMUS, PROLAPSE, PILES
060753 INGUINAL AREA, GROIN
060754 PERINAEUM
060755 MALE & FEMALE EXTERNAL GENITALIA AND PUBIC AREA
060800 UROGENITAL (GENERAL CONDITIONS)
060900 URINARY TRACT AND FUNCTIONS
061000 GENITALIA FEMALE AND REPRODUCTION
061100 PREGNANCY: CONDITIONS OF
061101 PREGNANCY: FORBIDDEN/ABORTION Points
061125 PARTURITION
061126 POST-PARTUM CONDITIONS
061200 MAMMARY FEMALE
061300 MENSTRUAL CYCLE, CONTRACEPTION
061316 MENOPAUSE: GENERAL Points FOR FLUSHES & MENOPAUSAL PROBLEMS
061400 REPRODUCTION MALE (IMPOTENCE, SPERMATORRHOEA ETC )
061500 GENITALIA MALE
070000 PELVIC LIMB , ITS ORGANS AND FUNCTIONS
070200 BUTTOCK
070239 HIP
070240 THIGH, FEMUR
070300 KNEE, POPLITEAL
070315 PATELLA

070400 LEG, CALF

070417 TIBIA, FIBULA
070429 ACHILLES AREA, HEEL
070500 ANKLE, TARSUS
070503 TARSAL-METATARSAL
070600 METATARSAL, FOOT
070608 TOE
080000 SKIN
080124 HAIR,SKIN : ALOPECIA;BALDNESS;HAIRLOSS;OPPILATION
090100 FEVERS
090101 CHILLS
090200 SWEATING PROBLEMS
090300 INFECTIONS: MALARIA,TB,CHOLERA,TYPHOID,TYPHUS,HERPES,ETC
090400 IMMUNITY
090410 TONIC EFFECTS
090419 GANGRENE, ISCHAEMIA OF EXTREMITIES
090420 LYMPHADENOPATHY
090500 BONES, JOINTS (GENERAL)
090600 MUSCLE, TENDON, SOFT TISSUES (GENERAL)
090700 ANALGESIA, PAIN CONTROL (GENERAL)

010100 EMERGENCIES /
39 References / 168 Points / Rating .964
GV26

KI01

ST36

PC06

A 01

LI04

PC09

GV20

LU11

LI11

.851

.824

.521

.500

.497

.441

.391

.362

.338

.319

010200 FIRST AID /

32 References / 145 Points / Rating .959
GV20

ST36

PC06

GB20

LV03

GV26

Z 03

LI04

Z 09

LU11

.570

.564

.521

.414

.322

.306

.293

.290

.283

.221

020100 PSYCHE AND MENTAL DISORDERS /

46 References / 344 Points / Rating .967
HT07

SP06

PC06

ST36

GB20

LI04

GV20

LV03

BL15

CV12

.867

.780

.771

.692

.634

.620

.539

.521

.515

.515

020200 ADDICTIONS /
18 References / 71 Points / Rating .950
ST36

SP06

LI04

BL13

PC06

CV12

BL21

CV06

LV03

GB08

.637

.579

.409

.327

.292

.292

.275

.269

.234

.211

020300 BRAIN, ITS FUNCTIONS & PARTS, MENINGES, POLIO, CONVULSI-ONS, MEMORY,
TETANUS, CVA ETC / 53 References / 477 Points / Rating

.953

LI04

LI11

ST36

GB34

ST06

LI15

GB20

GB30

ST04

GV14

.800

.741

.703

.663

.634

.610

.608

.604

.594

.578

020323 MEMORY: LOSS OF;AMNESIA;FORGETFUL /

15 References / 45 Points / Rating .940
HT07

GV11

BL15

BL43

HT03

GV20

HT09

NL04

ST36

PC06

.553

.383

.340

.319

.270

.270

.241

.213

.199

.199

020349 BRAIN, MENINGES /

19 References / 100 Points / Rating .937
LI04

GV15

GB20

ST36

GV12

LI11

GB34

BL64

KI01

GV14

.444

.427

.427

.371

.360

.303

.264

.258

.213

.213

020350 CVA, POLIO, PARALYSIS, HEMIPLEGIA /

44 References / 401 Points / Rating .964
LI04

LI11

ST36

GB34

ST06

GB30

ST04

LI15

TH05

GB39

.858

.792

.767

.743

.731

.719

.684

.656

.618

.616

020351 CONVULSIONS, EPILEPSY, TETANUS, TREMOR /

35 References / 272 Points / Rating .960
GV14

ST36

LI04

GV26

KI01

GV20

LV03

LI11

GB20

PC06

.723

.693

.690

.670

.664

.661

.658

.607

.604

.589

020353 SPINAL CORD /

10 References / 27 Points / Rating .910
BL11

GV14

GV04

BL60

GV15

KI07

BL10

GV20

ST36

KI08

.440

.440

.429

.330

.297

.253

.220

.220

.209

.187

020400 HEAD, FOREHEAD, VERTEX, OCCIPUT, TEMPLE, HEADACHES, SINUSITIS ETC /

52 References /

286 Points / Rating

.965

LI04

GB20

Z 09

GV20

LU07

Z 03

BL10

LI20

BL02

BL60

.902

.845

.725

.657

.635

.610

.556

.540

.500

.494

020433 FOREHEAD, FRONTAL SINUSES /

34 References / 74 Points / Rating .971
LI04

Z 03

GB14

BL02

GV23

Z 09

GB20

LU07

ST44

GV24

.800

.594

.491

.430

.403

.355

.297

.273

.206

.203

020434 VERTEX /
27 References / 51 Points / Rating .948
GV20

GB20

LV03

KI01

LI04

BL07

GV19

BL60

GB11

SI03

.832

.574

.492

.387

.340

.223

.215

.188

.156

.148

020435 OCCIPUT /
35 References / 80 Points / Rating .957

GB20

BL10

SI03

BL60

GV15

BL65

LI04

LU07

GV20

OT05

.854

.606

.409

.310

.260

.254

.254

.236

.227

.173

020436 TEMPLE /
23 References / 57 Points / Rating .961
Z 09

GB20

GB08

GB41

LI04

TH03

TH05

TH23

GB07

LU07

.579

.471

.448

.430

.344

.308

.213

.213

.208

.181

020500 FACE, CHEEK /

49 References / 198 Points / Rating .963
LI04

ST06

ST04

ST07

ST02

LI20

BL02

GB14

TH17

ST03

.860

.860

.780

.780

.595

.581

.547

.532

.513

.487

020600 EYE, EYELID, VISION ETC /

43 References / 292 Points / Rating .958
BL01

LI04

GB20

ST01

Z 09

BL02

ST02

GB14

TH23

BL18

.835

.811

.735

.648

.595

.590

.583

.566

.558

.512

020700 NOSE, NOSTRIL, NASAL SINUSES, OLEFACTION /

43 References / 204 Points / Rating .963
LI04

LI20

GB20

GV23

LI11

GV14

Z 03

BL07

LI19

ST02

.930

.867

.684

.577

.512

.495

.457

.437

.367

.350

020800 THROAT, PHARYNX, LARYNX, TONSIL, VOICE /

43 References / 208 Points / Rating .960
LI04

LU11

CV22

LI11

ST44

LU10

CV23

PC06

LI18

SI17

.952

.634

.598

.586

.545

.484

.409

.395

.378

.378

020900 EAR, HEARING, MENIERES DISEASE, EUSTACIAN TUBE, MASTOID ETC /

45 References /

276 Points / Rating

.964

TH17

GB02

SI19

TH21

TH05

GB20

LI04

TH03

ST36

GV20

.843

.733

.721

.721

.680

.671

.659

.624

.583

.539

021000 LIP, ORAL MUSCLES /

22 References / 57 Points / Rating .955
ST04

ST03

LI04

ST06

CV24

GV26

ST07

ST44

LI20

LI03

.638

.519

.510

.419

.329

.267

.233

.186

.181

.171

021014 MOUTH

28 References / 104 Points / Rating .950

LI04

LI11

ST04

ST06

PC08

GV12

GV27

LI07

Z 20

ST44

.680

.492

.455

.421

.346

.301

.289

.282

.256

.241

021100 TOOTH, GUM /

44 References / 170 Points / Rating .959
LI04

ST06

ST07

ST44

ST05

CV24

SI18

LI03

LI11

ST03

.891

.874

.822

.616

.410

.386

.299

.296

.296

.296

021124 TOOTH, UPPER /

10 References / 24 Points / Rating .950
LI04

ST07

ST06

ST44

SI18

LI20

ST02

ST36

GV26

SI05

.589

.589

.411

.411

.389

.316

.316

.211

.211

.200

021125 TOOTH, LOWER /

17 References / 35 Points / Rating .959
ST06

LI04

ST05

LI03

ST07

ST44

ST36

CV24

TH08

LI11

.699

.515

.472

.411

.288

.233

.184

.184

.153

.104

ST06

GB20

Z 21

021200 TONGUE, SPEECH /

38 References / 179 Points / Rating .961
CV23

GV15

LI04

HT05

TH17

LI11

TH05

.732

.641

.600

.501

.397

.392

.389

.345

.310

.247

021222 SALIVA, SALIVARY GLANDS ETC /

11 References / 34 Points / Rating .964
ST40

SP04

LV03

LI04

SI05

LI10

ST43

BL59

GB07

GB38

.283

.283

.283

.274

.255

.245

.189

.189

.189

.189

021300 MAXILLA /
25 References / 65 Points / Rating .960
LI04

ST02

ST07

ST03

ST06

LI20

ST04

SI18

GV26

ST44

.679

.675

.525

.508

.479

.450

.329

.317

.313

.279

021313 CHIN /
4 References / 12 Points / Rating .925
CV24

ST04

ST05

CV22

GV27

SI10

SI07

GB05

GB21

GV22

.730

.541

.541

.541

.541

.459

.270

.270

.270

.270

021315 MANDIBLE /
39 References / 110 Points / Rating .962
ST06

ST07

LI04

CV24

ST05

ST04

ST36

LV03

TH17

ST44

.773

.669

.640

.392

.381

.365

.315

.267

.248

.232

021316 TEMPORO-MANDIBULAR JOINT, MASSETER /

37 References / 76 Points / Rating .962
LI04

ST07

ST06

GB02

ST05

SI19

TH17

LV03

GV26

TH21

.705

.702

.654

.346

.323

.267

.261

.197

.194

.191

ST05

LI20

ST44

021317 MAXILLA, MANDIBLE /

33 References / 100 Points / Rating .967
ST06

ST07

LI04

ST02

ST04

ST03

CV24

.755

.755

.721

.508

.458

.442

.398

.386

.367

.332

030000 NECK AND CERVICAL SPINE /

49 References / 254 Points / Rating .963
GB20

GV14

LI04

BL10

SI03

LI11

OT01

GB21

GB39

SI15

.676

.540

.530

.489

.485

.468

.434

.413

.409

.381

030129 THYROID, PARATHYROID /

28 References / 110 Points / Rating .964
CV22

LI11

LI04

ST09

PC06

GB20

LI18

BL10

CV23

GV14

.567

.426

.422

.419

.385

.304

.289

.237

.237

.233

040000 THORACIC LIMB, ITS ORGANS AND FUNCTIONS /

48 References / 291 Points / Rating .983
LI11

LI15

TH05

LI04

SI03

TH04

HT03

PC07

LI10

OT05

.978

.879

.842

.792

.688

.669

.608

.606

.604

.604

040200 SHOULDER, SCAPULA, CLAVICLE /

45 References / 181 Points / Rating .960
LI15

LI11

TH14

SI11

SI09

LI04

OT01

SI10

OT05

BL11

.873

.713

.625

.507

.491

.470

.449

.417

.403

.396

040300 AXILLA /
17 References / 40 Points / Rating .959
HT01

GB40

GB42

GB22

SI09

PC01

GB38

PC05

LI15

TH12

.460

.411

.405

.362

.344

.344

.276

.184

.160

.160

040400 ARM, HUMERUS /

33 References / 167 Points / Rating .961
LI11

LI15

LI04

SI09

SI11

TH06

LI10

TH08

LI14

PC03

.874

.659

.451

.429

.394

.391

.391

.360

.353

.328

040500 ELBOW /
42 References / 126 Points / Rating .967
LI11

TH05

LI04

HT03

LU05

LI10

OT01

LI12

TH10

SI07

.852

.520

.453

.453

.404

.404

.335

.313

.310

.239

040600 FOREARM, RADIUS, ULNA /

27 References / 106 Points / Rating .948
LI11

HT03

LI10

LI04

PC06

HT07

PC03

TH05

SI08

TH09

.707

.676

.672

.563

.559

.434

.434

.422

.367

.363

040700 WRIST, CARPUS /

36 References / 97 Points / Rating .967
TH04

TH05

LI04

PC07

LI05

LU07

SI04

PC06

LI11

OT01

.690

.500

.422

.391

.330

.307

.273

.250

.247

.247

040800 HAND, PALM /

32 References / 101 Points / Rating .953
LI04

LI11

A 22

SI03

PC07

LI03

PC08

SI04

TH03

PC06

.564

.380

.380

.338

.302

.292

.289

.213

.213

.193

040900 FINGER /
38 References / 130 Points / Rating .958
LI04

A 22

SI03

LI03

TH05

SI04

SI07

PC07

PC06

TH04

.555

.536

.503

.409

.401

.371

.368

.365

.354

.349

050000 THORAX AND BACK, ITS ORGANS AND FUNCTIONS /

53 References /

431 Points / Rating

.962

PC06

BL13

BL17

ST36

LI11

LI04

GV14

GB34

GB20

HT07

.812

.808

.808

.755

.741

.733

.722

.696

.688

.682

050001 THORAX, CHEST, RIBS, STERNUM /

44 References / 231 Points / Rating .975
GB34

PC06

TH06

BL18

CV17

BL17

LV13

BL14

LV14

BL15

.746

.730

.615

.515

.492

.401

.401

.375

.361

.347

050002 THORACIC SPINE, BACK AREA /

38 References / 203 Points / Rating .958
GV14

BL40

OT01

GV12

OT05

GV13

X 35

GV09

BL60

OT06

.505

.473

.407

.404

.401

.398

.349

.338

.330

.269

050200 HEART, PERICARDIUM /

39 References / 242 Points / Rating .964
PC06

HT07

BL15

HT05

PC05

ST36

BL14

PC07

PC04

CV17

.843

.766

.633

.556

.492

.457

.452

.449

.439

.439

050228 CIRCULATION, BLOOD PRESSURE /

36 References / 142 Points / Rating .958
LI11

ST36

LV03

GB20

ST09

PC06

SP06

KI01

CV12

HT07

.690

.687

.545

.539

.406

.400

.342

.328

.313

.299

050229 ARTERIES, VEINS, ARTERIOSCLEROSIS, ISCHAEMIA /

14 References /

123 Points / Rating

.914

ST36

GB20

BL10

CV06

SP06

GV20

GB21

LV03

GV14

OT05

.797

.719

.570

.523

.500

.500

.492

.453

.438

.438

050300 OEDEMA, FLUID RETENTION, ASCITES /

25 References / 114 Points / Rating .952
SP09

CV09

KI07

BL23

ST36

BL20

ST25

SP06

CV05

CV08

.647

.597

.559

.517

.475

.445

.441

.437

.349

.315

050400 BLOOD, BODY DEFENCES, HAEMORRHAGE, THYMUS ETC /

29 References / 111 Points / Rating .959
BL17

ST36

BL20

LI04

LI11

CV04

GV14

SP06

CV06

SP10

.752

.680

.464

.410

.410

.392

.374

.335

.306

.284

050500 RESPIRATORY SYSTEM (TRACHEA, BRONCHI, LUNG, COUGH, PNEUMONIA, ASTHMA

ETC / 48 References / 345 Points / Rating .963
BL13

GV14

CV22

LI04

LU05

LU07

CV17

ST40

BL12

PC06

.831

.797

.736

.725

.710

.686

.667

.641

.602

.587

050541 PLEURA /
15 References / 144 Points / Rating .913
BL42

BL47

BL43

KI23

ST12

KI22

BL13

BL11

GB22

GB44

.628

.628

.620

.620

.555

.555

.533

.482

.482

.482

050543 TRACHEA /
21 References / 49 Points / Rating .938
CV22

ST40

LI04

BL13

LU02

GV14

BL11

LU07

CV17

PC06

.670

.401

.386

.365

.244

.234

.223

.183

.183

.152

050544 BRONCHI, LUNG, PNEUMONIA, ASTHMA /

44 References / 251 Points / Rating .966
BL13

CV22

CV17

GV14

LU05

BL12

PC06

LI04

LU07

ST36

.816

.753

.725

.602

.562

.544

.532

.494

.466

.452

050545 COUGH GENERAL /

41 References / 198 Points / Rating .961
BL13

LU05

LU07

ST40

CV22

LU10

GV12

BL12

CV17

GV14

.627

.622

.599

.586

.548

.343

.343

.338

.338

.327

050600 OESOPHAGUS /
20 References / 96 Points / Rating .935
PC06

BL17

ST36

LI04

CV17

LI10

BL10

CV12

CV22

BL20

.604

.487

.412

.401

.390

.337

.337

.337

.326

.294

050700 DIAPHRAGM /
34 References / 86 Points / Rating .962
BL17

PC06

CV12

ST36

CV15

CV17

LV14

GB24

ST13

CV22

.728

.569

.419

.355

.355

.324

.318

.291

.263

.245

060000 ABDOMEN AND BACK, ITS ORGANS AND FUNCTIONS /

53 References / 489 Points / Rating .966
ST36

SP06

CV12

CV04

BL23

PC06

GB34

CV03

CV06

ST25

.969

.961

.924

.922

.908

.885

.850

.850

.830

.826

060141 ABDOMEN UPPER, EPIGASTRIC, HYPOCHONDRIAC AREA /

28 References / 115 Points / Rating .979
ST36

PC06

CV12

BL21

BL51

GB34

BL23

LV13

LV01

BL18

.639

.569

.526

.420

.288

.182

.168

.168

.164

.164

060142 ABDOMEN MIDDLE, PERIUMBILICAL AREA /

18 References / 65 Points / Rating .989
SP14

ST36

ST25

CV06

CV08

CV07

BL23

BL25

GB34

CV04

.388

.382

.331

.281

.225

.169

.112

.112

.112

.112

060143 ABDOMEN LOWER /

38 References / 132 Points / Rating .961
ST36

L 13

SP06

ST25

CV04

LI11

ST37

CV03

SP13

CV06

.710

.542

.499

.493

.438

.340

.241

.238

.236

.236

060200 DORSO-LUMBAR SPINE AND AREA /

31 References / 150 Points / Rating .968

BL40

BL23

X 35

BL60

OT01

BL37

GB30

GV14

OT05

OT06

.523

.447

.397

.363

.230

.230

.230

.230

.227

.197

060228 COCCYGEAL AREA /

9 References / 34 Points / Rating .911
BL34

BL40

SI06

BL30

OT01

BL37

X 35

OT05

OT06

BL35

.683

.610

.488

.488

.488

.366

.366

.366

.366

.317

060231 LOWBACK (LUMBO-SACRAL, RENAL, SACRO-ILIAC), LUMBAR, SACRAL SPINE /

49 References / 250 Points / Rating .963
BL23

BL40

GB30

BL60

GB34

BL25

BL37

GV04

BL57

BL31

.879

.862

.761

.701

.678

.672

.617

.553

.515

.506

060232 WAIST, FLANK AREA /

13 References / 76 Points / Rating .962
GB34

GB40

BL40

GB30

GB41

ST36

BL23

GB39

LV02

LV13

.944

.480

.448

.448

.320

.312

.280

.232

.232

.232

060300 LIVER (INFLAMMATION, CALCULI, JAUNDICE, ACETONAEMIA ETC) /

35 References / 158 Points / Rating

.951

BL18

LV03

BL19

GV09

BL20

ST36

LV13

GB34

BL48

SP06

.793

.748

.736

.640

.598

.550

.483

.471

.399

.378

060323 GALLBLADDER, BILEDUCTS (INFLAMMATION, CALCULI, OBSTRUCT-ION ETC) /

34 References / 102 Points / Rating

.956

BL19

ST36

GB34

L 23

PC06

GV09

GB24

LV03

BL18

GB40

.717

.689

.671

.548

.474

.471

.412

.400

.363

.348

060400 SPLEEN /

25 References / 65 Points / Rating .948

BL20

ST36

LV13

BL51

SP06

CV12

PC06

X 16

LV03

BL22

.603

.553

.397

.287

.241

.241

.228

.211

.207

.190

060410 PANCREAS, DIABETES MELLITUS, HYPO- & HYPER- GLYCAEMIA /

28 References /

91 Points / Rating

.950

KI02

CV12

BL23

ST36

SP06

CV04

BL20

BL18

BL17

X 12

.429

.417

.414

.398

.391

.391

.387

.383

.316

.301

060500 GASTROINTESTINAL TRACT /

49 References / 343 Points / Rating .963
ST36

ST25

PC06

CV12

CV06

SP06

CV04

BL21

TH06

BL20

.945

.875

.835

.811

.718

.697

.672

.604

.597

.572

060503 INDIGESTION, INAPPETANCE, NAUSEA, VOMITING /

44 References / 287 Points / Rating .959
ST36

PC06

CV12

ST25

SP06

CV06

BL21

BL20

SP04

LI04

.986

.872

.860

.666

.595

.590

.581

.569

.438

.422

060542 PAIN, COLIC, SPASM IN ABDOMEN OR ITS ORGANS, PERITONITIS /

52 References / 344 Points / Rating

.965

ST36

CV12

SP06

PC06

CV04

ST25

CV06

BL23

BL21

CV03

.849

.843

.829

.729

.671

.655

.633

.629

.588

.554

060543 DIARRHOEA, DYSENTERY, CONSTIPATION /

43 References / 215 Points / Rating .963
ST25

ST36

CV04

CV12

SP06

TH06

CV06

BL25

CV08

SP09

.930

.867

.722

.657

.635

.611

.609

.529

.490

.454

060600 STOMACH AND DUODENUM /

46 References / 250 Points / Rating .961

ST36

CV12

PC06

ST25

BL21

CV13

CV06

BL20

SP04

SP06

.941

.912

.747

.692

.690

.491

.473

.455

.428

.412

060700 SMALL INTESTINE, APPENDIX, CAECUM, COLON, RECTUM /

39 References / 213 Points / Rating

.959

ST36

ST25

BL25

CV04

L 13

CV12

BL27

PC06

SP15

ST37

.832

.791

.644

.580

.556

.532

.511

.444

.441

.436

060752 ANUS, TENESMUS, PROLAPSE, PILES /

38 References / 132 Points / Rating .961
GV01

BL57

GV20

BL32

SP06

BL25

BL31

BL33

BL30

BL34

.847

.770

.718

.496

.474

.455

.419

.419

.389

.370

060753 INGUINAL AREA, GROIN /

21 References / 91 Points / Rating .943
LV01

SP11

SP12

SP13

ST30

KI11

LV03

LV04

LV06

SP06

.480

.384

.348

.298

.293

.288

.278

.253

.253

.232

060754 PERINAEUM /
19 References / 68 Points / Rating .932
BL32

GV01

BL31

BL30

BL33

BL34

LV01

LV10

SP06

ST36

.316

.299

.271

.260

.226

.226

.226

.226

.215

.209

060755 MALE & FEMALE EXTERNAL GENITALIA AND PUBIC AREA /

23 References / 86 Points / Rating

.948

CV04

CV03

SP06

LV08

CV07

LV04

LV12

CV01

LV02

LV01

.683

.606

.431

.353

.344

.312

.303

.275

.257

.252

060800 UROGENITAL (GENERAL CONDITIONS) /

50 References / 290 Points / Rating .964

SP06

CV04

BL23

CV03

CV06

BL28

KI03

BL32

ST36

SP09

.979

.880

.863

.757

.676

.660

.637

.620

.566

.564

060900 URINARY TRACT AND FUNCTIONS /

47 References / 235 Points / Rating .964
SP06

BL23

BL28

CV03

CV04

CV06

KI03

SP09

CV02

BL32

.925

.808

.702

.702

.700

.611

.570

.536

.459

.426

061000 GENITALIA FEMALE AND REPRODUCTION /

41 References / 232 Points / Rating .959
SP06

CV04

GV04

CV06

SP10

CV03

GB26

BL32

LV03

ST36

.863

.781

.585

.580

.565

.555

.517

.509

.506

.491

061100 PREGNANCY: CONDITIONS OF /

25 References / 81 Points / Rating .952
BL67

ST36

PC06

LV03

SP04

SP06

BL18

CV17

CV12

KI21

.542

.475

.445

.273

.235

.223

.197

.197

.193

.189

061101 PREGNANCY: FORBIDDEN/ABORTION Points /

23 References / 71 Points / Rating .957
SP06

LI04

BL67

BL60

LV03

BL32

ST36

CV04

CV03

BL31

.745

.623

.623

.436

.427

.305

.259

.259

.241

.218

061125 PARTURITION /
26 References / 47 Points / Rating .958
SP06

LI04

BL67

BL60

BL32

LV03

BL31

ST36

SP09

BL62

.735

.655

.558

.382

.353

.349

.313

.241

.197

.157

CV07

Y 18

CV06

061126 POST-PARTUM CONDITIONS /

27 References / 120 Points / Rating .963
SP06

GV20

CV04

Y 16

CV02

LV01

CV03

.635

.485

.481

.462

.442

.415

.392

.331

.308

.304

061200 MAMMARY FEMALE /

27 References / 101 Points / Rating .978
CV17

SI01

ST18

GB41

ST36

ST16

SP18

LI04

LV03

GB21

.777

.625

.621

.371

.333

.284

.284

.261

.223

.212

061300 MENSTRUAL CYCLE, CONTRACEPTION /

45 References / 210 Points / Rating .962
SP06

CV04

CV03

CV06

SP10

ST36

BL23

LV03

BL32

BL33

.917

.824

.776

.674

.651

.515

.510

.467

.464

.464

061316 MENOPAUSE: GENERAL Points FOR FLUSHES & MENOPAUSAL PROBLEMS /

7 References / 11 Points / Rating

.914

ST36

SP06

CV04

LI04

PC06

GB21

CV03

SP10

LV14

CV05

.609

.609

.609

.313

.156

.156

.156

.141

.141

.141

061400 REPRODUCTION MALE (IMPOTENCE, SPERMATORRHOEA ETC ) /

42 References / 180 Points / Rating

.964

SP06

CV04

BL23

CV03

CV06

BL32

GV04

BL33

BL31

ST36

.953

.877

.859

.728

.662

.590

.565

.558

.543

.531

061500 GENITALIA MALE /

25 References / 137 Points / Rating .956
SP06

CV03

CV04

ST29

BL32

BL33

BL34

LV01

BL31

LV04

.854

.753

.707

.611

.565

.485

.481

.473

.444

.431

GB39

GB31

KI03

070000 PELVIC LIMB , ITS ORGANS AND FUNCTIONS /

52 References / 330 Points / Rating
GB34

ST36

GB30

SP06

BL60

BL40

.965
BL57

.940

.884

.841

.809

.793

.773

.751

.735

.691

.687

070200 BUTTOCK /
18 References / 80 Points / Rating .956
GB30

BL36

OT01

ST36

BL23

BL54

BL37

OT05

BL40

BL60

.564

.407

.401

.285

.285

.285

.285

.233

.174

.174

070239 HIP /
37 References / 100 Points / Rating .968
GB30

GB34

GB29

GB31

BL40

BL60

OT01

GB39

ST36

LV08

.888

.595

.408

.380

.352

.304

.279

.274

.193

.176

070240 THIGH, FEMUR /

27 References / 124 Points / Rating .963
GB30

GB31

GB34

LV08

ST36

BL23

LV11

BL40

BL37

SP06

.773

.585

.519

.512

.458

.400

.362

.335

.304

.300

070300 KNEE, POPLITEAL /

44 References / 146 Points / Rating .968
GB34

BL40

L 16

ST35

SP09

ST36

ST34

LV08

OT01

GB31

.864

.608

.596

.568

.479

.390

.383

.380

.272

.251

070315 PATELLA /
4 References / 21 Points / Rating .975
SP09

SP10

GB33

OT01

OT05

BL40

LV08

BL11

ST30

SP05

.769

.769

.769

.769

.744

.513

.513

.487

.256

.256

070400 LEG, CALF /

47 References / 208 Points / Rating .962
BL57

GB34

ST36

SP06

BL40

GB30

BL60

GB39

ST32

LV03

.701

.657

.555

.553

.509

.480

.363

.314

.292

.237

070417 TIBIA, FIBULA /

17 References / 63 Points / Rating .965
ST36

GB35

GB34

GB37

BL40

LV03

GB36

GB30

BL62

LV02

.543

.402

.366

.360

.348

.305

.287

.244

.226

.226

070429 ACHILLES AREA, HEEL /

17 References / 58 Points / Rating .971
BL60

KI03

BL57

BL61

KI04

SP06

OT01

ST36

ST41

BL40

.606

.594

.545

.352

.352

.303

.303

.182

.182

.182

070500 ANKLE, TARSUS /

40 References / 112 Points / Rating .973
BL60

ST41

KI03

GB39

GB40

SP06

BL57

OT01

ST36

SP05

.769

.725

.555

.506

.427

.360

.355

.280

.254

.252

070503 TARSAL-METATARSAL /
15 References / 38 Points / Rating .967
GB41

OT01

ST41

OT05

BL59

KI06

GB40

BL60

SP05

KI03

.483

.483

.414

.414

.338

.269

.269

.262

.207

.200

070600 METATARSAL, FOOT /

36 References / 138 Points / Rating .956
BL60

KI03

LV03

SP06

BL57

ST41

GB39

OT01

ST42

GB41

.608

.570

.462

.448

.395

.363

.337

.317

.308

.308

070608 TOE /
34 References / 118 Points / Rating .965
L 08

SP04

SP06

LV03

OT05

ST36

GB34

OT01

BL60

SP05

.454

.378

.360

.351

.299

.268

.241

.241

.207

."01

080000 SKIN /
38 References / 223 Points / Rating .963
LI11

LI04

SP10

SP06

ST36

BL40

GV14

OT05

BL13

GB20

.836

.710

.689

.522

.503

.495

.380

.374

.325

.273

080124 HAIR,SKIN : ALOPECIA;BALDNESS;HAIRLOSS;OPPILATION /

9 References /

66 Points / Rating

.956

BL16

BL40

GB20

OT05

LI04

BL10

CV12

ST36

BL43

CV04

.547

.419

.349

.349

.233

.233

.233

.221

.221

.221

090100 FEVERS /
37 References / 195 Points / Rating .959
GV14

LI11

LI04

PC05

BL40

GV13

A 01

PC09

LI01

LU10

.932

.907

.786

.468

.437

.431

.420

.408

.403

.389

090101 CHILLS /
17 References / 100 Points / Rating .929
GV14

ST36

LI04

GV16

BL40

HT06

GB25

LI11

TH04

BL12

.791

.551

.544

.481

.418

.354

.241

.234

.222

.215

090200 SWEATING PROBLEMS /

26 References / 94 Points / Rating .954
KI07

LI04

HT06

SI03

SP02

LV02

LU08

LU10

LU11

GV14

.815

.536

.460

.383

.278

.270

.185

.185

.181

.149

090300 INFECTIONS: MALARIA,TB,CHOLERA,TYPHOID,TYPHUS,HERPES,RU-BELLA,

VARI-CELLA ETC / 34 References / 195 Points / Rating

.965

GV14

ST36

PC05

LI04

SI03

LI11

GV13

PC06

SP06

CV12

.726

.680

.616

.576

.543

.530

.497

.460

.375

.345

090400 IMMUNITY /
12 References / 19 Points / Rating .933
ST36

LI04

GV14

SP06

LI11

CV04

BL18

BL19

BL23

CV06

.598

.580

.580

.321

.313

.250

.179

.179

.179

.179

090410 TONIC EFFECTS /

28 References / 156 Points / Rating .957
ST36

CV06

CV04

BL43

BL20

PC06

BL23

LI04

SP06

LI11

.821

.451

.448

.444

.246

.243

.228

.216

.209

.198

090419 GANGRENE, ISCHAEMIA OF EXTREMITIES /

11 References / 33 Points / Rating .973
OT02

OT05

A 22

L 08

LI11

HT03

GB34

SP09

SP06

BL43

.467

.458

.374

.374

.364

.364

.364

.280

.178

.178

090420 LYMPHADENOPATHY /
12 References / 32 Points / Rating .917
ST36

HT03

BL60

SP06

GB39

OT02

ST31

PC01

LI01

LI13

.264

.236

.236

.182

.182

.182

.173

.173

.155

.155

090500 BONES, JOINTS (GENERAL) /

34 References / 214 Points / Rating .959
OT05

OT06

ST36

LI04

OT01

GB34

LI11

TH05

BL11

BL23

.669

.491

.479

.463

.457

.423

.417

.325

.322

.298

090600 MUSCLE, TENDON, SOFT TISSUES (GENERAL)

28 References / 133 Points / Rating .946
OT05

OT01

GB34

ST36

OT06

LI04

LV03

LI11

SP06

OT03

.600

.540

.491

.438

.389

.385

.321

.317

.287

.275

090700 ANALGESIA, PAIN CONTROL (GENERAL) /

23 References / 78 Points / Rating .957
LI04

ST36

LI11

TH05

OT05

SP06

LV03

GB34

A 22

GB38

.482

.436

.355

.341

.341

.314

.273

.264

.227

.209

QUESTIONS
1. Using LU LI / ST SP / HT SI / BL KI / PC TH / GB LV / CV GV to denote the
Channel-Organ Systems (COSs), indicate the most appropriate Channel to respond to
the following Shu/Mu combinations:
(a) BL13/LU01 is best for which COS ?
(b) BL14/CV17 is best for which COS ?
(c) BL15/CV14 is best for which COS ?
(d) BL18/LV14 is best for which COS ?
(e) BL19/GB24 is best for which COS ?
(f) BL20/LV13 is best for which COS ?
(g) BL21/CV12 is best for which COS ?
(h) BL22/CV05 is best for which COS ?
(i) BL23/GB25 is best for which COS ?
(j) BL25/ST25 is best for which COS ?
(k) BL27/ST04 is best for which COS ?
(l) BL28/CV03 is best for which COS ?
2. Indicate the condition most likely to respond to the following set of points: PC06;
ST36; CV12; BL21; BL27; CV04
(a) nephritis/cystitis
(b) hepatitis/cholecystitis
(c) splenitis/pancreatitis
(d) oesophagitis/pericarditis
(e) gastritis/duodenitis

3. Indicate the least effective point for utero-cervical bleeding:

(a) GV03
(b) GV04
(c) BL25
(d) BL26
(e) BL27
4. Indicate the least effective point for collapse/shock:
(a) GV26
(b) KI01
(c) LU11
(d) LI01
(e) PC06
(f) BL23
(g) HT07
(h) SI10
5. Indicate the least effective point for lumbar disc disease:
(a) GB30
(b) GB20
(c) BL23
(d) GB34
(e) GV03
(f) local points
6. In each set (1 to 5), indicate the most effective point (a to e) for spinal disorders:
(a) (b) (c) (d) (e)
Set 1: BL62 BL01 BL67 BL37 BL57

Set 2: SI11 SI19 SI03 SI08 BL04

Set 3: GB28 GB34 GB01 GB42 GB40
Set 4: KI15 KI17 BL23 KI03 KI27
Set 5: KI03 LI08 LV13 SI10 ST01
7. One of the following statements is not correct. Indicate the incorrect statement:
(a) In most local problems the best prescription combines AhShi + local + distant points on
the affected or related Channel.
(b) It is not important to check the AP point location as regards the nerve supply and the
Channel. For example, the best combination for pain in the medial epicondyle of the humerus
is identical to the best combination for the lateral epicondyle.
(c) Modern neurophysiological concepts of AP stress that adequate stimulation of the affected
or related NERVES will produce results as good as the traditional method but adequate
clinical or research testing of the traditional versus modern (nerve theory) methods has not
been done.
(d) In disease of internal organs, the most important points lie near the organ in the
thoracoabdominal area or in the paravertebral area (the Mu, Shu and Huatochiachi (X 35)
points, CV and GV points).
(e) Where the organ has a named Channel (LU, LI, ST, SP, HT, SI, BL, KI, PC, GB, LV) it
is common to include one or more points on that Channel (distant as well as local points).
(f) The course of the Channel is important. For example, the liver, kidney and spleen
Channels traverse the inner thighs and groin area. Distant points on these Channels are
important in genital and lower abdominal conditions.
8. One of the following statements is not correct. Indicate the incorrect statement:
(a) If a symptom or abnormal function can be traced to a specific organ or COS, treat that
COS.
(b) If more than one symptom/organ system is involved, choose a combination of points
which will influence all major symptoms or upset organs.
(c) In acute serious conditions with multiple symptoms and pathology, it is acceptable to
rely solely on AP therapy.
(d) In chronic complicated cases, where immediate life-threatening symptoms or pathology
are absent, one can rely on AP as the main therapy (in cases amenable to treatment).
(e) The aim of good medicine is to help the patient to the greatest extent, with the minimum of
side effects. Therefore, it is good practice to use whatever complementary therapies seem
best indicated.

9. One of the following statements is not correct. Indicate the incorrect statement:
(a) Points LI04,11; ST25,36; SP06; HT07; BL23,40; PC06; TH05; GB20,34; LV03;
CV06,12; GV04,12,14,20,26 are used in a high proportion of cases. In complex cases, if one
has difficulty in deciding on a prescription, it is advisable to include a few points from that
list.
(b) A patient had recurrent symptoms (at different times) during a period of 6 years, beginning
two years after radical right lung surgery: recurrent haemorrhagic nephritis; cystitis; rightsided sciatica; right-sided paravertebral pain (C6-T4 area); right-sided headache and bouts of
acute conjunctivitis (right); right ear tinnitus; waking at night with severe pain along the SI
Channel of the arm to the little finger, with the arm in spasm. The patient had marked scarformation and tenderness in the area of the BL Channel on the right thorax. Cookbook AP
would be indicated in such a case.
(c) If a Cookbook prescription does not produce definite results by 2-3 sessions, it is
necessary to change the choice of points, or consider other therapies, or regard yourself as
unable to assist.
(d) Complicated or deeply rooted problems require holistic (traditional + modern +
complementary + intuitive) therapy.
(e) Cookbook prescriptions based on many references and high point scores are likely to be
successful in single-symptom cases
1 a=LU; b=PC; c=HT; d=LV; e=GB; f=SP; g=ST; h=TH; i=KI; j=LI; k=SI; l=BL;
2=e;
3=b;
4=h;
5=b;
6 Set 1=a; Set 2=c; Set 3=b; Set 4=c; Set 5=a;
7=b;
8=c;
9=b

COMPUTER APPLICATIONS IN THE STUDY AND CLINICAL USE OF

ACUPUNCTURE
SUMMARY
1. There is no standard way of choosing AP prescriptions but ancient Chinese laws give useful
guidelines. There is considerable variation between textbooks as to the functions of specific
AP points and as to the "best points" to use in specific problems.
2. Beginners can build their own databases by storing every listed function of each specific
point on computer. The more textbooks and clinical articles stored in this way, the better the
database. The database can be "tidied up" at intervals by sorting on condition and author,
eliminating any duplicate entries and amalgamating complementary data. However, storing
data in this way is a very tedious process. It took the author 10 years to check point codes,
cross-reference the functions and store the data from 55 textbooks and other articles on human
AP on a Hewlett-Packard 1000 - Series F Mini-computer with 20 MB hard disc. The database
contains points for > 1100 clinical conditions.
3. From the raw data, it is possible to construct a Database Summary. This is a complete
listing of each point coded under each specific condition. Before output, the points are sorted
according to a weighted citation index, so that the most frequently recommended points are
listed first and the least frequently come out last. Each point has its citation score attached,
enabling the user to see at a glance the "value" of the point. The author codes - key to the
source material - are also listed.
4. The Database Summary is used as the basic source of the prescription. When, say, points
for "shoulder arthritis" or "male impotence" are needed, the relevant condition codes are
entered into the computer. The Database Summary is searched to locate the condition and all
points and scores and author codes for the condition are output to the screen or the printer.
5. With modern computer graphics it is possible to store the body charts in digital form and to
use graphic display to output the location of the points (or selected points from the list) to the
screen or to a plotter.
6. Beginners, research workers and experienced acupuncturists who wish to have access to a
comprehensive database (but who do not have the time or patience to construct their own)
may be interested in commercial AP databases. (The Rogers database is not available
commercially).
7. Computer-based filing is far more efficient than paper- or card- index systems. However, to
be able to beat power-failures or hardware/ software faults, it is advisable to keep at least one
"hard copy" (paper printout) and one software "backup" of the database summary.
8. The list of points output are all the points ever listed for the condition in the database. In
general, the first 4-6 points on the list will be suitable for routine use. However, for best
results, the user should be familiar with the basic concepts of AP, especially as they relate to
choice of points for therapy. S/he should be able to adapt the prescription to the specific needs
of the patient, selecting possibly a few points further down the list because these may be
highly relevant to that particular patient.

9. Research workers involved in controlled trials of AP effects can ensure that no point in the
database list is used as a placebo point.
10. Students and beginners may also use the graphics and the database as an aid to their study
of meridians, point locations and functions. Self- assessment tests are also possible.
11. Clinicians could use the computer to store case records, treatments given etc.
12. Clinicians and research workers could use computers with touch- or light- sensitive
screens, combined with "revolving models" of their patients to log the location of any AHSHI
points or trigger points in relation to the location of pain, pathology or diseased organs. Such
data would save time in subsequent visits and would be a very useful research tool in
reflexology and AHSHI/Trigger Point therapy.
INTRODUCTION
Mastery of AP requires years of study and practice. It involves concepts and relationships
which are foreign to western thought and training. As a consequence, most western
professionals in the medical, physiotherapy, dental, psychiatric and veterinary field are
unwilling to devote the time, energy and expense necessary to this study. Those who study AP
usually rely on relatively short courses which concentrate only on the basics. Later, through
reading (self-study), practice and discussion with colleagues, they develop their expertise.
Most have their favourite personal methods of choosing AP prescriptions. In this choice they
are guided by (a) their previous experience and training and (b) indications given in a few AP
textbooks.
There is no standard method of choosing an AP prescription for any specific condition or
syndrome but there are about 14 "laws" (most of which are based on traditional concepts)
which assist the practitioner in the final choice of points for specific patients.
The problems with individual textbooks are great. Up to now, there is no internationallyaccepted nomenclature for the AP points. Some books list points and indications which are
not listed in other books. Point names, codes and usage vary between textbooks. The serious
student of AP will also find many mistakes in the coding of points in some books.
One solution to the dilemma is for the practitioner to set up a cross- reference system listing
all uses of individual AP points from the texts and articles at his/her disposal. Many
practitioners have done this, using a card-index or loose-leaf system. Some of these systems
have been published commercially (Shenberger 1980). The relevant card or page for a specific
symptom or syndrome is consulted when required and the most frequently recommended
points are determined by a visual examination or manual frequency-ranking of each point
filed for the specific condition. However, these manual systems are relatively inflexible and
require much time to operate. Each time a new reference is added, the point rankings may
change and may require re-calculation.
Modern microcomputers can store, sort, process, retrieve and display vast amounts of data.
They have replaced manual filing systems in industry, science, general practice and research
areas. In the next decade computers seem set to become even more powerful, cheaper and
more versatile. For instance, voice input systems may well replace the typewriter keyboard.
Voice output systems are already available for many microcomputers but the VDU, printer

and graphics plotter will probably remain standard features. Most modern micro- computers
have high-quality screen graphic display as a standard feature already.
This paper will discuss some of the applications of microcomputers in the study and practice
of AP. It will concentrate primarily on the construction and retrieval of AP prescriptions but a
few applications in the study of AP and in AP research will be outlined.
A. SETTING UP DATABASES OF AP POINTS
Two main types of database are possible: 1. Comment files and 2. Files relating only to the
points used for specific conditions.
1. The comment files can retain data on the uses of the points (methods of stimulation;
intervals between sessions; differential diagnosis; complementary methods of therapy etc).
They can also be used to store data which is not yet amenable to coding for the point files
(e.g.) data on Earpoints, Scalp Zone points etc which may not be catered for in the type 2
files.
2. The point files contain the list of points recommended by each reference text for each
specific condition.
Before either Comment or Point files can be set up, the user must plan carefully the coding
system to be used to identify the condition, the reference and the point codes.
Condition codes: A six digit number can be used to identify specific con- ditions. For ease of
use and purposes of later amalgamation, it is probably most suitable to code the conditions on
the basis of the body region primarily involved, rather than on a random basis. For instance
condition code 040708 could represent stenosing tenosynovitis of the radial styloid at the
wrist in a coding system which uses the following convention, in which the first two digits
specify the main body region involved:
Emergencies and first aid 0lXXXX
Head, its functions and organs 02XXXX
Neck 03XXXX
Thoracic Limb 04XXXX
Thorax and back 05XXXX
Abdomen 06XXXX
Pelvic limb 07XXXX
Skin 08XXXX
Fevers, infectious diseases,miscellaneous 09XXXX
The second two digits can specify the subregion involved.

For instance:
Thoracic limb, general conditions 040lXX
Shoulder, scapular area 0402XX
Axilla 0403XX
Arm 0404XX
Elbow 0405XX
Forearm 0406XX
Wrist 0407XX
Hand 0408XX
Finger 0409XX
The last two digits can specify the specific condition or symptom.
For instance:
Elbow area (general points) 040501
Elbow: AP analgesia for surgery of 040502
Elbow: pain, arthritis etc 040503
.
Elbow spasm, contracture 040505
.
Elbow: Paralysis 040508
Etc
The condition codes and their specifications can be set up on a file named CCODES.
Reference Codes: The database will probably rely mainly on material from textbooks,
journals, study manuals etc. These can be stored on a file called RCODES. Each reference can
also be assigned an "authority rating" in the range 0.1 to 1.0. For instance, textbooks
published by the Academy of Traditional Medicine, Beijing can be given the maximum rating
(1.0) where- as a poorly written, anecdotal article in a dubious journal could be given a low
rating (0.1 or 0.2). These authority ratings can be used in the cal- culation of "weighted point
scores" at a later stage. If authority ratings are used, it is important for the beginner to take

expert advice on what value to assign to each reference. Not all books from Far East are of top
quality. Not all books from western sources are of poor quality.
Point codes: The western convention for point nomenclature uses an alpha code for the
meridian and a numeric code for the point. Thus point Hoku (Large Intestine 4) is usually
called CO 4, LI 4, GI 4, DI 4 depending on the text and language etc (Colon; Large Intestine;
Gros Intestin; Dikke Darm etc). This confusion in alphanumeric point coding causes serious
pro- blems. One must ascertain which system is being used by each reference. One must then
recode this to the system being used by oneself. For instance, data from a French text relating
to (say) acute gastritis might read: 36E, 12CV; 6MC, where E= Estomac; CV= Vaisseau de
Conception; MC= Maitre du Coeur. This must be transformed to ST36; CV12; PC 6 if the
user's convention is ST= Stomach; CV= Vessel of Conception; PC= Heart ConstrictorPericardium.
It is essential that the user adopt one convention and retain that one. However, since
alphanumeric data requires more storage space in the computer and since it is easier to sort
and manipulate numeric data, the user must also adopt a numeric code for each point. Thus,
the typical point code file would have the following details: user's alphanumeric code; user's
numeric code; point name; point location. This file can be called PCODES.
Setting up the Point Files: Having set up the files for the condition codes (CCODES),
reference codes (RCODES) and point codes (PCODES), the user can develop an input
program to take raw data from the keyboard, transform it to numeric point code and store it
under the appropriate condition and reference codes. The input program can be fully
interactive, requiring no memorised knowledge of the condition or reference codes. It can also
contain screen prompts; error traps to prevent accidental entry of wrong point codes etc. At
the end of the entry session, a record of the entries can be printed for editing. Any mistake in
the point code file or the comment file can be corrected immediately. The corrected entries
can then be passed for merging with the relevant database files.
B. PROCESSING THE DATABASE POINT FILES
As the database (raw data) is being expanded, conditions and references are usually added in
sporadic input sessions. Before processing, the database must be sorted by condition code and
author code. The sorted database can then be read by another program to eliminate duplicate
entries and amalgam- ate points that may have been entered in two or more input sessions for
the same condition and author. This tidied-up database is then substituted for the original.
Three main types of processing are possible:
1. Auto-processing;
2. Processing for specific conditions;
3. Combining a number of conditions to obtain a summary of the points for specific regions,
organs etc.
1. Auto-processing: A program can be developed to read the first condition code and author
code. The "authority ranking" (rating value) is assigned to each point for that author. The next
author is then read and point scores are added to the previous values. When a new condition is

met, the program sorts the points for the previous condition according to descending values of
the point scores. The sorted list of (numeric) points is transferred back to the user's
alphanumeric point codes. This frequency-ranked list is then sent to the printer and to a
summary file (DATSUM), together with the point scores and author codes. The next condition
is processed in the same way (having zeroed the registers). When the last condition is
processed, the program ends. Thus, a complete listing of all the points (with their scores and
references) for each condition in the database is generated on the printer and on the summary
file. This file (DATSUM) is the one which will normally be used for quick reference. If the
database is expanded frequently, updates of DATSUM will be needed every 3-12 months,
depending on the intensity of the input.
2. Processing for specific conditions: This uses a similar program to the auto-processing
program, except that the condition code(s) required are specified by the user. It may be of
value when rather rare conditions are being examined, if the user believes that additional
relevant data may have been added to the database since the last auto-processing (generation
of the last DATSUM file).
3. Processing for a combination of conditions: This option is probably of most interest to
the research worker or to the user who finds that the data for a specific condition in file
DATSUM is scanty. For instance, one may want to summarise all the points listed under
Elbow conditions. For this purpose a program must be written to (a) search the database for
all points coded under 0405XX. These data are stored on a temporary file (HOLDER) and all
conditions on it are given a dummy code 040500 (=elbow). File HOLDER is then sorted by
author, so that all points listed for elbow conditions by each author are in sequence. The
sorted HOLDER file is then put through the auto-processing program ((1) above).
Alternatively, (b) the user may specify which conditions are to be amalgamated - for instance
elbow pain, elbow tremor, elbow spasm etc. The relevant codes are entered, the conditions
located and recoded 040500 (=elbow), the data passed to the HOLDER file and processed as
in (a) above.
C. CHOOSING APPROPRIATE PRESCRIPTIONS
If one's sole source of reference is a single textbook, the choice of points for specific
conditions may appear to be simple - the therapeutic index included in most good textbooks
usually lists 4-10 points. If the user is unsure of the best ones, s/he may alternate prescriptions
between sessions, so that all points in the therapeutic index are used at some stage in that
patient. This is inferior Cookbook AP, akin to broad spectrum antibiotic cover or blunderbuss
therapy.
The user with access to a computer database faces much greater difficulty. For instance, under
the heading "Sequel to CVA, polio etc (hemiplegia, paralysis)" an early version of a database
summary based on 28 references listed 217 points which might be relevant: The top 6 points
were LI11; GB34; ST36; LI 4; TH 5; LI15. Their scores were .89, .74, .68, .66, .65 and .64
respectively. At the end of the list, the last 6 were BL41; GB41; LV 4; LV 6; BL14; Z 31
(scores .03 to .02 respectively). One might assume that the top 6 would be the most
appropriate but this need not be so. For instance, if the main symptoms referred to the lower
limb, LI11, LI 4, TH 5 and LI15 would not be very relevant. If the main symptoms were facial
paralysis + aphasia, those 6 points would be of little value. However, if the user searched
under the headings "upper limb paralysis", "lower limb paralysis", "facial paralysis" and

"aphasia", much more information would be forthcoming. The following table lists the top
points for each of those conditions;

Upper limb paralysis

Lower limb paralysis
Facial paralysis
Aphasia, mutism

-(1)- -(2)- -(3)- -(4)- -(5)- -(6)LI11 TH 5 LI15 LI 4 SI 9 LI10

LI11 TH 5 LI15 LI 4 SI 9 LI10
ST 6 ST 4 LI 4 ST 7 TH17 ST 2
CV23 GV15 HT 5 LI 4 GB 2 TH17

It is important to search under the MAIN SYMPTOM or the MAIN REGION/ORGAN

involved. Even this may not be specific enough. For instance, if the facial or lower limb
paralysis involved specific nerves or joints, these should be searched also. The following table
illustrates this (only the Top 6 points for each condition are shown) :
Facial paralysis, hemiplegia
Optic branch LI 4 LI20 ST 7 ST 4 ST 6 TH17
Maxillary branch ST 4 ST 6 CV24 ST 7 ST 3 GV26
Mandibular branch ST 6 CV24 LI 4 ST 4 ST 7 ST 3
Lower limb paralysis, hemiplegia
Saphenous nerve BL38 ST36 GB31 BL60 GB30 ST44
Tibial nerve (upper) SP 5 SP 6 KI 3 BL62 SP 9 SP11
Thigh paralysis LV 8 BL23 BL25 ST36 ST33 BL38
Obturator nerve SP 6 KI 6 LV 8 - - Femoral nerve ST36 GB34 ST30 SP10 GB30 GB39
Knee paralysis L 16 BL40 GB34 ST33 LV 8 SP 7
Leg and calf paralysis BL57 ST36 SP 6 GB34 BL58 BL40
Tibial nerve (lower) ST36 LV 2 LV 3 BL62 GB35 BL37
Fibular nerve ST36 GB35 BL38 BL60 BL62 GB30
Ankle paralysis ST41 BL60 SP 6 KI 3 BL57 GB37
Foot paralysis BL60 KI 3 SP 6 GB39 BL61 ST41
Foot extroversion SP 6 KI 3 NL10 NL11 NL13 NL15
Foot introversion BL60 GB39 NL11 - - -

One drawback of the frequency-ranking system of constructing prescriptions is that powerful

AP points such as the "New points" and "Strange points" are not listed in many (especially
older) textbooks. They are described only very recently (in the past 10-15 years). The classical
(meridian) points have been documented for millennia. Therefore computer databases will
usually rank these new powerful points in a lower position than the meridian points. Users
must be aware of this. For instance, points like Lanwei (L 13); Tanlangtien (L 23); Szufeng (A
1); Tingchuan (NX 4) are very effective in appendicitis, cholecystitis, heatstroke and asthma
respective- ly. The naive user of a computer database may ignore such points because of their
lower frequency score. This could reduce the therapeutic success which would be obtained.
For really thorough work, the user should compare and contrast the list of points
recommended for the main area/organ, the main symptoms, related symptoms, the related
nerves etc. This presupposes that the user has a professional training in medicine or the
paramedical sciences, including veterinary medicine.
It is my opinion that the best use of AP would be in the hands of persons professionally
qualified in these areas. However, because of the complexity of AP, it is not enough to be a
doctor with access to a computer. A basic training in the principles of AP is essential for the
best results. When it comes to AP therapy, I would prefer to be treated by a well trained
acupuncturist (who need not be a doctor) than by a well trained doctor whose theory of AP is
weak !
The most common AP prescription is that which combines AHSHI (trigger) points, local
points and one or two distant points on the meridian through the affected area or organ. There
are, however, at least 14 Laws of choosing points. These Laws are covered in standard
textbooks of AP (for instance, The Essentials of Chinese AP, Peking, 1980). These laws are
fundamental to any serious study of AP. They include alternation of points between sessions.
Overuse of individual points is to be avoided - there is increased risk of infection, nerve
damage and loss of effect from overused points.
D. STUDYING AP FROM COMPUTER FILES
In many areas of study, the computer has already proved to be a very useful aid. By
interaction with the VDU (monitor screen), the user can play with the system. It is a pleasant,
painless learning process. Three main options are possible:
1. Studying the course of the meridians and the locations of the main AP points;
2. Studying the main functions of specific AP points and
3. Self assessment tests.
1. Studying meridians and points: With modern computer graphics it is possible to digitise
maps, pictures or other types of drawings. It is possible to digitise pictures of the body (man,
dog, horse, ox etc) with surface and deep anatomy shown in full colour. The course of the
meridians and the location of each AP point could be digitised on separate files. These files
could be used for study-purposes by calling up the body outline to the screen and searching
the files for (say) ST meridian or specific points. These would be displayed on the screen.
Alternatively, when choosing points for a particular patient, the program could display the
location of the top 6 points in one colour and the next 6 in a different colour and so on. The

database summary for any specific condition, the spatial relationships of the points to the
affected part/function or organ could be seen readily. This would be a most powerful visual
aid to study. This technique will show that the most important points for specific parts or
organs are clustered on or near the affected areas with other points distant from the area.
For instance, the database summary (DATSUM) for stomach and duodenum may show the
top 6 points to be: ST36; CV12; PC 6; BL21; ST25; CV 6. Of these only CV12 is directly
over the stomach and BL21 (Bladder Shu Point for Stomach) is below spine of T 12 in the
innervation area of the stomach. However other points over the stomach area or in the flanks
or back (in stomach innervation areas) will also be shown: CV14-09; KI17-22; ST19-24;
SP16; BL17-22 and 46-50. In addition, the "New" and "Strange" points in these areas will
also be shown. It will also be obvious that many distant points, especially on the PC, TH, ST,
SP and LV meridians will be shown also. These meridians are closely related to stomach
function in traditional Chinese concepts.
2. Studying the main functions of points: Having established a database summary
(DATSUM), this can be used to generate ones own "textbook" of point functions, which can
be stored on a new file (PTFUNC). The user may opt to store the top 6 points for each
condition, together with the condition code. By sorting this file on point Code, all the uses of
each point are stored together. For instance, suppose the top 6 points for the following
conditions were:

Condition code

010101

GV26

KI 1

LU11

HT 9

PC 9

GV26

ST36

GV20

LU11

LI 4

ST36

GB39

BL57

ST32

GB34

SP 6

.
.
010108
.
.
090804

The read program would then transform this to file PTFUNC as:

Point

Status

Condition

GV26

(1)

010101

GV26

(1)

010108

KI 1

(2)

010101

(3)

010101

(4)

010108

LU11

(4)

010101

LU11

(5)

010108

HT 9

(5)

010101

PC 9

(6)

010101

ST36

(1)

090804

ST36

(2)

010108

GV20

(3)

010108

LI 4

(6)

010108

GB39

(2)

090804

BL57

(3)

090804

ST32

(4)

090804

GB34

(5)

090804

SP 6

(6)

090804

The file would then be sorted on point code, status and condition code. The sorted file would
then be read against the condition code file (CCODES) to substitute the description of the
condition for the condition code. The final version of PTFUNC would be a most
comprehensive summary of all the main functions (status 1 to 6) of each point. Searching this
file as a study exercise would give a very complete view of the function of any point of
interest.
Note: the "New" points and "Strange" points would get poor representation in this exercise for
the reasons earlier. To study prime functions of these new points from the database summary,
the meridian points would have to be eliminated first and the remaining points processed as
on the last page.
3. Self-Assessment tests: The user could write a suite of questions based on the database,
point functions, point locations etc or on AP examination papers. The correct answers to these
questions could be stored. Self- assessment could be based on intermittent exercises in which
a random 50 questions would be chosen. The answers would be compared with the correct
answers. The users score would be stored and dated for future reference.
There is considerable scope for commercial software development in this area, as in the other
areas discussed in this paper.

E. COMPUTER APPLICATIONS IN AP RESEARCH AND CLINICAL WORK

There are three main applications in AP research:
1. In the selection of "active" and "placebo" points in clinical AP trials;
2. In the logging of AHSHI points (trigger points) in clinical disorders (myofascial pain
syndromes; internal disorders etc);
3. Case records.
1. "Active" and "Placebo" points in clinical AP trials: Controlled trials of AP effects are
largely confined to western countries. In the East, the clinical efficiency of AP is taken for
granted, (having been used for millennia). Controlled human trials using "placebo AP groups"
would be unethical to many Eastern researchers.
A typical double-blind Western clinical trial is based on at least 2 groups of patients; a control
group and at least one treatment group. The Control group is usually needled in "placebo AP
points" which are selected as being "non-active" in relation to the clinical problem. The
Treatment group is needled at points which are recommended as being "active" for the clinical
problem. The patient and assessing professional is unaware of whether or not the points being
used are "placebo" or "active". At the end of the trial, the clinical results are assessed and
compared. If the "active" group have significantly better results than the "placebo" group, the
conclusion is that AP at the "active" (correct) points caused this effect. If there is no
significant difference between groups the conclusion is usually that AP was no better than
placebo needling.
The design and conclusions from many such trials are frequently invalid for the
following reasons: "Placebo" effects in medical trials usually occur in 20-40% of patients. In
many AP trials 50-70% of "placebo AP" patients improved objectively or subjectively because
the points used as "placebo" points were active but the researchers did not know this !
Many AP trials have been conducted by workers whose detailed knowledge of AP was
negligible or minimal. These workers usually chose points from a "standard AP textbook" or
were guided by a "qualified acupuncturist". As discussed earlier, few if any textbooks (even
the best ones) are exhaustive in their coverage of all the effects of specific points or in their
listing of all points which may be "active" for any specific condition. Furthermore, many
qualified acupuncturists have blind spots and personal preferences in point selection and may
not be aware of data in textbooks, journals etc which they have not studied. Many qualified,
Eastern trained acupuncturists know little of the conclusions of western style "scientific" AP,
i.e. that the points are NOT as specific as the Traditional School would suggest and that the
effects of ap are mediated primarily via the neuro-endocrine and autonomic nervous
systems.
Thus, in the selection of "placebo AP points", one should avoid using any points close to the
affected area; on nerve segments related to the affected area; New, Strange, Hand or other
points listed in recent texts as effective in the clinical condition. For instance, point Lanwei (L
13) on the lateral aspect of the leg, has powerful effects in acute abdominal conditions,
including appendicitis. This point (as with all the newly described points) is not mentioned in
many textbooks. Inadvertent inclusion of active points in the "placebo group" will cause a

higher than normal "placebo" effect. Because of the high clinical success in the "placebo"
group, the "real AP group" stands little chance of showing significantly better results.
Other reasons for invalid results include: incorrect needling technique (it is important to
obtain DeQi: paraesthesia, heaviness, numbness, sensation radiating towards the affected part
etc); incorrect depth of needling; insufficient time; too few sessions etc. However, the choice
of valid "active" and "placebo" points is absolutely critical in the design of a valid experiment.
Workers who are interested to conduct clinical AP research would get very valuable data from
a comprehensive database. For best results, they should also have studied the basic concepts
of AP and the western conclusions on AP mechanisms. Despite such preparation, there are
some who argue that it is very difficult to design a fully valid trial of AP using "placebo AP"
controls.
2. Logging of AHSHI and other tender points in clinical disorders: Trigger Point and
AHSHI therapy have been discussed elsewhere. As a result of the research of Travell, Moss,
Fox, Melzack, Carole Rogers, Khoe, Chung, Pontinen, Macdonald, Kothbauer and many
others, trigger point/AHSHI therapy is widely accepted in Western medicine. Although most
authors have attempted to document the exact locations of the trigger/AHSHI points in their
studies, there is a need for a systematic documentation for every part of the body, including
the internal organs. The microcomputer, with a touch- or light-sensitive screen, offers a
unique application in this field. With modern optical techniques, it should be possible to
digitise a human-shaped doll (such as that used in the study of AP) so that it could be
"viewed" from any angle on the monitor screen. When the problem areas of the patient
(myofascial syndromes; other pain syndromes; internal organ disease etc) have been located,
they could be transmitted to the computer via the touch- or light-sensitive screen (having
"rotated" the model, if necessary). The precise location of the AHSHI/ trigger points could be
logged in the same way when they are detected by careful palpation. If this study were to be
conducted in a number of clinics simultaneously, a very precise, comprehensive database of
AHSHI/trigger points could be built in the same way as outlined in Section A of this paper.
This database could be summarised for each body region, muscle, organ etc as a software
package for clinicians. It would be an invaluable guide to clinical diagnosis and to the
location of the diagnostic/therapeutic points in those conditions in which AHSHI/trigger
points arise. A similar package could be constructed for veterinarians, especially those
interested in horses, dogs and cattle.
The logging of the location of AHSHI points would also be of use to the general AP
practitioner. It would save time in subsequent visits and offers a useful prognostic aid disappearance of the AHSHI points indicates that the condition is improving.
3. Case Records: Microcomputers are being used to log case histories, treatments given,
progress etc in medicine and veterinary medicine. The software packages could be adapted
relatively easily to cater for the additional data involved in AP diagnosis and therapy. Rapid
retrieval of the case record and previous treatment is helpful to general practitioners and
hospital staff alike. It also applies to dentists, physiotherapists and other health-care
professionals who may use AP as part of their therapeutic methods.
CONCLUSIONS

The microcomputer, with graphic display and sensitive screen input has many applications in
AP, whether at the level of the student, the clinician or the research worker.
Software packages, developed by the user or purchased commercially, will bring vast
information storage and retrieval power to the user. Acupuncture is set to enter the twenty-first
century, with a place of honour in western medicine, due to the pervading influence of the
ubiquitous micro. People who would otherwise not have studied AP will do so now.
REFERENCES
Anon (1980) Essentials of Chinese AP (College of Trad. Med.) Foreign
Languages Press, Beijing, China 432pp.
O'Connor, J. and Bensky D. (1983) AP - A Comprehensive Text. Shanghai
College. Trad. Med. (Eastland Press, Chicago), 750pp.
Shenberger, R.M. (1980) AP therapy prescription index. Shenco, 205
Pinecroft Drive, Roselle, Illinois 60172, USA.
QUESTIONS
1. One of the following statements is not correct. Indicate the incorrect statement:
(a) There is no standard way of choosing AP prescriptions but ancient Chinese laws give
useful guidelines
(b) There is considerable variation between textbooks as to the functions of specific AP points
and as to the "best points" to use in specific problems
(c) Computer databases offer a good solution to Cookbook AP. When, say, points for
"shoulder arthritis" or "male impotence" are needed, the relevant condition codes are entered
into the computer. The Database Summary is searched to locate the condition and all points
and scores and author codes for the condition are output to the screen or the printer.
(d) Software for the Rogers AP point database for personal computers is available
commercially.
(e) With modern computer graphics it is possible to store the body charts in digital form and
to use graphic display to output the location of the points (or selected points from the list) to
the screen or to a plotter.
2. One of the following statements is not correct. Indicate the incorrect statement:
(a) Research workers involved in controlled trials of AP effects can ensure that no point in the
database list is used as a placebo point.

(b) Students and beginners may use computer graphics and the AP point database as an aid to
their study of meridians, point locations and functions.
(c) Computers can be used for self-assessment tests.
(d) Clinicians can use computers to store case records, treatments given etc.
(e) Computers with touch- or light- sensitive screens, combined with "revolving models" of
human and animal patients can log the location of AHSHI points or trigger points in relation
to the location of pain, pathology or diseased organs. The hardware and software is available
"off the shelf" for less than 1000 US dollars.

1=d2=e

TECHNIQUES OF STIMULATION OF THE ACUPUNCTURE POINTS

INTRODUCTION
Traditional Chinese Medicine (TCM) is several millennia old. Its main therapeutic procedures
are Ben-cao (Herbology) and Zhen-jiu (Zhen = needle; Jiu = Fire) but other methods
(massage, diet, exercise, meditation etc.) are used also.
Zhen (needle) = acupuncture (AP); it literally means needle puncture (acus = needle) but the
term has a more general meaning: stimulation of specific AP points in the superficial areas of
the body by many different methods. Jiu (Fire) = moxibustion (combustion of mokusa
(Japanese term for burning herbs) is the direct or indirect application of heat to the AP points.
These will be dealt with in detail.
Other methods of stimulating the AP points will be discussed briefly. These include point
injection; "dermojet" injection; implantation; incision of the points; application of heat or
cold; massage, pressure or vibration of the points; cupping or application of a vacuum to the
points; electro-AP (EAP); transcutaneous electrostimulation, faradism; application of
magnetic, static, electromagnetic or electrostatic fields to the points; ultrasonic stimulation
and laser stimulation. Rare methods of stimulation include concentration of "psychic energy"
and "hand energy" to the points without actually touching the animal.
The most important aspect of AP is not the precise method of stimulation but to apply an
adequate stimulus to the correct points. Methods of choosing correct points are discussed
elsewhere.
NEEDLING (ZHEN)
In traditional AP, 9 types of needles were used. Some of these were like scalpel blades or
lances and must have inflicted severe pain on the animal. These are seldom if ever used in
western AP today. To avoid unnecessary suffering, the finest needles possible should be used.
In practice, this means using 25-32 gauge needles in small animals and 19-25 gauge needles
in large animals.
The length of the needles depends on the species of animal and on the location of the points to
be needled. Points over bony areas, such as the scalp, face, ears and distal limbs require the
shortest needles. Those over the thorax, abdomen and lightly muscled areas require medium
length needles and those over heavily muscled areas, such as the lumbar area, the hindquarter
(buttock and thigh) area and the heavy muscles of the shoulder area require the longest
needles.
In general, needle lengths ranging from 10-50 mm should suit all purposes in small animals
and needles 10-100 mm should suit all purposes in large animals. In human surgery under AP
analgesia, occasionally very long (up to 250 mm) needles are placed parallel to the incision
site, one on each side of the wound. This method is seldom used in veterinary surgery.
The needles can be of two types (a) special solid, stainless steel AP needles, made of very
high quality steel wire and (b) standard hypodermic needles.

a. AP needles: The cheapest needles are made in China and Taiwan but many other eastern
and western countries make AP needles. They are available through AP supply houses. The
cheapest source is via Hong Kong mail-order houses, such as Mayfair Medical Supplies,
which accepts international credit cards and orders can be placed by Fax (852-721-2851).
Human-type needles are suitable for small animals but they are too fine for use in large
animals. The problem is that muscular twitching and spasm, which frequently occurs during
the needling session (especially when the needles are electrically stimulated), can twist the
fine needles into bizarre shapes (L-shapes, Z-shapes and U-shapes etc), making them difficult
to extract and destroying them for future use. AP needles are expensive and between 1 and 20
may be required during a session. If 6-12 needles are bent or destroyed each time, the cost in
one year can be high. Therefore, the thicker needles (19-25g) are used in large animals. Even
then, some of them will be bent during therapy. Chinese (Yuan Li) needles, 30 mm long and
21 gauge wide are ideal for use in large animals. Similar vet needles made by the Richter
Company, Wels, Austria, are also available.
b. Standard hypodermic needles have the advantage of being very cheap and disposable but
they have the disadvantage of causing more pain and they may introduce dirt or skin into the
tissues because they have a lumen. They also cause more tissue damage and bleeding.
Before use, each needle should have been properly sterilised. It should be checked to ensure
that it has no physical defects such as a blunted or hooked tip, bent or rusted body or loose
handle. The points are clipped and cleaned with alcohol or other antiseptic solution. In my
opinion, unless the skin is visibly dirty, attempts to clean it by alcohol swabbing or by aerosol
spray are a public-relations exercise more than a useful hygienic procedure. Clipping makes
the points easier to find on subsequent visits. Occasionally clipping is omitted, as some
owners may object to their animal being clipped in up to twenty places.
Insertion of needles: The animal should be restrained adequately. Hypodermic needles can
be inserted to the required depth in one swift, firm movement. In nervous or dangerous
horses, it may help to have a twitch placed on the horse's upper lip, or ear, and to apply
counter-pressure to the point (using, for instance, the plastic needle cover) with one hand as
the needle is thrust home with the other hand.
AP needles need a different technique. They are inserted by a push-twirl technique in two
stages: the first movement to penetrate the skin and the second to place the needle to the
required depth in the tissues. With longer needles, it is useful to hold the needle shaft with one
hand about 25 mm from the tip (using a cotton-wool bud or piece of sterile tissue) and to
push-twirl the handle of the needle with the other hand. Alternatively, a stainless steel or
plastic needle guide can be used. Needle guides are hollow tubes, about 10-13 mm shorter
than the needle. The guide is placed firmly on the point and held with one hand. The needle is
inserted into the tube and the needle-handle, protruding from the guide, is tapped firmly with
the finger of the free hand to drive the needle 10-13 mm deep. The guide is then removed and
the needle is advanced to the correct depth.
It is not possible to give an exact depth or direction for needle insertion: these vary between
points (within species) and between points (between species). The direction of insertion
depends on the body region being needled. Over muscular areas, the needle is usually inserted
at 90o to the skin, deep into the muscle. Over bony areas and on Earpoints, the needle is
inserted perpendicularly until- the skin is penetrated and then is advanced subcutaneously.

One should not normally needle the periosteum (except in cases where this is specifically
indicated) or the ear cartilage. Accidental striking of bone can bend the tip of the needle,
making it difficult to extract and destroying the tip.
Penetration of the human ear cartilage can cause a chronic auricular chondritis which can be
very difficult to cure. In animals (because ear AP is less commonly used than in humans) this
problem is uncommon but, it is safer to avoid penetrating the cartilage. Penetration of the
thoracic or abdominal cavities is normally forbidden, except in specific cases, such as
aspiration of fluid or releasing gas from the viscera etc. Therefore, when needling points over
the thorax and abdomen, the needles are usually inserted at 45o, to reduce the risk of
accidental penetration into the cavity. Penetration of major arteries (such as the carotid) or of
sensitive organs such as the eye is forbidden.
The depth of insertion also varies within and between species. In large animals the needles
can be inserted up to 100 mm deep in certain points, such as those over heavy muscles, or
when the needle is obliquely inserted in certain points on the head. However depths of 25-50
mm would be more usual. Certain points are merely pricked to a depth of 3 mm or so. The
exact depth and direction of needle insertion is described for each point in the vet AP
textbooks, such as those of Westermayer, Brunner, Klide and Kung etc.
In small animals heavy muscle groups would be needled to depths 10-50 mm, depending on
the amount of muscle. Pricking of certain points and shallow needling (up to 10 mm deep) of
other points is applied as in the human textbooks. (The Chinese have no texts on small
animals and Western vets have to approach these species by reference to similar human
conditions).
In humans and in animals, the most active points are over peripheral nerves especially main
nerves, such as the trigeminal, facial, radial, median, ulnar, sciatic, spinal nerves etc. Nerves
running on and in the muscles are also very important. The acupuncturist deliberately inserts
the (very fine) needles directly through these nerves. Nerve stimulation (by twirling the
needle clockwise and anticlockwise and pecking it up and down) causes very specific
sensations (De Qi) in humans. Shooting sensations (paraesthesia), numbness and heaviness
must be elicited, otherwise the needle is not exactly in the correct position. Once the needle is
correctly in the nerve point and De Qi has been attained, care is taken to avoid further pecking
motion with the needle to avoid physical damage to the nerve. This is more important when
hypodermic needles (with sharp cutting edges) are used.
When the needle is correctly placed and stimulated, a local reflex muscle spasm grips the
needle tightly, "like a fish taking the bait". The response is felt both by the patient and the
acupuncturist. Animals, however cannot tell the acupuncturist what they feel. Thus, vets have
to seek the objective signs of strong nerve stimulation. Animal reaction to this may differ, but
shivering, local muscle twitch, vocalisation, lifting of a limb, attempts to escape, bending of
the back, swishing the tail, lowering of the head and defensive reaction may occur during
strong stimulation. The needle should be tightly gripped by the tissue, as in humans.
Tonification and sedation techniques: Classic methods of manipulating the needle are
different if the diagnosis indicates a definite excess of Qi in a meridian (SHI diseases = excess
Qi) or definite deficiency of Qi in a meridian (XU diseases = deficient Qi). These topics are
discussed further in the paper on "Holistic concepts of health and disease". In SHI diseases
use XI (Sedation) technique. In XU diseases use BU (Tonification) technique. In both

methods, the needle is manipulated until De Qi arrives (i.e.) until sensation of tingling,
numbness, heaviness and gripping sensation needle occurs.
In BU (tonification) technique the needle is thrust in heavily and rapidly. It is rotated (twirled)
with small amplitude and low frequency and is lifted gently and slowly before the next rapid
and heavy thrust.
In XIE (sedation) technique the needle is thrust in gently and slowly. It is then twirled
strongly (large amplitude) at high frequency and is lifted forcibly and rapidly before the next
gentle and slow thrust. The techniques are summarised below.
Needle Tonification Sedation
Needle Manipulation

Tonification
Sedation
(BU technique)
(XIE technique)
(in XU (deficiency) diseases) (in SHI (excess) diseases)

Thrusting in

Heavily, rapidly

Gently, slowly

Twirling

Small amplitude, slowly

Large amplitude, quickly

Lifting up

Gently and slowly

Forcibly and quickly

Duration of needling: Needles are usually left in position for 10-30 minutes in conditions
such as rheumatism, muscle pain, arthritic lameness etc. Occasionally the vet may be too busy
to wait for up to 30 minutes until the needles are withdrawn. In these cases the farmer or
owner may be instructed to twirl the needles for 10 seconds every 2-4 minutes, until 10-30
minutes have elapsed and to remove the needles then. (In this case, disposable needles are
used). In some cases, for instance rhinitis, conjunctivitis, shock etc, duration of needling can
be very short, 10-60 seconds.
Textbooks seldom indicate whether quick needling or longer duration of needling is required.
In general, for paralysis and painful conditions (especially of the muscles) long duration of
needling (up to 30 minutes) is indicated, whereas for most other conditions a quick needling is
sufficient. Some Chinese sources claim that if De Qi is obtained, there is no advantage to be
gained from leaving the needles in situ for 10-30 minutes, except in certain chronic
conditions, such as peripheral nerve damage. Thus, a short, quick, strong needling may
replace the longer, more gentle method in many diseases.
Needles falling out: If (having been properly planted at the beginning) a needle falls out
during treatment, it is usually left out. Relaxation of the muscles around the needle is taken to
indicate sufficient stimulation for that point.
Other types of needling: The textbooks describe other types of needle - the blood needle and
the fire needle.
The blood needle is a thick needle or lance used to puncture points over superficial blood
vessels to allow a small amount of blood to escape. A mild haematoma around the puncture
would may cause longer stimulation of the point than if a fine needle were used. However this
method has few adherents at best.

The fire needle is a thick needle which is heated before use by burning a swab soaked in
alcohol on the needle. It is then plunged in the tissues, taking special precautions. This
method is seldom used in the West.
Moxa-needle: This method is used widely, especially in muscle rheumatism and "Cold
Diseases", such as chronic infertility in cattle. ln this method, standard AP needles are
inserted into the points as usual. A piece of moxa about 20 mm long and 20 mm diameter is
pushed aver the handle of the needle and is ignited. The moxa burns slowly for 5-10 minutes
and the heat is transferred to the needle and the tissues. This method is not painful and does
not usually cause noticeable tissue damage. At the end of the session the animal may be
sweating profusely near the needle site and occasionally in other areas if multiple needles are
used. (It is well known that heat applied to the trunk will cause reflex sweating of the face in
humans).
POINT INJECTION
This method is popular in human and vet AP. It has two advantages (a) it is much quicker to
use than classic needling and electro-needling and (b) it produces stimulation which lasts for
up to 1 hour or more after injection.
The points are chosen in the usual manner. Standard precautions of needle sterility and skin
cleanliness are taken, and sterile solutions are used. Disposable hypodermic needles, 19-25
gauge (depending on species) are inserted to the correct depth. The needles are manipulated to
elicit the needle reaction (De Qi) as described above. Then a syringe is attached and 1-10 ml
of solution is injected. Small volumes are used in small animals and on Earpoints. Larger
volumes are used in large animals and in muscular areas.
The choice of solution is largely a matter of personal preference: aqua pro injectione; sterile
saline; weak glucose saline; very dilute Lugol's iodine; 0.25-0.5% procaine or lignocaine or
xylocaine solution; "Impletol" (a procaine solution manufactured by a German
pharmaceutical firm, Bayer); Sarapin; P Block; dilute Vitamin B12, B1, or C solution; very
dilute sodium salicylate solution; DMSO/B12 saline; placental fluid etc.
If orthodox drugs, suitable for intramuscular injection (such as antibiotics, hormone solutions,
electrolyte solutions etc) or plant extracts (as in Chinese herbal medicine) are indicated, they
can be diluted, as needed, before injection into the points. Alternatively, they can be given
subcutaneously over the points if they are suitable for s/c injection. Some vets claim that
drugs injected at the correct AP points have clinical effects at much smaller dose rates than if
they were injected in random (usual) sites. This claim, however, is not proved.
In Austria, Germany and France, homeopathic remedies are widely used in human and animal
medicine. Special injectable preparations are available from the homeopathic supply houses.
Vets who use the system claim that the clinical results are markedly improved if the correct
homeopathic drugs are injected into the correct points for the pathological condition. Walter
Greiff (Memmingen) uses this method to great effect. I have witnessed two almost incredible
responses to his treatment. (1) A cow with total rumen stasis, anorexia, depression and drop in
milk yield was found to be very sensitive on a point in the intercostal space between ribs 9-10,
left side. This point corresponds with one of Kothbauer's "Rumen Points". One needle was
used to inject the point with Spasmovetsan (homeopathic: Chelidonium, Colocynth, Nux
Vomica; potency 1-2; Willmar Schwabe, Karlsruhe, Laupheim, West Germany). Within three

minutes the cow began to eat and I confirmed that the rumen was now active. (2) A calf in
extremis with scouring, dehydration, hypothermia, limb spasticity and opisthotonos (probably
E. coli enterotoxaemia) had needles placed at Jen Chung (GV26), Ya Men (GV15), Ta Chui
(GV14); Feng Chih (GB20); Hsin Shu (BL15); Chi Hai (CV06). The points (except GV26)
were injected with a mixture of Dysenteral (homoeopathic: Arsen alb., Rheum.,
Podophyllum; c. 30 preparations Waldemar- Weimer, Baden, West Germany), Laseptal
(homoeopathic: Lachesis, Echinacea ang., Pyrogenium, Chlorophyll; potency 1-14; WillmarSchwabe, Karlsruhe, Laupheim, West Germany) and 5 ml Borgal (sulphadoxin/
Trimethoprim). An electrolyte powder was left with the farmer for administration as fluid
replacement therapy. Within 20 hours the calf was remarkably improved and standing. In my
opinion, the Borgal and electrolyte alone by conventional routes, would not have saved that
calf. These two cases were treated by Walter Greiff, Memmingen.
Injection of scar tissue: The importance of treating tender areas along scars, (especially those
which cause marked twisting or distortion of tissue on a major meridian) has been discussed
elsewhere. Such scars can be quickly treated, using a dental or tuberculin syringe, set to
deliver 0.1-0.2 ml/point. The solution (Impletol or procaine solution) is injected intradermally
at a depth of 2-5 mm, using a very fine (c. 25 gauge), short (2.5-10 mm) needle. The scar is
injected at intervals of c. 4 mm along its length, (i.e.) about 11 shots along the length of a 40
mm scar. Some experts inject straight into the centre of the scar. Others inject from the
periphery of the scar, towards its centre. Still others inject only the tender (sensitive) parts of
the scar.
The use of Dermojet instrument (see next section) is ideal for treating scar tissue. Scars
should be injected c. 3 times at intervals of 2-7 days, as part of the general AP therapy. If
scars are in accessible areas, the owner is encouraged to massage the area as strongly as the
animal will allow for c. 5 minutes each day during the course of AP therapy.
If one does not wish to inject scar tissue, one may still reestablish the flow of Qi through the
area by a technique known as "Bridging the Scar". In his Manual on Small animal AP,
Gilchrist lists a number of different methods of using needles to do this. They are summarised
in the diagrams below.
The needles are left in position for up to 20 minutes and are then removed. The scar is treated
3-6 times at intervals of 2-7 days.
Intradermal point injection: Some experts use dental, tuberculin or Dermojet syringes to
inject intradermally in the location of the Ear or body AP points. This method uses dilute
procaine, vitamin B12 or other solutions (as in the injection method). The small blebs which
are created give physical (pressure) stimulation for a short period after injection. The number
of sessions and the interval between sessions is similar to "standard" AP methods.
DERMOJET INJECTION
This is a very fast and simple method of point stimulation. It uses a high-pressure (jet) spray
injection technique, without the need for needles. It is very suitable for stimulating points on
the limbs of horses and cats which would not accept needling of the same points. It is also
ideal for the treatment of zoo animals.

The nozzle of the instrument is held 1-2 cm from the skin and the lever is depressed. The jet
of spray is shot into the point, leaving a blister on the skin. Solutions which are suitable for
point injection are also suitable for the dermojet technique. This technique is especially
valuable in nervous or highly-strung animals. French vets claimed highly successful results in
treating colic in horses by using Dermojet treatment of points such as Tsu San Li (ST36), Pi
Shu (BL20), Ta Chang Shu (BL25), Kuan Yuan Shu (BL26) and Tien Shu (ST25). Dermojet
is also very valuable in the treatment of cats.
Cats tolerate needling of the face and trunk very well but they resent needling of the distal
parts of the limbs. Dermojet is ideal for these parts.
IMPLANTS, INCISION, NERVE MASSAGE
In human AP sterile foreign bodies are often implanted in the tissues at AP points to elicit
long-term stimulation in chronic diseases, such as chronic bronchitis and asthma.
Stainless steel AP needles and other special steel implants may be used. They are anchored
externally or internally so that they can be removed easily, if required.
Absorbable material such as catgut and foetal or placental tissue is also used. In this method
a curved suture needle is used to introduce the material in through the active point and out
through another (such as Fei Shu (BL13) and Chueh Yin Shu (BL14) in asthma). The ends are
cut off at the skin and the skin is massaged to bury the material in the tissues, where it is left
until it is resorbed by the body. This method is listed as a valid method in vet AP textbooks
but it does not appear to be popular. It could be used in chronic conditions of the lumbo-sacral
and sacroiliac region and chronic gastric and pulmonary conditions.
Other types of implant include press needles, AP staples and gold beads. Press needles and
intradermal needles are made of stainless steel, usually 30-32 gauge. Press needles may be 1
or 2 mm long. Intradermal needles may be up to 10 mm long. They are inserted into the
dermis and are taped in position for 1-6 weeks, depending on the condition being treated.
Press needles are used especially on Ear AP points. Intradermal needles (5-10 mm long) may
be used on Ear or body points (but usually on the body points). They are used especially in
human chronic diseases and chronic pain. For instance to counteract withdrawal symptoms
when cigarette smokers let go of the habit, press needles may be put in Ear points Lung and
Shenmen and left in for 2-4 weeks. In asthma, intradermal needles may be put in points PC06;
NX04; CV17; BL13 and press needles in Earpoints Lung or Asthma. Intradermal needles are
left in position for 1-2 days in summer and for longer periods in winter. Care must be taken to
prevent local infection at the needle sites.
Gold beads 1 mm diameter, are useful implants in certain chronic conditions in animals. For
instance in treating hip dysplasia in dogs, the late Grady Young of Thomasville, Georgia,
inserted these beads under general anaesthesia. The hip area is shaved and prepared for
surgery. Then, 5-8 hypodermic needles, c. 50 mm long and 12-14 gauge are inserted through
the skin and tissue until the tip of each needle touches the rim of the acetabulum. A stilette is
then used to deposit one gold bead near the rim of the acetabulum.
The technique is fast, safe and very effective. Only one session is needed. Alternatively, small
double knots of orthopoedic suture wire, with the loose ends clipped off, can be used instead
of gold beads. They are inserted in the same way as the beads. To prevent postoperative

infection/ inflammation, penicillin is injected i/m and oral antibiotic is given for 5 days
afterwards. Young used gold bead implants in >200 dogs, with no serious complications.
Marked improvement in the clinical signs can be expected in >80% of cases in 1-3 days after
the operation.
Stainless steel staples, shot into the skin by special surgical staple-guns, are used by
American and Canadian vets. The technique is fast and easy to use, especially in large
animals. The staples are left in position until they fall out. The method has been used on body
points with claims of success in many conditions responsive to AP. They have also been used
on Ear points. However, chondritis (which may be difficult to treat) may follow puncture of
ear cartilage. (The use of such staples in the human ear has caused this problem already).
The advantage of the method is its speed and the claim that many conditions (such as
muscular lameness, pain and other chronic conditions) respond to one treatment session
because the AP stimulus continues for a long time after insertion. Some authorities would
advise against the use of staples near the eyes; over bony areas; over major blood vessels and
nerves and in the ears. Their use over well muscled areas would seem to be safe enough.
Incision of certain AP points, leaving a 10-25 mm wound in the skin down to the
subcutaneous layer, is used in certain chronic human conditions also. An example is Yu Chi
(LU10) in chronic asthma. This method does not appear to be used in vet AP in the West,
although in vet AP texts it is mentioned in relation to certain points, especially in the horse
and ox. The use of the wide (spear-shaped) lance needle would have identical effects.
In the West of Ireland, traditional healers (not vets !) used a method similar to incision and
implantation to treat shoulder lameness and dislocation of the shoulder joint in cattle. Two
twigs about 250 mm long and 10 mm diameter were cut from the willow tree. The external
bark was removed to leave the moist, white inner wood. One end of each twig was sharpened
with a knife. Then 4 stab-incisions were made with the knife about 70 mm above, below,
cranial and caudal to the shoulder joint. One twig was inserted above and advanced
downwards to emerge at the lower incision. The other twig was inserted at the cranial incision
and advanced to emerge at the caudal. A piece of string was used to secure the implants in
position. It was said that the lameness disappeared quickly and that dislocated joints
spontaneously reset themselves. The implants were removed when the problem was corrected
or within one week, whichever occurred first. I cannot vouch for the efficiency of this method
but it was still used in the countryside in the 1960s.
Incision, with exposure of the nerve and blunt massage of the nerve using artery forceps is
used in poliomyelitis paralysis in China. For instance incision of Chien Cheng (SI09) over the
junction of the radial, median and ulnar nerves above the posterior axillary crease is used in
paralysis of the upper limb or difficulty in raising the shoulder. Other points which may be
treated in this way in very serious cases are Ho Ku (LI04) and Chu Chih (LI11) near branches
of the radial nerve; Huan Tiao (GB30) near the superior gluteal nerve; Yang Ling Chuan
(GB34) near the tibial and common peroneal nerves and ST36 near the deep peroneal nerve.
This method does not appear to be used in vet AP.
MOXIBUSTION (JIU = FIRE)
One of the most ancient forms of treatment is to apply fire (Jiu) to various parts of the body.
Many methods were employed, irons treated in a fire being used for centuries in human and

animal medicine. In vet practice, line and point firing (using hot irons) is still used for tendon
problems in some countries but many Vet Associations have banned this type of treatment on
humane grounds.
Moxibustion: In China, a dried preparation of Artemisia vulgaris, rolled into cigar or
cigarette shape has been used to heat the points since before the time of Christ. The
preparation is called the Moxa and the process of using it is called moxibustion. It is used in
human and animal medicine. When moxa is ignited, it burns slowly like a cigar. It is used in 4
ways (a) Non-scarring method, (b) moxa-needle, (c) scarring method and (d) festering
method.
a. Non-scarring method: The moxa is held at a distance of about 25 mm from the skin until
the patient feels pain (human) or reacts defensively. It is removed for a few seconds and the
process is repeated 10-20 times. Alternatively a slice of garlic or ginger is put on the point and
a small ball of moxa the size (if a pea, is put on the slice. This prevents severe burning but
care must be taken that the moxa does not touch the skin.
b. Moxa-needle: Using moxa to heat the needles, has been mentioned earlier. This method is
most suitable for vet use. Moxa emits an acrid irritating smoke and must not be used near the
eyes.
c. Scarring method: The moxa is burned directly on the skin, causing intense pain, with
second or third degree burns. This method is not acceptable in western medicine or vet
practice.
d. Festering moxa: This is also a scarring method. An irritant blister paste is applied to the
heated area to increase further the stimulation of the area. Alternatively, garlic juice or
crushed garlic is rubbed into the points before moxa is applied. Pustules form within a few
days. These are drained and dressed with antiseptic cream until they heal. Festering moxa
often causes severe skin damage and is not recommended except in very difficult chronic
diseases, such as human rheumatoid arthritis or psoriasis, in which GV points from GV14 to
GV03 are used.
In vet AP texts, another method uses alcohol which is ignited and allowed to burn on the skin.
This is also not recommended.
Thermostatically heated probes at 80oC have been used to heat the points. They are safe if
checked regularly and not applied too strongly or too long.
Other methods of heating the points include ultraviolet rays, infrared rays and
microwaves. Special instruments are available for these purposes but they appear to be used
in humans rather than in animals.
If heat is to be used in therapy, care should be taken to avoid burning the patient and to avoid
sensitive areas such as the eyes, major blood vessels and mucous membranes. Moxibustion
should not be repeated in the same area more than once unless the area is perfectly free from
burns or blisters. Moxibustion can be used in "cold diseases" (chronic diseases), such as in
chronic cases of muscular rheumatism, arthritis, asthma, abdominal pain, severe enteritis and
vomiting, pyometra and metritis; chronic tendinitis, chronic lymphangitis and chronic pain.

COLD
Cryostimulation or stimulation of the AP points by the application of cold is effective in
many pain conditions. Modern cryosurgical instruments, solid carbon dioxide and ethyl
chloride spray may be used. Care is taken to avoid "burning" the skin by reducing the time of
application. The idea is to induce numbness and coldness of the tissues near the AP points. It
is especially useful in human acute painful conditions. In fever, cold applied to GV14 helps to
reduce the fever.
A very useful first-aid treatment of acute human toothache is to massage the LI04 points in
the 1st-2nd inter-metacarpal area with ice-cubes until the area seems numb. This requires
about 5 minutes. The toothache usually disappears within minutes. Occasionally it may be
necessary to add Chia Che (ST06). The method is ideal for treating children. For headaches
try GB20, LI04 and Lieh Cheuh (LU07).
The method has not been used widely in vet medicine but applications could include acute
myositis and lowback syndromes. If the vet wishes to show the owner the correct points to
work on, the owner could use the ice or dry-ice method between therapy sessions, thereby
making the vet's work easier.
MASSAGE, PRESSURE, VIBRATION
Massage is a form of self-help and first-aid in minor human conditions. It is widely used in
the East by the ordinary people to treat their ordinary day-to-day aches and pains. Massage is
sometimes combined with rubbing adrenalin cream, alcohol or rubifacient agents (menthol,
eucalyptus etc) into the points. It is of great benefit in minor human headaches, muscle aches,
toothaches, earaches, nausea, upset stomach, insomnia, etc. The same AP points as would be
needled (for the specific condition) are massaged firmly and deeply.
There are many types of Chinese massage, including slapping, pinching, rubbing, kneading
and deep pressure. The type used depends on the area to be massaged. AP points over
muscle masses can be heavily kneaded and deep finger pressure and slapping is used also.
Points over bony areas are pinched, rubbed or slapped. For human first-aid use, especially
useful in children, the following are suggested.
Nausea and upset stomach: ST36, CV12, PC06, BL21.
Earache: GB20, LI04, points around the ears; TH05.
Toothache: LI04 and ST06 with hard pressure on the Earlobes.
Muscle ache: seek out the tender points in the muscles and add main points for the affected
region.
Headache: GB20; heavy massage of the Trapezius muscles, especially GB21 + LI04; LU07;
Yin Tang (Z 03, between the eyebrows); Tai Yang (Z 09, in the hollow of the temple lateral to
the eye).
One of the most useful applications of massage in first-aid is in the treatment of human
fainting, shock, collapse etc. For this purpose, the main point is JenChung (GV26) +

YungChuan (KI01). Strong pressure and vibration is applied to GV26 (in the philtrum) using
the thumbnail. In many cases, especially if the patient's head is kept lowered, consciousness
returns in 30-60 seconds. GV26 is the shock point par excellence and can be used anywhere,
anytime in emergencies when other therapies may not be available. If nausea or angina
pectoris is also present point PC06 is added, pending medical attention.
Spooning is a variation of massage used in humans. The edge of a large soup-spoon is rubbed
repeatedly over the area (for instance BL13-16 (FeiShu to TuShu) and BL42-45 (PoHu to
YiHai) in asthma and bronchitis) until the whole area is bright red. It helps if oil is spread over
the area first to make it easier to move the spoon.
Mechanical vibrators are also useful, especially for muscle massage in rheumatism.
Physiotherapists who use these machines could greatly improve their results by adding the
main AP points for the region as well as applying local vibration and using the AHSHI
(tender) points.
Fisting: Massage techniques are not used commonly by vets in large animals because of the
large body areas and the time involved. However, key points, especially the AHSHI points
over heavily muscled areas, can be clipped and owners or handlers can be shown how to
"fist" the points. Fisting to the animal's tolerance for 4-6 minutes/day between AP sessions
can shorten the recovery time. Fisting should not be used over the spine or over bony tissues.
It is especially useful in horses with paraspinal AHSHI points.
Vibrators: Some practitioners use vibration techniques in racehorses and dogs for muscular
problems and other minor lameness but in general these techniques are not popular in busy
practices.
CUPPING, VACUUM
Application of reduced pressure to points (+ the use of needles or moxa) is used occasionally
in humans. Special instruments (glass or bamboo cups) are used. A lighted swab, soaked in
alcohol, is put into) the cup, which is then applied firmly to the point. Reduced pressure
causes suction on the skin, causing congestion to the area. Mechanical devices (similar to
vacuum cleaners, or based on a syringe and plunger principle) could cause the same effect.
Although it is mentioned in some vet texts, it is rarely used in animals the west.
ELECTROSTIMULATION (ES)
Stimulation of the points by the application of electric impulses is one of the most common
methods used in western medical AP. The stimuli can be applied via electrodes attached to
AP needles or via simple (non-invasive) skin electrodes, such as those used in ECG
measurements. The stimulators are battery operated, easily portable and are available from AP
supply houses. Waveform can be single pulses, adjustable from 1-50 Hz or more; densedisperse forms (a train of high followed by a train of lower frequency pulses). Other
waveforms are also used but the common one is single pulses (triangular, square or bipolar) in
the range 1-10 Hz. For most purposes a 3 Hz wave is adequate but individual practitioners and
patients have their own preferences. Output voltage is fully controllable from 1-160 volts or
more. The current is very small, being measured in mA.

Modern stimulators use bipolar pulses to avoid the necessity of altering the polarity of the
electrodes. (This was necessary with earlier stimulators which had positive and negative
electrodes and which could cause electrolytic lesions if used more than a few minutes without
reversing polarity).
Before the electrodes are attached, the needles should be checked to ensure that they are in the
correct points i.e. that they can elicit the De Qi sensation (the needle reaction). Julian
Kenyon, Liverpool, has evidence that simple needling for a short time is as effective as
electro-needling for 10-30 minutes in most conditions responsive to AP, provided that De Qi
is obtained when needling. De Qi is most important in effective ap therapy. It is claimed,
however, that exact positioning of the needles is not so important with electro-AP as with
manual AP because the electrical stimulus diffuses for quite a distance from the needle.
Electrodes are attached to the needles in pairs. The output control for each pair of needles is
slowly advanced until the needles begin to twitch strongly (due to muscle twitch) at the same
frequency as the frequency setting. (Care is taken that each member of the pair is on the same
side of the body for needles inserted in the thorax. Electrical stimuli which cross the spinal
area in the thorax may cause cardiac fibrillation). Normally, 10-30 minutes per session is
allowed. At the end of the session the output voltage is turned to zero and the power is
switched off. The electrodes are disconnected and the needles are removed.
Modern (Western) electrostimulators (such as those used in transcutaneous electrical nerve
stimulation (TENS), transcutaneous electro-stimulation (TES) or Faradic stimulation) can be
used without needles. The skin (contact) electrodes are coated with electrode jelly and are
applied to the points using adhesive plaster. Otherwise they are used in the same way as the
AP stimulators. Both types of stimulators can be obtained in mini- versions which fit in an
inside pocket. Human patients or owners whose animals who require frequent stimulation
may purchase their own and use them at any time via contact electrodes left semi-permanently
in position.
ES is most often used in the relief of human chronic pain syndromes, in the relief of pastoperative pain and in the treatment of withdrawal symptoms in narcotic/alcoholic
detoxification clinics. ES can be used in ANY disease in which AP is indicated. In AP
analgesia for surgery, stimulators are regarded as essential equipment. (Although AP
analgesia can be produced by manipulation of the needles and other methods, most operations
under AP analgesia use the stimulators).
In the treatment of addictions, special ear-clips are used to keep metal ball electrodes in
contact with Earpoint LUNG (in the concha of the ears). Alternatively, ECG electrodes can be
used to stimulate the area of the mastoid processes. Portable stimulators deliver mild, pleasant
electrical stimuli to the ears. Detoxification (without withdrawal symptoms and without
substitution therapy) is complete in 6-10 days in 90% of patients.
TES is also useful in childbirth and dental surgery as a method of analgesia and in the relief of
cancer pain.
In vet medicine the uses of these techniques are similar to those in humans but the two main
uses would be (a) in the treatment of pain, lameness and nerve paralysis and (b) to induce
analgesia fur surgery. In spite of its effectiveness, ES is not used often as a therapy in farm
animals or pets because of the relatively long time (10-30 minutes) required for each session.

For most purposes in human and animal patients, once De Qi is obtained, simple AP can elicit
results as good as EAP. In valuable animals, such as stud animals, racehorses and
greyhounds, however, EAP is used more widely, but more as a "hi-tech" public relations
exercise than as an essential method of stimulation.
MAGNETIC AND STATIC STIMULATION
It is possible to elicit analgesic and therapeutic effects in humans by stimulating the AP points
by magnetic, static, electro- magnetic and electrostatic fields without actually touching the
body. These claims are made in the American Journal of AP. Japanese workers have claimed
to have done Caesarean section on women whose hands and feet were encased in an ES- field.
Under experimental conditions in humans, static and electrostatic fields applied to the hands
cause analgesia in areas identical to`those which respond to simple needling of LI04. The
Chinese make portable stimulators which work on the EM and ES principle.
These methods are rarely used at present (in humans or animals) but they should be
mentioned as possible methods for the future. They also set an objective precedent for a
physiological effect induced by an intangible field (see the paper on "Holistic concepts of
health and disease" and the section below on psychic healing).
Special magnetic beads or discs, for instance "Corimags", can be taped or super-glued onto
the points for long-term stimulation.
ULTRASONIC STIMULATION (US)
US has many adherents in human and vet medicine, especially in treating soft tissue injury
(muscle spasm, muscular rheumatism, tendinitis etc). In orthodox use, the US head is applied
mainly to the area of pain or inflammation. In the Veterinary Record (1980, 106, 427-431),
Lang reported treating 53 horses, and 143 dogs and cats with US. The conditions included
sacroiliac, thoracolumbar, cervical, lumbosacral and coccygeal spinal lesions (50/67
successes); limb joint lesions (luxation, trauma, synovitis) (35/45 successes), trauma, lumbar
spasm, paresis, swelling etc (29/33 successes); bone and joint lesions in horses (5/10
successes); soft tissue trauma in horses (22/25 successes). The average number of treatments
was 2.7 per case. Rapid, complete recovery occurred in 64%.
The overall results are summarised below. Unfortunately these results were uncontrolled and
it is not known what percentage of these cases would have recovered without treatment.

Success

(n)
(%)

+++

++

Nil

127

31

31

198

15.7

4.5

15.7

100

64.1

Total

US, as a method of stimulating the AP points is used by medical more than by vet
acupuncturists. It is used for many conditions other than soft tissue injury - US merely
replaces the needle - and many of the conditions amenable to treatment by needling are also
responsive to US. As with all other types of AP stimulation attention is paid not only to the
local area of pain/inflammation but also to the AHSHI points and other AP points which are
active in treating the affected area. One of the advantages of US is that it is a fast method of
therapy. American medical acupuncturists recommend 10-30 seconds/point. The
manufacturer's instructions on maximum output and duration of treatment should be followed.
A contact jelly must be used if the area to be treated can not be immersed in water.
Those of you who already use US in your practice will further increase your success rate and
widen the scope for treatment of other conditions if you combine US with AP theory. It is also
useful in treating local infection such as in the ears, vagina, nose etc. US therapy is especially
good using the AP points on the human ear. In animals, however, we have much to learn
about the potential of this method of treatment. As animal Earpoints are not fully documented,
it is not possible to use earpoint therapy to the same extent as in humans.
LASER STIMULATION
Laser light (monochromatic, polarised and coherent) is another type of electromagnetic
energy but the wavelength frequency is in the light range. The most common type of cold
laser (power <50 mW/cm2) is the visible (red) light from He-Ne lasers. Red light (ruby laser)
is also used. Infra-red (I-R) lasers emit invisible light but the clinical effects are marked.
The power of cold lasers varies widely, from 1-50 mW/sq cm. Lasers emitting <10 mW/cm2
are not powerful enough to reach deep trigger points. For large animals, lasers emitting 30-50
mW/cm2 are recommended.
Most He-Ne and I-R lasers, even those emitting <5 mW/cm2, are effective in treating
superficial disorders (cuts, bruises, granuloma, ulcers, wounds).
Rapid interruption of the light beam at fixed intervals is called pulsing. Pulsed lasers
(especially those interrupted 2000-10000 times/second (Hz) penetrate deeper than unpulsed
lasers.
Laser stimulators are available as robust, portable instruments. They are operated by batteries
or by mains electricity. The laser probe is held within 0-5 cm from the skin and the laser light
is directed to the point. Treatment time depends on emission power. With 30-50 mW lasers,
dose time is very short, 10-60 seconds per point. There is no pain or noxious sensation. The
method is ideal (if it works !) for treatment of Earpoints (when documented properly !) and all
points on nervous or difficult animals, such as the points below the carpus and tarsus of
horses. Cats tolerate the laser very well.
The commercial claims are for excellent results. Russian and German workers have used cold
laser stimulation of the human AP points for some years now. Since 1984, there are many
papers on the method in humans. (See "AP for immune-mediated disorders", Rogers 1990).
The use of cold laser in conventional veterinary practice (as a therapy for tissue trauma,
wounds, granuloma, myositis, tendinitis etc) is growing rapidly. Laser is also be used in vet
AP (instead of needles) to stimulate the AP points in animals but there are few published

studies to date. The author (PAMR) has used a 30 mW I-R laser with similar results to those
of EAP or point injection in horses since October 1989. However, there are reports that the
lower power lasers (especially those <10 mW/cm2) are not as effective as AP.
Further work is needed to document the uses and limitations of laser, the effects of power,
wavelength, different pulse frequencies, different exposure dosage etc. In the next few years, I
believe that we will see much more use of electromagnetic types of therapy, including
ultrasound, microwave and laser stimulation in medical and vet therapy.
TREATMENT OF CATS AND ZOO ANIMALS
Cats and zoo animals present special problems to vets who wish to use AP therapy. For
effective needling, proper restraint is necessary. Cats resent needling on the extremities of the
limbs and on the medial aspects of the limbs. Because of their sharp teeth and claws, needling
points on the ventral abdomen can also be dangerous for the operator. Also, the duration of
needling must be short.
Some vets find it useful to sedate these animals lightly before AP. Methods of choice in these
species include painless techniques, such as laser, ultrasound and EM or ES fields. (Sedation
is usually not necessary in domesticated species, other than cats, with these methods).
Alternative, quick methods are point injection, Dermojet injection and quick needling, all of
which may require sedation.
Using the Dermojet method, at a distance of 5 cm from the skin, Demontoy has treated many
cats without sedation, using limited numbers of points. Cases which gave excellent responses
included vomiting, diarrhoea, (gastritis, enteritis, gastroenteritis), constipation, urolithiasiscystitis-urethritis; urine retention; induction of parturition in overdue females; hormonal
alopecia; coryza (rhinitis, conjunctivitis, gingivitis); cough (tracheitis, bronchitis, pneumonia);
shock and anaesthetic emergencies. For details, see: Demontoy, Revue d'AP Veterinaire
(1981), No.8, p.17-21 (published by Assoc. des Vet. Acupuncteurs de France, 3 Rue Letellier,
Paris 75015, France).
Qi Gong, PSYCHIC AND TOUCH HEALING
This paper has concentrated on the more physical methods of stimulating the AP points. It
would not be complete, however, without a brief mention of paraphysical methods. Modern
Chinese Communists do not believe in a soul (a personal energy/memory independent of the
body) that survives death. However, recent (unconfirmed) reports from China indicate that
research in Qi Gong is producing exciting results. Mental and physical focusing/ control of
body Qi is possible. It can be learned and used for many purposes, including diagnosis and
healing. Acupuncturists who are Masters of Qi Gong can often "sense" the location of
disturbed Qi in the patient and, without touching the patient, can treat the disorder by
directing their own Qi to the correct AP points.
The whole area of "paranormal" diagnosis and healing is difficult to assess in terms of our
scientific methods. Little or no thorough research has been done in the area. Many
confidence-tricksters make large sums of money from the public by claiming (falsely) to have
these abilities. Nevertheless, the phenomena, although rare and unpredictable, are real.

There are people who are gifted with natural ability to diagnose disease and to heal in strange
ways. Some of the diagnostic and therapeutic aspects of psychic methods have been discussed
briefly in another paper (see "Psychic methods of diagnosis and treatment in AP and
homeopathy" by Rogers, Belgian Veterinary AP Society Seminar 1982). Psychic healers often
have no training in biology and medicine. Some of these people believe that God acts through
them; others may not believe in a God, but they use some type of meditation /trance or
"thought projection" to help the patient. The healer may be near or far distant from the patient.
Some vets and doctors have these gifts to a greater or lesser degree. They may not realise that
they have the ability and they may attribute their diagnostic skills and clinical success to
"luck" or good fortune as well as good medicine. I would ask you to keep an open mind on
these questions. If some of you recognise these abilities in yourselves, please read as much as
you can of the literature on the paranormal. You will find that your clinical success will
improve when you combine these techniques with scientific medicine.
a. Psychic diagnosis: There are people who can sense, by "paranormal" means, the nature and
location of human and animal disease. Some do this in the presence of the patient. Others do it
from a long distance, using the dowsing (divining) facility or by other psychic means.
The late Erwin Westermayer (Bellamont), a great healer, did not have to see the animal patient
or to have a detailed history of the case. He relaxed into a type of trance and within a minute
or so, sensed in his own body the site of pain or other lesion which he saw when he later
examined his patient clinically.
b. Therapeutic energy emission: The healer's hands are held near or on the patient. Many of
these healers have a strange phenomenon associated with their hands - if they hold an
earthworm in their hand, the worm dies within a minute or two. If they go fishing, they need
to have a friend with them to put worms on the hook for them.
c. Thought projection: There are people who can heal animals or humans by psychic means
with or without the conscious knowledge of the patient. They do not have to be near the
patient - they simply pray for or visualise or concentrate/ meditate on the patient and "project
healing energy / Qi / Prana" to the diseased area, Chakra or AP points.
How does this relate to AP ? Firstly, the seers of the East and West have claimed that all
living things have an Aura, or Energy Field. This aura reflects the mental and physical state
of the organism. It responds to the internal environment of the organism and also to its
external environment (terrestrial and extra-terrestrial forces). It is the interface between the
external and internal environments.
The AP points are the areas where the Energy Field is strongest. In disease, the energy pattern
at the AP points changes. These changes can be sensed (by paranormal sight or touch) by
psychic people. With some experience, the nature and location of disease can be diagnosed by
the changes in the Energy Field. (By telepathic means, trance, clairvoyance or other
paranormal means, these changes can be sensed at great distances by trained psychics).
Secondly, healing can be stimulated by altering the Energy Field of the patient so that normal
patterns of energy are re-established. Transfer of energy from the healer to the patient causes
this to occur.

Those who are trained in the AP method can concentrate more specifically on sensing and
altering the Energy Field at those AP points which are most affected. I have given much
consideration as to whether or not I should discuss this section on psychic healing with a
scientifically trained audience of vet colleagues. There is a danger that my discussion of this
section may undermine the credibility of the whole paper, if not my entire credibility as a
qualified lecturer ! However, whether we like it or not, there is a growing consciousness of
these topics in the West. It is time that scientists discuss the "paranormal" even if we do not
accept its validity.
If you are scandalised, please, forget this section and try some of the other techniques
mentioned earlier. AP can be explained satisfactorily by orthodox physical concepts without
the necessity of invoking the "paranormal". To those of us who have first-hand experience of
psychic methods, they merely add another dimension to a fascinating tapestry that is total
reality.
CONCLUSIONS
It can not be stressed often enough that successful AP is based on the choice of the correct
points. These points may be on the body, limbs, ears etc. (See other papers on this). Methods
of stimulating the points are of secondary importance.
Many different methods of point stimulation are possible but care and common-sense should
be used to avoid damaging the tissues (Rogers 1981).
The methods used by vets are mainly a matter of personal preference and experience.
Although the needle and moxa have the longest history of use, they are likely to be replaced
in Western AP by electronic, non-invasive methods, such as laser, TES/TENS, US and
microwave. Until then, it is likely that point injection, simple AP, EAP and moxa will
remain the most commonly used methods of AP therapy in vet medicine.
FURTHER READING ON PSI-ESP
1. Lethbridge, T.C. (1974) ESP-beyond space and time. Sidgwick & Jackson Ltd., London.
Paperback. ISBN 0-283-98378-0.
2. Stelter, A. (1976) PSI healing. (Bantam Books, USA) ISBN 0-553-02505-8.
3. Wilson, C. (1973) PSI healing. (Hazell Watson & Viney Ltd., Aylesbury, Bucks, UK).
Paperback (Abacus).
4. Parkes, M.W. (1974) Healing and the wholeness of man. (Regency Press, London).
Hardcover.
5. Shealy, N. & Freese, A.S. (1975) Occult medicine can save your life. (Dial Press, New
York). Hardcover. ISBN 0-8037-8816-9.
6. Koestler, A. (1975) The act of creation. (Pan-Picador Books). Paperback. ISBN 0-33024447-7.

7. Schumaker, E.F. (1977) A guide for the perplexed. (Jonathan Cope Ltd., London.
Hardcover. ISBN 0-224-01496-X.
8. Castaneda, C. (1974-77) The techniques of Don Juan (Penguin).
(1976) Tales of Power (Penguin) ISBN 0-1400-4144.
(1975) Separate Reality (Penguin) ISBN 0-1400-3558-3.
(1973) Journey to Ixtlan (Bodley Head, London). Hardcover. ISBN 0-370-10482-X.
9. Monroe, R.A. (1974) Journeys out of the body. Corgi paperback. ISBN 0-552-09531-1.
10. Heywood, R. (1971) The infinitive hive. (Pen paperback) ISBN 0-330-23102-3
11. Randell, J.L. (1975) Parapsychology and the nature of man. Abacus. Paperback. ISBN 0349-12926-6.
12. Rogers, P.A.M. (1981) Serious complications of AP ... or AP abuses? Am. J. Acup., 9,
347-351 (added as an Appendix to this paper).
13. Yu Chuan & Hwang Yann-Ching (1990) Handbook on Chinese Veterinary AP and
Moxibustion. FAO Regional Office for Asia and the Pacific, Bangkok. 193pp.
QUESTIONS
1. One of the following statements is not correct. Indicate the incorrect statement:
(a) Human-type AP needles 28-32 gauge are suitable for small animals
(b) Thicker AP needles (19-25 gauge) are preferable in large animals, as the muscular
twitching and spasm which frequently occurs during the needling session can twist fine
needles into bizarre shapes, making them difficult to extract and destroying them for future
use.
(c) Standard hypodermic needles have the advantage of being cheap and disposable but they
have the disadvantage of causing more pain and they may introduce dirt or skin into the
tissues because they have a lumen. They also cause more tissue damage and bleeding.
(d) In most cases, it is not necessary to attempt to sterilise the skin but each needle should be
sterile
(e) Standard hypodermic needles should be inserted slowly and carefully by the push-twirl
method
2. One of the following statements is not correct. Indicate the incorrect statement:
(a) It is not possible to give an exact depth or direction for needle insertion: these vary
between points (within species) and between points (between species)

(b) The direction of insertion depends on the body region being needled Over muscular areas,
the needle is usually inserted at 90o to the skin, deep into the muscle. Over bony areas and on
Earpoints, the needle is inserted perpendicularly until the skin is penetrated and then is
advanced subcutaneously
(c) One should never needle periosteum
(d) Penetration of the human ear cartilage can cause a chronic auricular chondritis which
can be very difficult to cure
(e) Penetration of the thoracic or abdominal cavities is forbidden, except in specific cases,
such as aspiration of fluid or releasing gas from the viscera etc. Therefore, over the thorax and
abdomen, the needles are usually inserted at 45o
3. One of the following statements is not correct. Indicate the incorrect statement:
(a) In large animals the needles can be inserted up to 100 mm deep in certain points, such as
those over heavy muscles. However depths of 25-50 mm would be more usual.
(b) In small animals heavy muscle groups would be needled to depths 10-50 mm, depending
on the amount of muscle.
(c) The most active AP points are never over peripheral nerves especially main nerves
(trigeminal, facial, radial, median, ulnar, sciatic, spinal nerves etc).
(d) When the needle is correctly placed and stimulated, a local reflex muscle spasm grips the
needle tightly, "like a fish taking the bait".
(e) De Qi in animals is indicated by shivering, local muscle twitch, vocalisation, lifting of a
limb, attempts to escape, bending of the back, swishing the tail, lowering of the head and
defensive reaction. The needle should be tightly gripped by the tissue, as in humans.
4. One of the following statements is not correct. Indicate the incorrect statement:
(a) Needles are usually left in position for 10-30 minutes in conditions such as rheumatism,
muscle pain, arthritic lameness etc. In some cases, for instance rhinitis, conjunctivitis, shock
etc, duration of needling can be very short, 10-60 seconds.
(b) For paralysis and painful conditions (especially of the muscles) long duration of needling
(up to 30 minutes) is indicated, whereas for most other conditions a quick needling is
sufficient.
(c) Some Chinese sources claim that if De Qi is obtained, there is no advantage to be gained
from leaving the needles in situ for 10-30 minutes, except in certain chronic conditions, such
as peripheral nerve damage. Thus, a short, quick, strong needling may replace the longer,
more gentle method in many diseases.
(d) If needles fall out after 10 minutes of treatment, they must be re-inserted immediately
(e) Blood needles and fire needles are used in large-animal AP in China

5. One of the following statements is not correct. Indicate the incorrect statement:
(a) In AP point injection, the choice of solution is largely a matter of personal preference
(b) Scars, especially the tender areas, can be treated, using a dental or tuberculin syringe, set
to deliver 0.1-0.2 ml/point. The solution is injected intradermally at a depth of 2-5 mm, using
a very fine (c. 25 gauge), short (2.5-10 mm) needle
(c) Intradermal point injection, using dental, tuberculin or Dermojet syringes is used on scars
or on Ear AP points
(d) Dermojet injection is very suitable for stimulating points on the limbs of horses and cats
which would not accept needling of the same points. It is also ideal for the treatment of
restrained zoo animals
(e) Implantation (gold beads, orthopoedic suture wire etc) of animal AP points is not safe and
is not advisable
6. One of the following statements is not correct. Indicate the incorrect statement:
(a) Moxibustion is used mainly in "Hot diseases", such as in acute cases of muscular
rheumatism, arthritis; acute asthma and bronchitis; acute abdominal pain, enteritis and
vomiting; acute pyometra and metritis; acute tendinitis, lymphangitis and pain.
(b) Thermostatically heated probes at 80oC have been used to heat the points. They are safe if
checked regularly and not applied too strongly or too long
(c) Other methods of heating the points include ultraviolet rays, infrared rays and microwaves
(d) Moxibustion is used in 4 ways: Non-scarring method; moxa-needle; scarring method;
festering method. The latter two methods are not acceptable in western-style practise
(e) Moxibustion by burning alcohol on the moistened skin is not acceptable in western vet
practise
7. One of the following statements is not correct. Indicate the incorrect statement:
(a) Cold laser (power <50 mW/cm2) in the red visible range (He-Ne lasers and ruby laser) or
in the invisible range (infra-red) can be a useful means of stimulating superficial AP points.
(b) Lasers emitting <10 mW/cm2 are powerful enough to reach deep trigger points in large
animals
(c) Most He-Ne and I-R lasers, even those emitting <5 mW/cm2, are effective in treating
superficial disorders (cuts, bruises, granuloma, ulcers, wounds).
(d) Pulsed lasers (especially those interrupted 2000-10000 times/second (Hz) penetrate deeper
than unpulsed lasers.

(e) Treatment time depends on emission power. With 30-50 mW lasers, dose time is very
short, 10-60 seconds per point.
(f) The use of cold laser in conventional veterinary practice (as a therapy for tissue trauma,
wounds, granuloma, myositis, tendinitis etc) is growing rapidly.

1=e2=c3=c4=d5=e6=a7=b

CLINICAL USE OF LOW LEVEL LASER THERAPY

ABSTRACT
1. An infra-red (IR, 904 nM) LASUWA diode laser, pulsed at 5000 Hz and with a mean output
power of 30 mW when full on, was used in uncontrolled clinical tests in animal and human
subjects for 2 years.
2. Low level laser therapy (LLLT) had analgesic, vasodilatory and anti-inflammatory
properties. It greatly enhanced the healing of accidental /surgical wounds and of minor skin
burns. It gave rapid and excellent results in lesions of the skin, superficial tissues
(subcutaneous tissue and periosteum) and superficial Trigger Points (TPs).
3. When combined with a knowledge of the acupuncture (AP) system, LLLT was effective in
treating myofascial syndromes in dogs and humans, but it was about 10% less successful than
AP in treating myofascial problems in horses.
4. LLLT gave poor results in severe tendon strain in horses. It was useless in serious spinal
pathology, some idiopathic lameness in dogs and people, carpal swelling in horses and
arthritic swelling of human finger joints.
5. Although there were some complete and partial failures and although AP and other
therapies were combined with LLLT occasionally, the clinical results confirm published
claims that LLLT is valuable in veterinary and paramedical practice.
INTRODUCTION
Low level laser therapy (LLLT) is gaining increasing acceptance in conventional veterinary
practice (as a therapy for tissue trauma, wounds, granuloma, myositis, tendinitis etc). Cold
(soft) lasers are available as robust, portable instruments. They are operated by batteries or by
mains electricity.
LLLT also is used instead of needles in veterinary acupuncture (AP) to stimulate the
acupuncture points (APs) and Trigger Points (TPs) in animals but there are few published
studies to date. Commercial interests claim excellent results in a wide variety of clinical
conditions. Russian and German workers have used LLLT at the human APs for many years.
Since 1984, there are many papers on the method in humans (Rogers 1991g).
The history, theoretical uses and physics of laser are discussed in detail in Pontinen's textbook
(1995).
Though laser light is emitted in a continuous wave (cw) beam, it can be interrupted
(modulated) at variable frequencies and intervals by mechanical or electronic means.
Interruption of the light beam at fixed intervals is called pulsing. Pulsed lasers, especially
those interrupted 2000-10000 times/second (Hz), penetrate deeper in tissue than unpulsed
lasers.
LLLT has some advantages over needling or point injection in AP or TP therapy:

* It is aseptic, non-invasive, painless and, if used properly, has no reported side-effects. The
probe is held within 0-5 cm from the skin and the light is aimed at the point.
* It is ideal for use on painful (AhShi) points or in nervous/difficult animals. Children and
cats tolerate LLLT very well.
* It may be used safely on dangerous points in large animals (such as points below the carpus
and tarsus of cattle and horses).
* It is ideal for treatment of superficial APs, such as those on the ear.
LLLT usually is given on 2-8 occasions, at intervals of 1-3 days in acute cases and 3-7 days
in chronic cases. At each session, the laser is applied for 20-120 seconds/point over or around
the rim of the lesion and to each of the APs or TPs selected for the case.
Total treatment time/session depends on mean output power (MOP) and the depth of point.
High output lasers (MOP >30 mW) and superficial points need less irradiation time than low
output lasers (MOP 1-10 mW) and deeper points. With 30-50 mW MOP lasers, dose time is
10-60 seconds/point, but with 3-5 mW MOP lasers, the required dose time/point is 10 times
longer.
The LASUWA laser claims a MOP of 30 mW. It has a strong metallic probe, with the glass
shield of the diodes set back about 0.5 cm from its tip. In horses, the probe can be applied
with heavy pressure over muscular areas, thereby gaining 1-3 cm extra penetration into the
tissues, their TPs and APs, as well as achieving a massage effect at the tender areas.
From September 1989 to September 1991, I used LASUWA LLLT experimentally in clinical
conditions in horses, dogs and people. This article summarises my experiences during that
time.
CONDITIONS TREATED AND METHODS USED
The main types of conditions treated were: (a) equine, human and canine muscle pain and
lameness; (b) human and canine "disc disease"; (c) equine flexor tendon injuries; (d) equine
and human periostitis; (e) skin lesions; (f) miscellaneous human conditions; (g) haematoma.
From September 1989 and April 1990, most cases were treated by LLLT alone. The laser was
applied over or near the affected area, to TPs and key APs for the affected area. If systemic
signs were present, the relevant APs were treated also (for example in a case of chicken-pox,
LLLT was applied to points GV14, LI04,11; ST36 (for their effect on fever and the immune
system), as well as to the pruritic lesions. In a few cases, AP needles were inserted in TPs
also, especially if the TPs were deep, as in heavily muscled areas. In a small number of cases,
other therapies (electro-AP, local medication, Dermisol or ointments) were combined with
LLLT.
CLINICAL RESULTS
(a) Equine, human and canine muscle pain/lameness

Most cases involved para-vertebral pain (cervical, thoracic, lumbar or sacral). Some involved
pain of limb muscles (scapula, arm, forearm, thigh, gluteals, gastrocnemius).
LLLT (10-30 seconds/point) was used on the TPs and APs for the affected area and over the
painful muscle(s). As many points were treated at each session, the session time was usually
10-20 minutes. Treatment was given every 1-2 days in acute cases and every 5-9 days in
chronic cases. Excellent results were got in 2-4 sessions over 4-9 days in acute cases and in 17 sessions over 16-35 days in chronic cases.
In dogs and people, results were similar to those using simple AP, electro-AP or point
injection in similar cases over the previous few years. In horses, in which TPs can be 7-12 cm
deep, the clinical results were about 10% points below those attained by earlier AP methods
and clinical success took 1-3 sessions more to attain than with earlier AP methods.
(b) Human and canine "disc disease"
Four acute cases of human low lumbar disc disease were treated by LLLT, often with
needles, at TPs plus BL23, GB34 bilateral, plus GV03. The cases were diagnosed clinically
as Grade 1 by a positive "Straight Leg Raising Test" and a history of pain radiating along the
sciatic path. All had excellent results in 3-5 sessions at intervals of 1 week.
Three cases of acute canine thoracolumbar disc disease (diagnosed as Grades 1 to 3 on
clinical examination) were treated by LLLT, often with needles, at TPs plus BL23, GB34
bilateral, plus GV03. All had excellent results in 2-4 sessions at intervals of 5-9 days.
As the diagnosis was made on clinical grounds only (i.e. did not involve myelography or
radiography), some of these cases may have been myofascial paravertebral pain (section (a),
above), rather than "disc disease".
(c) Equine flexor tendon injuries
IR LLLT was used on 10 cases: 4 were acute (recent strain, hot and painful), 2 were acute
local nodules/swellings (caused by suspected brushing) and 4 were chronic (bowed tendon).
LLLT was used 3-6 times in 1-4 weeks (10-20 seconds/point) on about 8 points along each
surface of the tendon (lateral, posterior and medial), concentrating especially on the bowed or
swollen area. LLLT was used also on LI04,11 and Thoresen's Ting points (PC09, LU11,
HT09).
Of the 6 acute cases, two passed veterinary inspection for the Newmarket yearling November
sales and were sold within 5-7 days of presentation for treatment; 1 case became cool after 2
weeks but some tendon thickening was still present. Three cases failed (swelling and heat
persisted). That trainer refused to comply with my advice to rest the horses for the first few
weeks. He changed to another vet, who gave other treatments, which also failed.
All 4 chronic cases improved markedly, with disappearance of the "bow" and lessening of the
mediolateral thickening in 2-4 weeks. These cases were rested for 6 weeks (kept in the box
and given only walking or paddock exercise daily) before gradual resumption of training.

Initially, IR LLLT gave very encouraging results in tendon injury, whereas AP methods used
in previous years gave very poor success in such cases. However, all 4 of the chronic bowed
tendons relapsed or the horses broke down on the opposite leg and were shot or retired and
3/6 of the acute cases failed to become sound.
Today, I would confine my use of LLLT in equine tendon problems mainly to recent
superficial injury, especially that caused by brushing. Before starting to treat the case, I would
extract an undertaking from the trainer that the horse would not be worked for 10 months, or
until I was satisfied that the tendon was well healed.
I would attempt to treat chronic tendonitis only if trainer would undertake not to work the
horse for 10 months.
(d) Equine and human periostitis
During the acute (hot, painful) stage, 8 equine cases of splint, spavin or bucked shins were
treated 2-4 times every 1-2 days by local LLLT (20 seconds on a few positions on and around
the lesion and on AP + Ting points for the area). All cases became painless in 2-9 days.
LLLT was used in 3 chronic but painful human cases (1 shin splint; 2 cases of lateral humeral
epicondylitis, or "tennis elbow"). All became painless in 1-10 days. One patient (a human
with a painful shin-splint) ran in a cross country race 3 days after the first (and only) session.
He ran a good race, finishing in the top third of the field.
(e) Skin lesions
Many types of skin lesions were treated by IR LLLT (without AP needles). In all, about 19
cases were treated, mainly human lesions: (abrasions, knife cuts, minor burns, wounds,
chronic head ulcer; pruritic lesions (chicken-pox), facial herpes, retro- and para-scrotal wet
eczema; interdigital fungal infection (athlete's foot), acne). A few equine lesions were treated
also (granulation wound; cracked heels).
In addition, 2 surgical suture lines were treated: one purulent area following rumen
fistulation in a bullock and one swollen painful incision line following reposition of a
dislocated shoulder and a compound fracture of the clavicle in a man).
Acute cases were treated every day and chronic cases every 3-7 days. LLLT was applied
locally for 30-60 seconds, on and around the lesion. It was applied occasionally to AP points
or Ting points for the region also.
Clinical results in acute cases in humans were dramatic, with relief of pain or pruritus and
marked anti-inflammatory effect within 1-3 days and excellent healing within 7-14 days. In
wet eczema of the retro- and para-scrotal eczema, 1 session of LLLT + application of 5%
copper sulphate solution gave cure in 2 days.
In chronic cases, with granulation and purulent infection, healing was slower but was
markedly enhanced: purulent discharge was gone within days and healing (by second
intention) was complete within 3 weeks. LLLT was excellent in acne (2 cases): the lesions
cleared within 2 weeks (6 sessions).

(f) Miscellaneous human conditions

LLLT only
IR LLLT was used at TPs, local AP points and AP points for the region. Conditions which
were treated included joint sprain (shoulder, wrist, fingers, thumb, knee, ankle), headache,
acute and chronic sinusitis, purulent gingivitis, earache, painful haemorrhoids, minor
abdominal pain, hay-fever, bronchitis and gastroenteritis.
LLLT (1-2 sessions in 1-2 days) gave excellent results in joint sprain.
LLLT (1-5 sessions in 1-10 days) gave excellent results in headache, sinusitis, gingivitis,
earache, haemorrhoids and minor abdominal pain.
Results in hay-fever, bronchitis and gastroenteritis were positive but less satisfactory.
LLLT + AP
A 32-year old woman presented with a history of chronic mid-cycle abdominal and back pain
due to a medically-diagnosed cyst on the left ovary. She had been offered surgery but refused
it. She had been attending another acupuncturist who had given her considerable relief with
AP in 3 previous cycles. Her therapist was on holiday and the pain had recurred. Other
symptoms were abdominal cramps, sensation of bloating, headaches, depression, paraesthesia
of the left leg. She attributed some of the symptoms to hypoglycaemia and food allergy.
Manual AP was applied (10 minutes) to BL23 and SP06 bilaterally. LLLT was applied for 10
seconds each to BL22,23,24,25; SP06; ST25,36; LI04,11 bilaterally and to GV03,04,14;
CV03,06,12 and Earpoints SP, KI, Uterus, Ovary, Internal Secretion. She was told to use
thumbnail pressure on the earpoints and to massage SP06 daily.
Outcome: The woman did not return for session 2. Some months later, she reported that the
effect of session 1 was "miraculous" and that she was well since then. Years later, she reported
that the problem had not recurred.
(g) Haematoma
One case of penile haematoma in a stallion was treated with IR LLLT, applied locally and at
AP points for the penis (GV03; BL30,31,32,33,34; SP06). The results were excellent and the
stallion was back in service within 1 week.
CLINICAL FAILURES
No method is 100% successful in all cases. Failure using LLLT, with or without AP occurred
in some cases, notably idiopathic lameness, cervical vertebral spondylosis and posterior
paresis in old dogs. Other failures were due to misdiagnosis (carpal and sesamoideal chips not
diagnosed in the early stages).
(a) Idiopathic hindquarter lameness in a setter

This show dog was lame at the walk but ran normally. He had been referred, after a
conventional examination, by a colleague. No cause and no TPs were found. LLLT was
applied for 8 seconds to BL11,23,25,28,67; GB30,34,44 (all bilateral) and to GV03. The dog
had 3 sessions in 10 days, with AP needling added at the last session. There was no
improvement.
(b) Human cervical vertebral spondylosis
A middle-aged lady with radiologically confirmed spondylosis requested AP-type therapy for
chronic neck pain which had failed to respond to conventional therapy for more than 1 year.
She had TPs in the supra-scapular, trapezius and cervical muscles. She received 3 sessions of
LLLT on TPs plus neck points (GB20,21,34; SI03; ST38; Hand Point "Neck"), after which
she self-administered transcutaneous electrical nerve stimulation (TENS) for 1 month. There
was an initial improvement, followed by a relapse to her original state. Many months later,
she had a few sessions of neck manipulation (by an osteopath), a course of homeopathy and 7
or 8 sessions of needle AP (from a naturopath) without success. She still wore her cervical
collar. Some years later, this lady attended a different osteopath, claimed great improvement
following spinal manipulation and discarded the collar.
(c) Posterior paresis in old dogs
Two old dogs were presented with chronic paresis of the hind limbs. They had loss of deep
pain sensation on compression of the toes were treated with LLLT plus AP needling, as for
thoracolumbar disc disease. Their condition did not improve and treatment was terminated
after 4-6 sessions.
(d) Carpal swelling in horses
One foal with carpal cold oedema had marked success with 5 sessions in 12 days. LLLT was
applied locally + AP points for carpus + Ting points. The condition recurred (probably due to
trauma) on day 14.
One horse in training developed carpal pain and swelling, with heat in the joint. LLLT (3
sessions over 12 days) gave no success. Carpal chips were removed surgically but the horse
had to be retired from racing.
(e) Septic tendinitis (sesamoideal chips missed)
A horse with a severely infected tendon showed a dramatic reduction in the swelling after a
few sessions of LLLT. The swelling returned later and sesamoideal chips were found on Xray. The horse was shot.
(f) Arthritis of the fingers
Two women were treated for arthritis of the finger joints. One (middle-aged), with joint
enlargement and stiffness (no pain) got LLLT every 1-2 days for about 8 sessions (local
points + AP points LI04,11) There was no improvement. The other woman (elderly) got
LLLT + electro-AP every 5-8 days for 6 sessions at similar points, plus BL11. Joint pain and
stiffness were relieved greatly, but the joints remained enlarged.

DISCUSSION AND CONCLUSIONS

Clinical uses of LLLT: Trelles et al 1987 reviewed the use of local irradiation with cold laser
in therapy. The stimulus was applied mainly to local lesions to elicit the following types of
effect:
biostimulatory (reparative effects in ulcers, granulomas, burns, septic wounds and trauma to
superficial tissues (tendon, bursa, sheath, joint and muscle); it stimulates local cell metabolism
in damaged tissues in vivo and in vitro (mitosis, local DNA and protein synthesis, local
phagocytosis, antibody formation and activity of local tissue enzymes (succinyl- and lactatedehydrogenase, acid phosphatase, non-specific esterase). It enhances scar formation and tissue
regeneration (wounds, ulcers of skin and portio uteri), enhances mitogenic activity (cell
proliferation), enhances osteogenic activity (in bone fractures, arthritis, osteomyelitis),
analgesic, antiexudative, antihaemorrhagic,
antiinflammatory (in herpes lesions, urethritis, haemorrhoids, sinusitis etc),
antineuralgic, antioedematous, antiseptic,
antispasmodic (in muscle injury),
vasodilatory (in local disorders, organic disorders and alopecia areata).
Trelles et al 1987 and Muxeneder 1987 also reviewed the effects of LLLT in vertebral pain,
headaches and local immune responses. The main clinical uses include wound healing, pain
control, soft tissue injury, arthropathy and osteopathy and treatment of existing scars.
(a) Wound healing: Most He-Ne and IR lasers, even those <5 mW/cm sq, are said to be
effective in treating wounds (surgical, accidental or septic) and superficial disorders (cuts,
bruises, granulomas, ulcers, fistulas). Local irradiation stimulates extremely rapid healing,
even of extensive indolent superficial wounds. It is effective and safe. Wound area decreases
after 2 sessions and strength of the peripheral area increases due to growth of collagen tissue.
Scarring is minimal. The effects in wound healing (including wounds refractory to other
treatment) are dramatic (Mester et al 1985; Dyson and Yang 1986; Muxeneder 1987). It
increases peripheral vascularisation and local tissue nutrition; a "halo phenomenon" is evident
around treated wounds after 1-2 sessions (Muxeneder 1987). Speed of granulation, tensile
strength of the scar and speed of resolution are enhanced. Many irradiated septic wounds heal
as if by first intention.
Clean wounds can be irradiated (edges, underneath the flaps, exposed tissue). Septic wounds,
fistulas, ulcers and granulomas should be debrided before irradiation. LLLT is superb in the
management of post-operative wounds.
Apart from the review of Trelles et al (1987), little has been published on LLLT of burns but
it is probable that it would be effective. Sumano & Casaulon (1987) reported dramatic effects
of electro-AP and TENS in treating infected wounds and burns in experimental animals.
b. Pain control: Acute and chronic pain, especially traumatic pain in superficial tissues
(including joints) can be alleviated if the primary sites are irradiated. Results are even better if

the associated superficial TPs and APs are also treated (Airaksinen et al 1988; Pontinen
1987).

c. Soft tissue injury: Pain, swelling and inflammation in superficial muscles, tendons,
ligaments, bursae and sheaths can be alleviated by irradiation of the affected areas, TPs and
associated APs. In a double blind crossover study in humans, IR LLLT (1.5 J/point) caused a
highly significant elevation of pressure thresholds of TPs as compared with placebo LLLT
(Airaksinen et al 1988).
d. Arthropathy and osteopathy: Pain, swelling and inflammation of accessible joints can be
alleviated by mid lasers. Initially, the effect was thought to be anti-inflammatory but recent
work has shown that LLLT enhances the inflammatory response, to reach the proliferative
and healing stage much earlier. It is effective also in pain control and resolution of osteitis and
periostitis in superficial areas (splints, ringbone, curb, sore shins etc). It is preferable to
ultrasound in these conditions, as ultrasound can heat bone.
e. Treatment of existing scars: Old scars (surgical or traumatic) can act as TPs if there are
tender areas, keloid formation and adhesions along the scar. Such scars can be associated with
chronic, refractory functional (reflex) pain, lameness and autonomic effects. LLLT of such
scars, especially if concentrated on the tender and keloid- areas and on those with obvious
adhesions, can produce dramatic clinical improvement in these cases.
Dangers, contraindications and problems of LLLT: Mid lasers (Class 3A, 3B) may damage
the retina and should not be shone directly into the eye. They are used to treat keratitis and
corneal ulcers but should be aimed tangentially at the target for 30 seconds/session. Operators
who use mid lasers every day are advised to wear appropriate goggles. This is especially
important when IR lasers are used, as the beam is invisible.
Over-stimulation does not seem to cause problems but, because of the mitotic effects, it is
wise not to irradiate cancerous tissue. Some authors advise against using laser over acutely
infected closed swellings, as this may spread the local infection.
Faulty lasers may not emit at the stated MOP or may have a too wide divergence (angle of
irradiation). For maximum effect the light beam should be parallel and the light-spot should
be small (concentrated). The glass at the probe-tip should be cleaned regularly, as dirt may
limit MOP. The better IR lasers have an in-built optical sensor to monitor MOP before use.
Some devices, sold as lasers, do not emit laser light. Some "lasers" are based on light emitting
diodes and not on laser diodes. They emit non-parallel light of different wavelengths
simultaneously or by selective control. Sunlight or a cheap flashlight would probably be just
as effective.
Clinical results: From September 1989 and April 1990, my experimental use of IR LLLT
gave very encouraging results in equine, human and canine muscle pain/ lameness; equine
flexor tendon strain; equine and human periostitis; human and canine "disc disease" and
miscellaneous human conditions. In particular it gave dramatic results in skin lesions, wounds
and (minor) burn cases.

Cases which failed to respond to LLLT (and also failed to respond to AP) included human
cervical vertebral spondylosis and idiopathic lameness, posterior paresis in old dogs, carpal
swelling in horses and misdiagnosed cases.
From April 1990 and September 1991, I reduced my use of LLLT in horses. I have reverted
to injection of the AP points as the routine method of treating horses. Most cases respond to
AP point injection in 2-4 sessions, as compared with 2-6 sessions of LLLT.
In spite of initially encouraging results in equine tendon strain, most (70%) of the cases
treated by LLLT relapsed, broke down on the other leg, failed to heal or were shot or retired.
Therefore, unless the trainer undertakes not to work the horse for 10 months, I am reluctant to
use LLLT in equine tendon strain (as distinct from trauma due to brushing or superficial
traumatic swelling).
The present: Now, I use IR LLLT regularly with very good success in human and canine
conditions but I often combine it with standard AP techniques to get a faster and more longlasting response.
LLLT sessions in horses (because of their large size and the number of APs which may need
to be treated) take too much time (20-30 minutes, including examination time), or too many
sessions are needed. In the more common equine muscular problems, AP point injection is
10-20 minutes faster and the clinical results are 10% points better than LLLT. I confine
LLLT use in horses mainly to superficial injuries and periostitis.
There are also reports from veterinary colleagues that low MOP lasers (especially those <10
mW/cm sq) are not as effective as AP (Rogers, Jagger & Janssens 1987). These agree with
my experience that an IR mid-power laser (30 mW/cm sq) was not as effective as AP in
horses.
The future ?: Further work is needed to document the uses and limitations of LLLT, the
effects of power, wavelength, different pulse frequencies, different exposure dosage etc. With
the rapid pace of research in physical therapies, I believe that we will see increased use of
electromagnetic therapy, including LLLT, ultrasound and microwave stimulation in medical
and vet therapy in the next few years.
ACKNOWLEDGEMENT
I thank Normedica, PO Box 392, 8201 Schaffhausen, Switzerland for presenting me with the
laser for experimental purposes.
REFERENCES

Airaksinen,O., Rantanen,P., Kolari,P.J. and Pontinen,P.J. (1988) Effects of IR (904

nm) and He-Ne (632.8 nm) laser irradiation on pressure algometry at TPs. Paper
to Nordic AP Society Annual Congress, Laugarvatn, Iceland, August 26th. Scand. J. of
Acupuncture and Electrotherapy, 3,56-61.
Dyson,M. and Yang,S. (1986) Effect of laser therapy on wound contraction
andcellularity in mice. Lasers in med. science 1/2,125-130.

Kolari,P.J., Hietanen,M., v. Nandelstad,P., Airaksinen,O. and Pontinen,P.J. (1988)

Lasers in physical therapy-measurement of optical output power. Scand. J.
Acupuncture and Electrotherapy.
Mester,E., Mester,A.E. and Mester,A. (1985) The biomedical effect of
laserapplication. Lasers in surgery and medicine 5, 31-39.
Muxeneder,R. (1987). Soft laser in the conservative treatment of chronic skin
lesionsin the horse. Der Prakt. Tierarzt, 68, No. 1, 12-21.
Pontinen,P.J. (1987) Mid-laser and TNS in back pain. Nordic AP Society Annual
Meeting: Seminar on back pain. Oslo, September 26.
Pontinen,P.J. (1995) Low Level Laser Therapy (LLLT) and laser acupuncture: a
manual for physicians, dentists, physiotherapists and veterinary surgeons.
Rogers,P.A.M. (1991) AP for immune-mediated disorders. In: Acupuncture in
Animals (Proceedings 167 of the Postgraduate Committee in Veterinary Science,
University of Sydney), pp 124-142.
Rogers,P.A.M., Janssens,L.A.A. & Jagger,D. (1987) The efficacy of cold laser: A
survey of members of the International Veterinary Acupuncture Society.
Unpublished.
Sumano,H.L., & Casaulon,T. (1987) Evaluation of electro-AP and TENS effects on
wound- and burn- healing. Personal Communication, Veterinary School, Mexico
City.
Trelles,M.A., Mayayo,E., Mester,A. & Rigau,J. (1987) Low power laser-therapy:
Experimental and clinical data with special reference to Spain. Scandinavian
Journal of Acupuncture & Electrotherapy, 2, 80-100.

APPENDIX
(Summarised from Pontinen's 1995 textbook)
OPTIMUM LASER IRRADIATION DOSE
The irradiation dose is the most important parameter for LLLT. It is more important than the
type of laser used (visible v invisible; pulsed v unpulsed). The dose is measured in joules (J)
per treated point (J/point) or per square centimetre (J/cm). Both types of dose calculation
(J/point and J/cm) are needed, as LLLT is sometimes applied to specific points (TPs, AhShi
points, APs, local points etc) and sometimes to larger areas (wounds, ulcers sprained areas
etc).
The following are essential for successful results with LLLT:
1. For optimal biostimulatory effect (to treat wounds, burns, bruises etc), the irradiation dose
has a lower and upper limit, with an optimum in the middle. If the dose is too low, it may
induce no measurable effect. If the dose is too high, it may induce no effect, or may have a
negative effect.
2. The biostimulatory effect is cumulative: repeated doses, at suitable, relatively short
intervals, give an added response. Repeated low doses, at intervals of 1-7 days, induce
stronger effects than the same total dose given in one treatment. The optimal weekly
irradiation dose for HeNe LLLT is about 1 J/cm. With a laser emitting a mean output
power (MOP) of 3 or 60 mW, this would take 333 or 16.5 seconds/cm respectively. The dose
for a GaAs laser on fibroblasts is lower than that for HeNe laser.

3. For optimal effect on the AP points, doses recommended in the former Soviet
literature are about 0.1 J/AP point. With a laser emitting a MOP of 3 or 60 mW, this would
take 33 or 1.65 seconds/AP point respectively.
CALCULATION OF THE IRRADIATION DOSE
One joule (J, unit of energy) is equal to one wattsecond (Ws), i.e. the energy which is
generated when 1 watt (W) of power flows for 1 second (J = Ws).
The irradiation dose is the amount of energy which is conducted into the tissue. It is of great
importance whether this energy has to be conducted through a small point (say 1 mm) or
through areas of several cm2. Therefore, in treating surfaces such as wounds, ulcers etc, it
is better to express the dose as an energy density, i.e. as J/cm.
Because 1 J = 1 Ws, the irradiation dose (D) can be calculated as follows:
P (W) x t (s)
D (J/cm)

-------------

Equation 1,

A (cm)
where

D = Laser dose (J/cm),

P = Laser power conducted to the tissue (W, or MOP mW/1000),
t = time of irradiation (s)
A = Area of treated surface (cm)
This can be transformed to calculate the time needed for treatment:

D (J/cm) x A (cm)
t (s) = -------------------

Equation 2.

P (W)

To calculate the exposure time needed at a target area (A), the MOP of the laser must be
converted to W: for example a laser of MOP 15 mW emits 15/1000 = .015 W. As 1 J = 1 Ws,
1 W = 1 J/s. Therefore, if a laser has e.g. a MOP of 15 mW, it emits laser energy of 0.015 W =
0.015 J/s. In 10 s the emission is 10 x 0.015 = 0.15 J etc.
The following table shows the emission dose/second and /minute respectively from lasers
with MOP in the range 3 to 60 mW and the emission time needed to give a total irradiation
dose of 1 and 2 J respectively.

Mean
output

Emission dose
per second

Emission time needed to

per minute

deliver a target dose of

power

1 J

mW

mJ

mJ

.003

180

.006

10

or

2 J

min-sec

min-sec

.18

5-34

11-08

360

.36

2-47

5-34

.008

480

.48

2-05

4-19

10

.010

600

.60

1-40

3-20

12

12

.012

720

.72

1-23

2-46

15

15

.015

900

.90

1-07

2-13

20

20

.020

1200

1.20

0-50

1-40

25

25

.025

1500

1.50

0-40

1-20

30

30

.030

1800

1.80

0-33

1-07

40

40

.040

2400

2.40

0-25

0-50

60

60

.060

3600

3.60

0-16.5

0-33

The Table shows that a Class 3B laser, emitting a MOP of 60 mW, can deliver a target dose of
2 J in 33 seconds, whereas a Class A laser, emitting a MOP of 3 mW would need twenty times
longer (11 minutes and 8 seconds) to deliver the same dose (2 J). There is a practical
advantage in using lasers in the upper end of Class 3B. They cut down dramatically on
treatment time/session.
If GaAs lasers are made to work in a single pulsed mode with low frequencies, their MOP is
very low. In order to allow direct comparison of different models of pulsed lasers, their
emitted energy output (J)/pulse (Ep) and the pulse frequency/second (Hz) (F) should be
certified. Typical measured values for energy/pulse range from 0.1-5.0 J and typical pulse
frequencies range from 10-10000 Hz.
The MOP of a single pulsed laser depends on its frequency (F) and on the emitted
energy/pulse (Ep) as shown in the following Table.
MOP (in mW) is calculated as (Ep x F / 1000). For example, if a laser pulses at 10000 hz and
emits 5 J/pulse, its MOP is (10000 x 5 / 1000) mW = 50 mW.
Mean output power (MOP) for a single pulsed GaAs laser with different frequencies (F) and
varying pulse energy (Ep).

Pulse Freq.
(F) in Hz

Pulse energy (Ep)

0.1 J

0.3 J

1 J

3 J

5 J

Mean output power (MOP) IN mW

10

0.001

0.003

0.01

0.03

0.05

100

0.01

0.03

0.1

0.3

0.5

1000

0.1

0.3

1.0

3.0

5.0

10000

1.0

3.0

10.0

30.0

50.0

The table shows that a single pulsed laser is unlikely to be effective if the pulse frequency is
less than 1000 Hz. For example, a laser with a pulse energy (Ep) of 1 J and a pulse frequency
of 1 KHz (=1000 Hz) has a MOP of only 0.1 mW. If a (5 x 5) cm2 area needs a laser dose of 1
J/cm, the exposure time (for a 0.1 mW MOP laser) is calculated as follows (as in Equation 2):
Desired dose (D):

1 J/cm

MOP

(P):

0.1 mW = 0.0001 W

Target area

(A):

25 cm

D x A
t = --------, i.e.
P

1 x 25
t =

---------- = 250000 s
0.0001

thus, t = 4167 min = c. 70 hours. This says that a laser with a MOP of 0.1 mW is of no
practical use for LLLT. It also shows that one needs to know the MOP (or the mean pulse
frequency and power/pulse) of the laser and how to calculate roughly the irradiation dose
needed for effective LLLT.
Thousands of LLLT sessions have been given with irradiation doses far below the clinically
effective range, mainly due to ignorance of those critical parameters.
The MOP is not completely dependant on the pulse frequency; both pulse frequency (Hz) and
pulse energy (J/pulse) are important in deciding MOP. These calculations and the previous
Table demonstrate the advantage of high frequency pulse-train modulated, high pulse energy
GaAs lasers over a single pulse laser.
QUESTIONS

Channel codes used in these questions are: LU, LI, ST, SP, HT, SI, BL, KI, PC, TH, GB,
LV, CV, GV.
1. One of the following statements is not correct. Indicate the incorrect statement:
(a) Low level laser therapy (LLLT) has analgesic, vasodilatory and anti-inflammatory
properties.
(b) An infra-red laser, emitting at a wavelength of 904 nM, would be classed as an infra-red
laser.
(c) LLLT greatly enhances the healing of wounds and burns.
(d) LLLT gives adverse effects in periostitis.
(e) LLLT is very effective in treating superficial Trigger Points (TPs)
2. One of the following statements is not correct. Indicate the incorrect statement:
(a) LLLT gave excellent long term results in severe equine tendon strain
(b) LLLT reduced joint pain in humans but did not significantly reduce arthritic swelling of
human finger joints.
(c) When combined with a knowledge of the acupuncture (AP) system, LLLT was value in
the treatment of myofascial syndromes in dogs and humans.
(d) LLLT was about 10% less successful than AP in treating equine myofascial problems.
(e) LLLT gave poor results in serious spinal pathology
3. One of the following statements is not correct. Indicate the incorrect statement:
(a) The history, theoretical uses and physics of laser are discussed in detail in Pontinen's
textbook (1995).
(b) LLLT is gaining acceptance in conventional veterinary practice as a therapy for tissue
trauma, wounds, granuloma, myositis, tendinitis etc.
(c) Cold (soft) lasers are available as robust, portable instruments, operated by batteries or by
mains electricity.
(d) Russian and German workers have used LLLT at the human AP points for many years.
(e) LLLT is clinically far superior to needles in veterinary acupuncture (AP)
4. One of the following statements is not correct. Indicate the incorrect statement:

(a) Though laser light is emitted in a continuous wave (cw) beam, it can be interrupted
(modulated) at variable frequencies and intervals by mechanical or electronic means.
Interruption of the light beam at fixed intervals is called pulsing.
(b) Lasers with MOP = 50 mW need 5 times less irradiation time/session that those with MOP
= 5 mW
(c) Pulsed lasers, especially those interrupted 2000-10000 times/second (Hz), penetrate deeper
in tissue than unpulsed lasers.
(d) In LLLT, total treatment time/session depends on mean output power (MOP) and the
depth of the point.
(e) Superficial points need less irradiation time than deeper points.
5. In relation to advantages of LLLT over needling or point injection in AP or TP
therapy, one of the following statements is not correct. Indicate the incorrect statement:
(a) LLLT is aseptic, non-invasive, painless and, if used properly, has no reported side-effects.
(b) LLLT is ideal for use on painful (AhShi) points or in nervous or difficult animals.
Children and cats tolerate LLLT very well.
(c) LLLT may be used safely on dangerous points in large animals (such as points below the
carpus and tarsus of cattle and horses).
(d) LLLT is ideal for treatment of superficial AP points, such as those on the ear.
(e) Paravertebral AP points which give no clinical response to needling frequently respond to
LLLT
6. One of the following statements is not correct. Indicate the incorrect statement:
(a) LLLT is usually given on 2-8 occasions, at intervals of 1-3 days in acute cases.
(b) LLLT is usually given on 2-8 occasions, at intervals of 3-7 days in chronic cases.
(c) At each session, the laser is applied over or around the rim of the lesion and to each of the
APs or TPs selected for the case.
(d) In a busy clinical practice, lasers with MOP = 1-3 mW are preferable to those with MOP =
30-60 mW.
(e) As it can be used for deep massage also, the ideal veterinary laser for LLLT has a strong
metallic probe, with the diode- shield set back about 0.5 cm from the probe-tip.
7. One of the following statements is not correct. Indicate the incorrect statement:
(a) LLLT can be used alone, or in combination with other therapy.

(b) If systemic signs are present, the relevant APs were treated also, for example in a case of
chicken-pox, LLLT was applied to points GV14; LI04,11; ST36 (for their effect on fever and
the immune system), as well as to the pruritic lesions.
(c) LLLT has no clinical value in localised dermatitis or lick-granuloma.
(d) LLLT had marked clinical effect in equine, human and canine muscle pain/lameness,
especially paravertebral pain (cervical, thoracic, lumbar or sacral) and pain of limb muscles
(scapula, arm, forearm, thigh, gluteals, gastrocnemius).
(e) In dogs and people, results of LLLT were similar to those using simple AP, electro-AP or
point injection in similar cases over the previous few years.
8. One of the following statements is not correct. Indicate the incorrect statement:
(a) LLLT in horses, in which TPs can be 7-12 cm deep, took 1-3 sessions more to attain
clinical success than with earlier AP methods.
(b) Human Grade 1 and canine Grades 1-3 "thoracolumbar disc disease" are good indications
for LLLT, possibly combined with AP at TPs plus BL23, GB34 bilateral, plus GV03.
(c) Injury to the equine flexor tendon sheath (but with the tendon intact) is a very poor
indication for LLLT.
(d) When used 3-6 times in 1-4 weeks on about 8 points along each surface of the tendon
(lateral, posterior and medial), concentrating especially on the bowed or swollen area, and on
LI04,11 and Thoresen's Ting points (PC09, LU11, HT09), LLLT often reduced the bow in
chronic bowed tendons within 2-4 weeks.
(e) Superficial swellings on flexor tendons, treated by LLLT, can regress sufficiently to pass a
standard veterinary inspection within 2 weeks
9. One of the following statements is not correct. Indicate the incorrect statement:
(a) In the acute (hot, painful) stage of equine and human periostitis (splint, spavin, bucked
shins etc), LLLT (locally and on the Ting Points) every 1-2 days took more than 14 days to
resolve the pain.
(b) LLLT is very useful in human shin splint and epicondylitis
(c) LLLT was useful in abrasions, cuts, burns, wounds, pruritic lesions (chicken-pox), facial
herpes, retro- and para-scrotal wet eczema
(d) LLLT was useful in resolving postsurgical suture-line infection
(e) Clinical results in acute cases in humans were dramatic, with relief of pain or pruritus and
marked anti-inflammatory effect within 1-3 days and excellent healing within 7-14 days. In
chronic cases, healing was slower but was markedly enhanced.

10. Trelles et al 1987 reviewed the use of LLLT. The stimulus was applied mainly to local
lesions. One of the following statements is not correct. Indicate the incorrect statement:
(a) LLLT had biostimulatory effects (reparative effects in ulcers, granulomas, burns, septic
wounds and trauma to superficial tissues (tendon, bursa, sheath, joint and muscle)
(b) LLLT had no analgesic, antiexudative or anti-haemorrhagic effect
(c) LLLT stimulated local cell metabolism in damaged tissues in vivo and in vitro (mitosis,
local DNA and protein synthesis, local phagocytosis, antibody formation and activity of local
tissue enzymes (succinyl- and lactate- dehydrogenase, acid phosphatase, non-specific
esterase).
(d) LLLT enhanced scar formation and tissue regeneration (wounds, ulcers of skin and portio
uteri), enhanced mitogenic activity (cell proliferation), enhanced osteogenic activity (in bone
fractures, arthritis, osteomyelitis),
(e) LLLT had anti-inflammatory effect (in herpes lesions, urethritis, haemorrhoids, sinusitis
etc); it had anti-neuralgic, anti-oedematous, antiseptic, anti-spasmodic (in muscle injury) and
vasodilatory effect (in local disorders, organic disorders and alopecia areata).

1=d 2 = a 3 = e 4 = b 5 = e 6 = d 7 = c 8 = c 9 = a 10 = b

ADVANCES AND INSTRUMENTATION IN DIAGNOSIS AND

TREATMENT OF TRIGGER POINTS IN HUMAN MYOFASCIAL
PAIN: VETERINARY IMPLICATIONS
ABSTRACT
Normal muscle is not painful on palpation and contains no Trigger Points (TPs). The role of
TPs in maintaining myofascial pain and methods of TP therapy are outlined.
Chronic myofascial pain is most commonly associated with TPs in muscles, especially around
arthritic joints. Long term therapeutic success depends on TP detection and their elimination.
Objective assessment of myofascial pain has medico-legal applications as well as facilitating
an accurate monitor of the result of drug, physical or other therapies. Fischer adapted
analogue force gauges to facilitate objective assessment of the location and degree of
myofascial pain in human patients. The principle is more than 40 years old but has not been
documented properly until recently. Repeatability of readings is excellent.
a. A pressure threshold meter (pressure range 0-11 kg/cm sq) measures pain threshold at the
TPs. Pressure thresholds at TPs are 2-4 kg/cm sq lower than thresholds in healthy muscle.
Threshold pressures can be used to confirm the exact locations of TPs and to quantify their
sensitivity relative to healthy muscle.
b. A pressure tolerance meter (pressure range 0-17 kg/cm sq) measures pain tolerance at
standard sites in muscle and bone. Pressure tolerance over muscle and is used to assess overall
pain tolerance. Fit athletes and patients trained in self-hypnosis or relaxation therapy usually
have higher tolerances than people who are sedentary, unfit or poorly trained in mental
control. A low overall tolerance is a poor prognostic sign and may indicate generalised pain of
psychosomatic origin.
c. A tissue compliance meter (a special force gauge with a sliding plate) measures penetration
depth in tissue at probe pressures of 1, 2, 3, 4 and 5 kg/cm sq. Tissue compliance can be used
to quantify and demonstrate the degree of muscle tension or spasm.
d. A dynamometer (force range 0-27 kg) measures contraction power of the limb muscles.
Muscle dynamometry can be used to assess muscle power to flex, extend, abduct and adduct
limbs and joints.
These concepts do not seem to have been documented in animal patients. They offer a unique
possibility to assess myofascial pain, of great potential importance in the investigation of
equine and canine lameness and poor racing performance. The pressure threshold gauge could
probably be used to measure sensitivity at the diagnostic organ reflex (Shu and Mu) points of
classical acupuncture.
INTRODUCTION
The purpose of this article is threefold:
a. to review briefly the role of Trigger Points (TPs) in myofascial pain;

b. to discuss objective assessment of TP sensitivity in human myofascial pain and

c. to review methods of treating myofascial pain.
These concepts are important for veterinarians, especially those involved in equine or canine
sports medicine.
Pain may be classed as peripheral or central. Peripheral pain may be primary or secondary.
Primary pain may arise in trauma or inflammation of a nerve, muscle, organ, bone, joint,
vertebra etc. Physical lesions may or may not be present. Bones, joints and vertebral discs
may cause pain if they are luxated. Muscle pain may arise due to overstretching.
Secondary pain may be referred from foci of irritation in thoracic/ abdominal organs or other
body parts or may be referred from active Trigger Points (TPs) anywhere in the body. It may
arise also in generalised conditions, such as rheumatoid arthritis, allergy, gout or cancer in
humans or nutritional muscular dystrophy (selenium/vitamin E deficiency) and generalised
myositis (azoturia) of animals.
Trigger points (TPs): TPs are defined as foci of irritation which can initiate and maintain
acute or chronic myofascial or visceral pain in nearby or distant areas. Pressure on the TP or
needling causes great pain locally and radiates/triggers pain to the related body segment
(usually the location of the human patient's subjective pain). TPs, unless acute, are not
spontaneously painful - the patient is usually unaware of their presence until the points are
pressed (Travell and Simons 1984, 1985).
The AhShi point in human acupuncture (AP), is defined as a point, usually in muscle, which
is tender on palpation (Anon 1980). AhShi means Ouch! or Ah Yes! There are two kinds of
AhShi points:
a. those which radiate pain to the problem area (the area in which the patient complains of
pain) and
b. those from which palpation elicits only local tenderness.
Type (a) is the TP of western medicine and is the most important point in AP therapy. The
relevance of TPs as a sign of and a perpetuating cause of equine and canine myofascial pain
will be discussed in section A.
Moss (1972) noted that the locations of TPs in patients with musculoskeletal pain were very
similar to the locations of classic AP points used to treat the affected body areas. Melzack
(1979) reported 71% agreement between TP and AP point locations. Similar correspondence
was confirmed by Pontinen (1982), Chung (1983) and Dung (1987) in humans and by
Janssens (1987) in dogs.
TPs in human muscle have been called reactive points, Tender Points, fibrositic nodules,
AhShi points and rheumatic spots. TPs may be identical to rheumatic spots but are not
the same as local AhShi points (Type B) or tender points in fibromyalgia or fibromyositis,
nor are they the same as zones of referred pain.

A myofascial TP is a hyperirritable locus within a taut band of skeletal muscle. It is located in

the muscular tissue and/or its associated fascia.
Myofascial pain is defined as pain in the myofascial areas of the body. X-ray findings are
usually negative (Brook and Stenn (1983). The pain is associated with local or distant foci of
irritation in muscle, fascia, skin and subcutaneous tissue, viscera, joints and bones. It is a most
common type of pain in man and animals. It may occur in any part of the body, may be acute
or chronic and may appear to be superficial or deep, localised or diffuse.
Myofascial pain may be referred from and to nearby or distant structures. For instance,
cardiac hypoxia may refer pain and establish TPs near thoracic spines T4-T6 (AP points
BL14,15,16). Uterine or ovarian irritation may refer pain and establish TPs in the muscles
between L5-S1 or L2-L3 respectively (AP points BL26 and 23) and in the low abdomen (AP
points CV03, ST30). A TP in the long muscles of the back, just caudal to the scapula, may
refer pain to the buttock area.
Myofascial pain occurs frequently, but not always, in the same dermatome or sclerotome as
the TP but does not include the entire segment. It may refer to other segments also (Janssens
1984; Verhaert 1985).
Assessment of human myofascial pain: Pressure gauges have been used since the 1940's to
assess pain objectively (Steinbrocker (1949), Keele (1954), McCarthy et al (1965), Lansbury
(1966)) but little use has been made of them in human algometry/dolorimetry. Apart from
those methods there was no way available to enable general practitioners to quantify pain
objectively. At present, two basic criteria, both subjective, are used:
a. Questionnaires as to the subjective nature of pain: location (localised, generalised,
superficial, deep, shifting etc); duration (recent, chronic, relapse of old pain); type (dull,
nagging, sharp, fiery etc) and severity (various scales, such as a 0 to 10 visual analogue scale
(VAS)).
b. Observation of posture, movement (flexibility/lameness/stiffness/ guarding), joint
flexion, muscle spasm and autonomic changes (vascular, neurodermatitic).
Dung (1987) described a method of quantifying human pain by the number and sequence of
appearance of tender AP points (TPs), especially between the dorsal spinal processes and in
the paravertebral area (Dung 1986). Patients with >72 pairs of TPs on the body were likely to
have severe, non-specific, poorly responsive pain, with poor prognosis even after AP/TP
therapy. Those with 48-72 pairs (tertiary pain degree) were likely to be difficult cases. Those
with <48 or 24 pairs were likely to have less severe pain (secondary or primary pain degree
respectively) and a much better prognosis. Although it was claimed to be objective, Dung's
localisation of TPs and his quantification of pain depended on the patient's verbal response
to TP palpation. Therefore, it was not objective.
Infrared thermography: Measurement of skin temperature is very useful in the objective
diagnosis and evaluation of myofascial pain (Fischer 1986, 1988). IR thermography can
detect hot (vasodilation, muscle spasm) and cold (vasoconstriction) spots in tissues. Acute
pain-points, as in myositis or an active TP, usually show as areas hotter than nearby areas.
Fibrositic nodules (chronic, fibrosed TPs) and sensory root and nerve dysfunction show as
cold spots. Areas of referred pain may also show up as cold areas.

The method is useful in pinpointing the site of acute vertebral or joint pain (hot areas) but the
instrumentation is very expensive and is unlikely to be found in the family physician's
surgery.
Fischer (1984) proposed an objective, practical and relatively cheap method of quantifying
myofascial pain after the TPs and problem areas are located by careful clinical examination
and palpation. His methods are based on adapted force gauges to quantify pressure pain
thresholds at TPs, pressure tolerance of muscle and bone, tissue compliance measurements
and dynamometry of muscle, especially of limb muscle. Each of these concepts will be
discussed in section B. Advances in treating TPs and myofascial syndromes are discussed
briefly in section C.
A.1. TRIGGER POINTS (TPs) AND MYOFASCIAL SYNDROMES IN HUMANS
Types of TPs: There are different types: active and passive, primary and secondary. All TPs
are associated with dysfunction but only active TPs are associated with pain. Primary and
secondary TPs may be active or passive.
Active TPs are very tender on palpation and associated with existing pain or other
dysfunction. They may vary in irritability (associated with variation in symptoms) from hour
to hour and day to day. The severity and extent of the referred pain depends on the irritability
of the TP, not on its size or the size of the affected muscle. Active TPs can become passive
after alleviation of the precipitating factors, rest or inadequate therapy (Verhaert 1985).
Passive (latent) TPs are less tender on palpation. They may be found in clinically normal
patients and are associated with restricted movement (guarding) and weakness/fatigue of the
affected muscles. (Muscles "learn" to avoid movements which cause pain). Passive TPs can
be activated easily by many factors, especially overstretching/overuse, and can then trigger
clinical pain or dysfunction. The fitter the muscle, the more difficult it is to activate its passive
TPs (Verhaert 1985).
Primary TPs are those which arise as a direct result of physical injury, local irritation in virus
diseases or direct environmental effects on myofascial tissue. Active primary TPs, causing
pain, "guarding" and increased muscle stress elsewhere, may recruit secondary TPs in the
same or other muscles.
Secondary TPs are those which arise due to foci of irritation elsewhere, such as in visceral
disease or as recruits to very active primary TPs elsewhere.

Aetiology of TPs: Normal muscle, connective tissue, skin and fully healed scars are not
painful on palpation and should contain no TPs. When they arise, TPs are usually located in
muscle but foci of irritation in the skin, ligaments, fascia, subcutaneous connective tissue and
periosteum can also act as TPs (Janssens 1984; Verhaert 1985). Scar tissue, especially that
with keloid formation or areas of local tenderness, may also act a TP (Fox 1975; Khoe 1979;
Rogers 1982; Verhaert 1985). Tender scars may arise after surgical incision (especially
transverse), haematoma or tissue bruising, burns, local infection, abscesses, vaccination,
needle-track infection and in infected tooth-sockets.

TPs are usually initiated (or latent ones activated) by acute or chronic overload or direct
injury to the affected muscles (hyper-extension, strain, trauma, a fall, being cast etc). Fatigued
or unfit muscles are very prone to injury and, therefore, TPs can easily arise in them (Cain
and Rogers 1987).
TPs can also arise during periods of rapid growth (growing pains due to slight muscle, joint
and tendon stress/strain) or as a sequel to systemic infection or fever, especially virus
infection (Fox 1975; Janssens 1984).
Irritation of the thoracic or abdominal organs, of vertebral nerve-roots, joints, muscles or
periosteum may refer pain to related skin and muscle and may establish TPs in the same and
nearby spinal segments. Arthritis, subluxation of vertebrae, overriding of vertebral spines or
facet joints, vertebral disc lesions or spinal nerve pressure (entrapment) are often associated
with TPs. Over-exertion of muscle (hyper-contraction, tearing some of the weaker fibres) and
chills/draughts on exposed parts of the body, especially after exercise, or if the part is hot or
sweating can also activate TPs (Moss 1972; TP Therapy Symposium 1981; Janssens 1984;
Verhaert 1985).
Detection/elimination of active TPs are important in the treatment of clinical pain and other
disorders. Regular examination for and elimination of passive TPs (by massage and physical
exercise) can restore full muscular function and can prevent many problems. This is the basis
of Chinese acupressure, Shiatsu (Japanese AP massage) and Tai Chi (Chinese body exercises).

Clinical detection of TPs: TPs are located by careful palpation of the body, searching for
points of exquisite tenderness. As each point is pressed, the human patient is asked: "What do
you feel now ?". Unless the TPs are very active, the patient is unaware of their existence or
location until they are palpated. TPs persist under general anaesthesia and post-mortem
(Schade 1919).
To the palpating hand, TPs feel like nodules surrounded by a taut band of otherwise normal
muscle. Occasionally the affected muscle may be hypertonic or in spasm. If the examiner
pinches an active TP or snaps a finger across it, the patient may give a local or general jerk
(positive "jump sign"). Pressing, pinching or needling the active TP triggers pain to the
problem area (referred pain area, joint, other muscles or viscus) unless the referred area
is in severe pain beforehand. Local TP tenderness can last for hours afterwards (Verhaert
1985). Passive TPs have similar characteristics but are not as painful and do not refer pain
elsewhere to the same degree as active TPs.
The anatomical relationships between TPs and their area of referred pain are quite specific
and a detailed knowledge of these relationships can help to predict the location of TPs in pain
of specific organs or areas (Anon 1980; Travell and Simons 1984, 1985).
Histologically, TPs can show fat dusting. Severe forms may show fibrosis and dystrophic
changes (swollen mitochondria, destruction of myofilaments, ruptured sarcomeres and
collagen accumulation) in replacement connective tissue (Michlke et al 1960, Fassbender
1975).

Chronic myofascial syndromes typically present as an acute episode (active TPs present) but
with a history of recurrent episodes over months or years. This is due to alternation of the TPs
between the active and passive states with rest, time and various therapies which failed to find
or eliminate the TPs (Verhaert 1985). TPs, especially those entrapping spinal nerves, may
induce related sensory disorders (paraesthesia, hyperaesthesia, tinnitus, disturbed vestibular
function (vision, space perception, ataxia)) and autonomic signs (Chung 1983; Travell and
Simons 1984, 1985; Janssens 1984). In the early stages signs include: localised vasodilation
(thermographic hot-spots) with localised muscle spasm, secretion (saliva, sweat, tears etc) and
pilomotor activity. Chronic TPs may show vasoconstriction (thermographic cold-spots),
hyper-irritability of motor neurons (Verhaert 1985). The are often fibrotic and quite difficult to
penetrate with a needle.
Affected muscles have a restricted range of movement and resist passive or active stretching,
as this causes pain. Muscle contraction against a fixed resistance is also painful. They are
easily fatigued and can do less work. Muscle atrophy or neurological deficit is seldom present
unless the TP or local muscle spasm entraps a nerve (Verhaert 1985).
Although TPs may arise in association with spondylosis, arthritis, disc disease in humans and
animals and in canine hip dysplasia, radiography in the more common myofascial disorders is
usually negative. Blood tests for muscle enzymes are usually negative unless there is
extensive muscle damage, as in equine azoturia.
A.2. TRIGGER POINTS (TPs) AND MYOFASCIAL SYNDROMES IN ANIMALS
Veterinary acupuncturists have known for many years of the diagnostic and therapeutic
relationships between functional disorder of internal organs and the presence of tender points
in the paravertebral area (the Shu points, Kothbauer's Pain Points etc).
They also knew that stimulation of tender points (TPs, AhShi points) in muscle or scar tissue
by dry needling, procaine/Impletol (Bayer, Germany) injection, laser or electrical methods etc
could resolve many disorders (see references in Rogers 1974-1988). The classical AP reflex
points (paravertebral Shu and thoracoabdominal Mu points) and some diagnostic points have
been described for cattle (Kothbauer and Meng 1983) and horses (Cain and Rogers 1987).
However, documentation of the precise locations and related symptomatology of animal TPs
is poor in comparison with that of human TPs.
Janssens (1984) was the first to document in detail the presence of muscular TPs as a cause of
chronic pain in animals. Pain had been present in 21 dogs for a mean time of 6 months. TP
therapy (dry needling for 5 minutes/week or injection of the TPs (0.25-2 ml 1.0% xylocaine
or 0.5% procaine via 25-28 gauge needle)) gave 70% success in a mean time of 17 days (2.5
sessions). Relapse occurred in 33% and treatment of relapses gave the same result as initial
treatment.
In a second paper (Janssens 1987), he reported the occurrence of TPs in 47 lame or
claudicating dogs. Clinical signs had been present for a mean time of 6 months. TPs were
found in the following muscles:
triceps (AP point LU 1 in animals) (52%);
adductor and pectineus (AP point LV 9 or 10) (15%);

peroneus longus (AP point GB34) (12%);

gluteus medius (AP point GB29) (10%),
iliocostalis lumborum (AP point BL26) (6%);
quadriceps (4%).
TP therapy gave successful outcome in 60% of cases in a mean time of 19 days. Results with
Triceps TPs were better (79% success). Relapse occurred in 33%, usually with the original
TPs recurring again. Repeat treatment gave similar results to the initial treatment.
As in humans, TPs in animals can be due to trauma, muscle overload and by reflex effects,
associated with foci of irritation in internal organs or other body parts.
Fever or viral infection may initiate TPs: 'Flu is often associated with muscle pain and
tenderness. The sequel to 'flu may be multiple TPs. This may explain why large racing stables
may have many horses with recurrent myofascial pain and poor racing performance. There is
often a history of equine viral epidemics (especially equine 'flu) preceding a period of 1-2
years of poor racing performance.
While TPs in animals have diagnostic and therapeutic implications in all species, they are of
special importance in sports medicine. Animals used for competitive sports (racing, jumping,
polo etc) or for active work (draught animals, hunting dogs etc) need to be at peak physical
fitness. For top performance, they rely heavily on the musculoskeletal system. In particular,
they need full flexion and extension of the paravertebral muscles for maximum stride and
speed and to enable them to gallop around corners. TPs in the paraspinal muscles (neck to
sacrum) are commonly associated with lameness or stiffness in horses and dogs. TPs are also
common in the heavy muscles of the neck, shoulder and thigh. Unless TPs are "released",
muscle power and flexibility is impaired and athletic performance is reduced. TPs are selfsustaining and may remain indefinitely unless detected and eliminated (Verhaert 1985).
TPs can induce abnormal muscular and autonomic nervous function. This may manifest as
acute or chronic pain, spasm, tremor, incoordination, stiffness, muscle weakness (including
buckling of a limb (knee in humans; shoulder, elbow, hip or stifle in horses)), paraesthesia,
numbness and poor circulation. By firing spontaneously into the nervous system, TPs
maintain a state of reflex muscle guarding (spasm), with consequent pain, restriction of
movement and poor blood supply in affected muscles. Atrophy of disuse can arise but is rare
unless nerve entrapment occurs. Weeks to years after the pain stimulus which initiated them,
TPs can remain in an active or passive state. Effective TP therapy can have rapid, dramatic
effects on the wellbeing of the patient. Chronic pain due to unreleased active TPs has lasted
from months to several decades in human patients and TP therapy has eliminated it
immediately or in a matter of days (Travell and Simons; Verhaert 1985).
B.1. DIAGNOSTIC INSTRUMENTS TO ASSESS HUMAN MYOFASCIAL PAIN
The instrumentation consists of four different analogue force spring gauges. Each probe has a
discoid rubber tip 1 cm sq (diameter 1.12 cm ). Gauges 1 and 2 record the pressure (in kg/cm
sq) required to elicit pain threshold and tolerance in the muscle being investigated. Gauge 3
measures depth of penetration of a probe in muscle at precise pressures applied. Gauge 4

measures the force (kg) needed to overcome muscle power. Each instrument has a maximum
"hold clutch" to register the maximum force applied. It is released by pressing a zero button.
These four gauges can document the location and severity of muscle and TP pain and
weakness in humans and the outcome of treatment for medico-legal purposes. Accurate,
objective documentation of TP locations and pain is very relevant to clinical assessment,
diagnosis and prognosis. It also has most important medico-legal implications, especially in
the differentiation of genuine pain patients from malingerers in insurance/compensation
claims.
If pain is bilateral, a nearby normal area can be used as a reference. A decrease of pressure
threshold to 3 kg/cm sq is considered abnormal (Fischer 1988).
1. PRESSURE THRESHOLD MEASUREMENT OF MUSCLE AND TPs: The
instrument (Figure 1) is a spring gauge from 0-11 kg applied force, calibrated in steps of 0.1
kg. It is used to quantify the sensitivity of tender areas, such as sprains, strains, arthritic joints
or TPs located by clinical examination/ palpation and to demonstrate the difference between
thresholds of tender and healthy muscle. It also can demonstrate the disappearance of TP
tenderness as the case is treated successfully. A rubber-protected pressure probe, 1 cm sq is
used to apply vertical pressure to the tender areas. Pressure is increased steadily at 1 kg/sec.
To prevent the probe from slipping, it is steadied by the thumb and index fingers of the left
hand in right-handed operators. The patient is asked to indicate the first appearance of
pain/discomfort to the applied pressure, at which time, the gauge is read and the pressure
recorded in kg/cm sq. The "hold clutch" is released for the next measurement. Readings at
TPs can be compared with those in healthy muscle on the opposite side, which has pressure
thresholds 2-4 kg/cm sq higher than those recorded at TPs.
The gauge can be used to show the immediate improvement which occurs after correct
injection of TP and to prove that the whole TP has been injected. Pressure threshold values
increase typically by c. 4 kg/cm sq immediately after correct TP injection (Fischer 1986).
Clinical improvement in pain is associated with increased pressure threshold values in
patients whose pain is caused by TPs (Fischer 1984, Jimenez 1985).
Pressure algometry is highly reproducible (Merskey et al 1962, 1964). Pressure threshold
values reliably locate TPs and quantify their sensitivity. The repeatability of the
measurements within and between operators was confirmed by Reeves et al (1986) and Tunks
et al (1988). Makela and Pontinen (1988) confirmed the repeatability of pressure threshold
measurements at latent TPs in healthy volunteers and also in pain patients. They confirmed
the value of the method in demonstrating the success of TP therapy by lasers and TENS
methods of point therapy (Airaksinen et al 1988; Pontinen 1987).
2. PRESSURE TOLERANCE OF MUSCLE: The instrument (Figure 2) is a spring gauge
from 0-17 kg applied force, calibrated in steps of 0.2 kg. It is used to quantify the upper level
of sensitivity to pressure pain, i.e. the maximum pressure which can be tolerated when applied
to standard sites (lower medial tibia (shin bone) and medial deltoid muscles), exploring nontender areas and avoiding tender ones. (The deltoids seldom have TPs). A rubber-protected
pressure probe, 1 cm sq is used to apply vertical pressure, increasing steadily at 1 kg/sec to the
selected points. To prevent the probe from slipping, it is steadied by the thumb and index
fingers of the left hand in right-handed operators. The patient is asked to indicate when the

pressure pain becomes intolerable (very painful), at which time, the gauge is read and the
pressure is recorded in kg/cm sq. The "hold clutch" is released for the next reading.
The purpose of pressure tolerance measurement is to quantify pain sensitivity and aid the
diagnosis of abnormal muscle tenderness in relation to bone. In healthy subjects, muscle has
higher pressure tolerance values than shinbone and values are very similar on both sides of the
body. Fit athletes have higher pressure tolerance than unfit subjects. Men have slightly higher
pressure tolerance than women. In patients with high pressure tolerance over muscle and
bone, pressure thresholds at TPs may be higher than is usual.
Functional disorders show lower pressure tolerance values than those in organic disease.
If pressure tolerance of muscle is less than that of shinbone, generalised myopathy (a
common cause of chronic pain and treatable by hormone therapy) is considered. It may
arise in hypo- or hyper- thyroid disorders and in oestrogen deficiency (Fischer 1988).
If pressure tolerance is low at many measurement points over muscle and bone, it indicates
an hyperalgesic syndrome, sometimes with psychiatric implications. The prognosis is poor
and special therapies are needed (Fischer 1984, 1986, 1986, 1987, 1988). If there is a narrow
gap between pressure threshold and pressure tolerance, hysterical personality is likely.

3. TISSUE COMPLIANCE MEASUREMENTS: The tissue compliance meter (Figure 3) is

a spring gauge, force range from 0-5 kg in steps of 0.05 kg, with a special 5 cm diameter
displacement head set flush at right angles to the probe. The rubber-protected pressure probe,
1 cm sq is used to apply vertical pressure. The displacement of the head (in mm) from the
zero position is read off a scale at exactly 1, 2, 3, 4 and 5 kg applied pressure over the muscle
being investigated. The principle is that a probe applied at a given pressure sinks deeper into
healthy muscle than into tense or spastic muscle. When the displacement curves of normal
and tense or spastic muscle are compared, the degree of tension can be demonstrated
objectively. Especially in the range 2-5 kg/cm sq, penetration in tense or spastic muscle is 2-7
mm less than in healthy muscle. The meter can quantify displacement in other types of soft
tissue pathology also: haematoma, oedema, scarring, tumours, inflammation, flaccidity etc
(Fischer 1987). It can also be used to monitor the response to physical and other therapies
(Fischer 1988).
4. DYNAMOMETRY OF JOINTS AND MUSCLE: The instrument (Figure 4) is a spring
gauge from 0-27 kg applied force, calibrated in steps of 0.5 kg. It quantifies the current state
of muscle power or weakness and the speed and extent of recovery of strength in cases treated
successfully. It is used to assess the muscle power (flexion, extension, adduction, abduction)
of individual joints or limbs. A rubber-protected contact plate, 14 cm sq is used to spread the
force applied vertically to the part under investigation.
B.2. DIAGNOSTIC INSTRUMENTS TO ASSESS ANIMAL MYOFASCIAL PAIN
Similar instruments to those described in B.1. (above) could be adapted for

veterinary use, especially to quantify TP tenderness and muscle spasm in dogs and horses.
Adapted gauges would be especially useful in the investigation of lameness or poor racing
performance, where muscle pain (paravertebral, shoulder, thigh etc) is suspected as the cause.
Although pressure meters are being tested by a few veterinarians at present, this area of
research is wide open, as there appears to be nothing published on the topic yet.
C. RECENT ADVANCES IN TP/MYOFASCIAL SYNDROME THERAPY IN
HUMANS AND ANIMALS
Conventional treatment of lameness in athletic animals includes physiotherapy, rest, analgesic
and anti-inflammatory medication, topical application of liniments, poultices, hot- or coldpacks, dressings or support bandages etc. Severe damage to fascia, tendons or muscles may
need surgery. Treatment of equine back-pain may involve change of saddle or rider or the use
of better saddle-pads. In spite of conventional measures, many horses and greyhounds take
weeks or months to regain the potential for full athletic performance.
Direct injury, overstretching and viral diseases are the main cause of TPs. Active TPs can
become passive following a period of rest or conventional treatment. Passive TPs are easy to
reactivate (Verhaert 1985). Therefore, it is advisable to search for TPs in patients recovering
from such incidents, even those patients which appear to be clinically normal. All TPs should
be treated by first-aid or professional methods.
Animal TPs are easy to find by palpation. Finger or probe pressure or electrical stimulation of
TPs is very painful: their palpation usually causes dogs to howl, snap or bite (Janssens 1984,
1987) and cattle or horses to vocalise, buck, kick, cringe, yield or go down or take definite
aversive action (Kothbauer and Meng 1983; Cain and Rogers 1987). All TPs should be
eliminated. Fully healthy tissue contains no TPs.
If multiple TPs are present and if pain is generalised, one must be selective in the choice of
points for treatment. Treatment of many TPs in one session can be very painful. The human
patient may not return for follow-up treatment and the animal patient may be much more
difficult to handle in subsequent sessions. One can manage such cases as follows:
a. Humans with multiple TPs are best treated at special AP points (such as LI 4, LV03, ST36,
PC06, BL23) for 1-3 sessions before TP therapy begins. In many cases, these preliminary
sessions help to localise the clinical pain, making the selection of TPs easier.
b. Animals with multiple TPs: The special AP points ((a), above) are easy to locate and needle
in dogs. However, in horses and cattle, LI 4 and LV 3 are difficult to locate or needle and
ST36, PC06 are difficult to needle. In those species, one can use BaiHui (lumbosacral space),
TH15, BL23 in the preliminary sessions.
With manageable numbers of TPs at presentation (or following preliminary AP sessions),
one may start with the less painful TPs. These tend to be older, less active and associated with
earlier symptoms than those of the current problem. Their palpation may refer little pain.
Their elimination often eliminates the current problem also. If not, the more recent TPs are
treated later on (Verhaert 1985).

Where there are few TPs to be treated, the most important ones to treat are the most painful
ones. These are usually the most recent, are active and, on palpation or needling, refer pain to
the patient's subjective problem area. Elimination of the more recent active TPs may shift the
patient's pain pattern to that of older (less active or, now, passive) TPs. These may be treated
later, if they persist.
Many methods are used to treat TPs. They include "stretch and spray", massage/vibration, TP
injection, dry needling, electro-AP, TENS, laser and other methods.
TP "stretch and spray" technique: This is a method suggested by Travell and Simons. The
muscle(s) containing the TPs are stretched (painful) and sprayed by an aerosol coolant (ethyl
chloride or similar substances). It may be suitable for TPs in limb muscles in humans and
dogs but has little practical application in horses because of the pain involved and the mass
and power of the muscular system in horses.
TP massage/vibration: This is a common form of first-aid and is used 1-2 times/ day in
physiotherapy. It is very useful to prescribe Do It Yourself or First-Aid massage (by a friend,
partner, animal handler etc) daily between TP therapy sessions.
Massage/vibration can be given by hand or by mechanical instruments. Because of the mass
of the equine muscular system, massage is best done by "fisting" the TPs for 4-6 minutes/day.
Massage can be combined with rubs or liniments containing physical stimulants/rubefacients
(such as alcohol, menthol, mustard, turpentine, acetic acid, salicylate) or penetrating agents/
dispersants (DMSO: operator should wear gloves !). Moss recommended massaging in
adrenalin cream in humans.
TP injection is very successful and takes little time. It was the original method used in
German Neural Therapy. Melzack (1977) said that short acting local anaesthetic blocks of
TPs often give prolonged, sometimes permanent, relief of some forms of myofascial or
visceral pain. It is the most suitable method for busy medical and veterinary practitioners, if
the patient can tolerate it. Cain and Rogers (1987) have used TP and AP point injection
successfully in equine patients for many years.
The solution for injection can be saline; Impletol (Bayer, Germany); 0.5-1% procaine or
xylocaine; solutions containing Vit B1, B12, salicylate, DMSO; homoeopathic preparations
etc. Many different types of solution are used, with similar results. Some clinicians feel that
better results are obtained with saline or slightly irritant solutions than with those containing
local anaesthetics. They explain this by longer periods of TP stimulation post- injection.
It is important to "hit" the centre of the TP. Chronic, fibrotic TPs may be difficult to
penetrate. This can be very painful to the patient and (in humans) usually refers pain to the
patient's subjective pain area. Needle sizes vary from 10-40 mm, depending on the depth of
the point. Needles are 21-25 gauge. The volume injected at each TP depends on the tissue to
be injected. In dogs and humans, volumes are 0.25-5 ml; in horses 1-10 ml.
Fischer believes that vigorous needling and injection is necessary to break down the scar
(fibrous) tissue in chronic myofascial TPs. However, this belief is not shared by others. For
instance, Janssens (1984, 1987) treated TPs using 5 minutes simple needle insertion/session
in some dogs and injection in others. He could see no clear difference between the methods.

Pontinen has used TENS, Laser and simple AP successfully to release TPs in humans and
Rogers has used electro AP successfully to release TPs in horses with myofascial pain.
Scars are usually injected with small volumes, 0.1-0.2 ml/point and all tender points along the
scar are injected. A dental syringe and 25 gauge needle are used. Alternatively, the French
Dermojet (high pressure) spray-injector can be used.
TP dry needling: This is the usual method of stimulating AhShi points and AP points. Sterile
28-34 gauge AP needles or fine hypodermic needles are inserted into the centre of the TPs.
They are left in-situ for 5-20 minutes, with or without manipulation (pecking, rotation). It is
suitable for relaxed, placid patients but requires a longer session time than injection. Janssens
(1984, 1987) has reported good results with simple needling in dogs. The method may not be
suitable for very nervous, active or dangerous patients.
TP Electro-AP: This method is similar to dry needling but the needles are stimulated by an
AP electro-stimulator. It has been used successfully by Pontinen in humans and Rogers in
dogs and horses. It requires a longer session time than injection.
TP TENS: Transcutaneous Electrical Nerve Stimulation can be used to treat TPs in humans
(Pontinen 1987). Skin electrodes are lubricated with a saline jelly and are taped over the TPs
and connected to the stimulator. Output frequency is usually set in the range 1-10 Hz. Output
is increased gradually until a strong but comfortable stimulus is attained. The muscles
underneath usually show a visible twitch. Session time is usually 20 minutes. Patients can be
treated at the clinic 1-2 times/week or can be given a personal, portable TENS instrument and
shown which points to stimulate and how to operate the instrument. In that case, TPs are
treated daily for 10-60 minutes. The results are excellent.
TENS in animals poses many problems. Little has been published on the use of TENS on
animal TPs. The hair may need to be clipped and electrodes are more difficult to keep in place
than in humans. A variation of TENS, using AP stimulators connected to gauze bandages
soaked in saline solution and applied to AP points on the limbs or painful joints/bones has
been used successfully by some veterinary acupuncturists. The use of TENS in animals needs
to be supervised at all times.
TP Laser: Laser is an electromagnetic energy in the visible or infrared light range. The beam
but can be interrupted (modulated) at variable frequencies and intervals by mechanical or
electronic means. Mid-power lasers (5-30 mW/cm sq), mainly class 3A and 3B are used.
The most common is the Gallium Arsenide (Ga-As) or diode laser, emitting invisible light
(902 nM) in the infra-red range. The depth of penetration increases with wavelength (Kolari
et al 1988). Thus, cold laser is most effective when the tissues to be treated are superficial and
infrared laser penetrates deeper than HeNe (red) laser.
Laser is usually given 2-8 times, at intervals of 1-3 days. At each session, the laser is applied
for 20-120 seconds to or around the rim of the lesion and to each of the AP points or TPs
selected for the case. Irradiation time depends on output power and depth of point. High
output lasers and superficial points need less irradiation time. Airaksinen et al 1988 and
Pontinen 1987 reported good results in TP therapy in humans.

Although Laser has been used successfully to treat back pain in horses (Martin and Klide
1987) and many veterinary acupuncturists are using lasers, there is little published on the use
of laser on animal TPs. It is possible that lasers for human use may not be powerful enough to
reach deeper TPs in large animals. More powerful veterinary lasers are being tested now.
Laser irradiation of scars, especially if concentrated on tender points, keloids and areas of
marked adhesion, can produce dramatic clinical improvement in these cases.
Other methods have been used to treat TPs. They include heat, cold, faradism, ultrasound
and moxibustion. Ultrasound and faradism are said to give poor results (Melzack et al 1977;
Melzack 1978; Brook and Stenn (1983), Janssens 1984).
CONCLUSIONS
Many syndromes in human and animal patients involve acute or chronic pain, sensory and
autonomic components and may be caused by, or associated with, unreleased TPs, especially
in muscle and scar tissue.
Detection of TPs by clinical palpation is relatively easy. Quantification of TP sensitivity, pain
threshold and tolerance, tissue compliance and limb dynamometry is now possible in humans.
Similar methods may be applicable in animals.
TP therapy is an effective, rapid method of treating these problems. Many methods are
effective but TP injection and infra-red Laser offer the most convenient methods for busy
practitioners and personal TENS instruments offer a useful method of self-treatment for
human patients once the case is diagnosed and the TPs are located. Unsupervised TENS is
unsuitable for veterinary use.
ACKNOWLEDGEMENTS
P.A.M.R. thanks the Nordic Acupuncture Society for funding his trip to their 1988 Annual
Congress at Laugarvatn, Iceland, at which TP therapy, pressure algometry and thermography
were discussed.
This review was prompted by the work of co-authors Fischer and Pontinen and by Janssens'
documentation of TP therapy in dogs. The Thesis by Dr. J. Verhaert (Belgium) was a most
helpful source of concentrated information. It is recommended reading. The paper was given
at the International Veterinary Acupuncture (IVAS) Training Course, Oslo, Norway,
November 1988.
Medical knowledge is often based on animal experimentation before it is applied in human
patients. Now, veterinarians may learn from human experimentation.
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QUESTIONS
1. One of the following statements is not correct. Indicate the incorrect statement:

a. TPs are the same as zones of referred pain

b. TPs are different from local tender points in fibromyositis
c. Pressure on Trigger Points (TPs) is painful locally
d. Pressure on TPs triggers pain to the related body segment
e. Pressure thresholds at muscle TPs are 2-4 kg/cm sq lower than thresholds in healthy
muscle
2. One of the following statements is not correct. Indicate the incorrect statement:
a. A low overall pressure tolerance is a bad prognostic sign
b. A low overall pressure tolerance may indicate generalised psychosomatic pain
c. Tissue compliance measures penetration depth in tissue at probe pressures of 1-5 kg/cm
sq
d. Tissue compliance quantifies the degree of muscle tension or spasm
e. The AhShi point is always a TP
3. One of the following statements is not correct. Indicate the incorrect statement:
a. If an active TP is pinched, the patient may give positive "jump sign"
b. TP locations have predictive value as to where the areas of referred pain are likely to be
c. Tender Shu points are the same as TPs
d. TPs may arise at the Shu point locations
e. TPs feel like nodules surrounded by a taut band of normal muscle
4. One of the following statements is not correct. Indicate the incorrect statement:
a. Normal muscle is not painful on palpation and contains no TPs
b. Myofascial pain associated with TPs in muscles, especially around arthritic joints, is a most
common form of chronic pain
c. TPs maintain myofascial pain for weeks to years
d. Methods of TP therapy include "Stretch and spray", needling, point injection but Laser
therapy of TPs gives poor results
e. Long-term therapeutic success depends on detection and elimination of TPs

5. One of the following statements is not correct. Indicate the incorrect statement:
a. Janssens found that TPs were more than 10 times more common in the triceps than in the
quadriceps muscles of dogs
b. Janssens found that TP therapy gave successful outcome in 60% of cases in a mean time of
19 days
c. Relapse occurred in 33%, usually with the original TPs recurring again
d. Repeat treatment gave similar results to the initial treatment
e. Results with Triceps TPs were worse than with most other TPs

1=a2=e3=c4=d5=b

ACUPUNCTURE ANALGESIA FOR SURGERY IN ANIMALS

SUMMARY
Surgical analgesia can be produced by methods involving peripheral or central stimulation,
such as acupuncture (AP) analgesia (AA). The most common method is Electro-Acupuncture
Analgesia (EAA), using a special electrostimulator attached to needles in AP points.
The major advantages of AA or EAA are its safety in high-risk patients and excellent postoperative pain relief, freedom from complications and enhanced healing which follows
surgery under AA. The major disadvantages are the long induction period (10-40 minutes)
and variable degrees of analgesia, even in skilled hands.
Many combinations of AP points can be used to induce EAA in large and small animals and
there is no agreement on which combination is best for which operation. However, certain
points have marked analgesic effects. They are LI04,11; TH08; PC06; points along the GV
Channel; (BaiHui, WeiGan, TianPing, SanTai; ChihYi points); points between the digits
(BoKoKu, InKoTen in dogs; second interdigital space in rabbits), certain Earpoints; the Root
of the Ear; LU01; BL23,30; ST25,36,44; SP06; GB34; and X 35. Sometimes needles are
inserted parallel to (or at both ends of) the incision, together with some of those points.
The choice of point combinations depends largely on the personal preference and experience
of the operator. However, it is useful to consider the Channels in relation to the operation site
and to choose points from (a) distant points on Channels whose superficial, deep, collateral
or other branches pass through the operation site, plus (b) local points near the operation
site, plus (c) points along nerves supplying the operation site or related to the operation site
by spinal reflexes.
There is no agreement on the choice of stimulation parameters, although work by Toda et al,
Matsumoto and others show that these can be critical. Further research in this area is needed.
The mechanisms of AA involve stimulation of peripheral sensory nerves, spinal cord and
supraspinal areas (thalamus, midbrain and hypothalamus). Release of endorphin and serotonin
activates a descending pain-inhibition mechanism. ACTH release assists healing. Extra-spinal
and autonomic transmission may also be involved in AA mechanisms.
Stimulation-Produced Analgesia (SPA) and Transcutaneous Electro-Stimulation Analgesia
(TESA) are closely allied with EAA and involve endorphin release. Vaginal Stimulation
Analgesia (VSA) appears to use different mechanisms. Electro-restraint ("Stockstill") appears
to be quite a different phenomenon and may have little analgesic effect.
Electro-Narcosis, Electro-Anaesthesia and Electro-Sleep (Cerebral Electro- Therapy) differ
from the other techniques, as they cause unconsciousness during Electro-Stimulation (ES).
Combining AP and western concepts, as in combination anaesthesia, will lead to development
of safer and more reliable methods of surgical anaesthesia.
INTRODUCTION

Acupuncture (AP) can be used to obtain pain relief in clinical disorders or as an alternative or
complementary method of inducing pain control during surgical procedures.
AP analgesia (AA) is a misnomer. It should really be called AP hypoalgesia. It is a pain
inhibition phenomenon caused by stimulation of peripheral nerves via certain AP points. The
degree of pain inhibition may be complete or partial.
In vet surgery, the AA technique, if applied carefully, often is sufficient to allow surgery
without the use of other anaesthetics. Consciousness is retained throughout the operation but
many animals become slightly drowsy (as if slightly sedated) during and for a short time after
AA stimulation. All other sensations (touch, traction, pressure, tickle etc) and reflexes (to
sight or sound stimuli, fear, traction etc) are intact.
AA can be induced by simple AP (manual twirling of the needles) but it is more common to
use electrical stimulation (ES) via the needles. In this case the technique is called Electro-AP
analgesia (EAA).
In emergencies a slight degree of hypo-algesia can be obtained in humans and animals by
heavy digital pressure over the correct AP/nerve points. This method may have application
in time of war or national disasters, when anaesthetists and anaesthetics may not be available.
AA also can be induced by other stimuli, such as injection or electro-static fields applied to
the points. Since the late 1980s, research on uses of low-power (cold) Laser as an AA
stimulus is ongoing, with some positive results. However, it is too early to attempt to assess
that method.
Stimuli via the AA points are carried in the peripheral sensory nerves to the spinal cord. They
reach the midbrain via the ascending spino-thalamic tracts. In the midbrain the ascending
signals cause release of endorphin, serotonin and other neurotransmitters which activate a
"descending inhibition mechanism" and prevent the "pain signals" from the surgical area from
reaching the cerebral cortex. Thus, AA can be said to "close" various "pain gates" in the
nervous system. These gates are thought to be located in the spinal cord, thalamus and
possibly other areas. The result is that the human (and, presumably, the animal) patient can
feel the knife, the touch and traction etc but does not "feel pain".
Stimulation-Produced-Analgesia (SPA): Since the 1970s, western researchers, working
independently of the Chinese, found that various types of stimuli applied indirectly or directly
to the nervous system can reduce or abolish clinical and operative pain. Transcutaneous
Electro-Stimulation Analgesia (TESA) has been used in childbirth in the human female and
is somewhat comparable to EAA. Dorsal Column Stimulation (DCS) of the spinal cord has
been used in intractable pain in humans. ES via electrodes implanted in specific sites in
human or animal brain can induce a high degree of analgesia, usually involving the entire
body. Direct ES of human thalamic or spinal areas can abolish clinical pain. Vaginal
stimulation (electrical or mechanical) can cause potent whole-body analgesia in rats.
SPA has some similarities to AA. The main difference between these methods is that SPA
tends to cause "whole body" analgesia, whereas the area of analgesia is much more localised
in AA and is related to the site of the AA stimulation.
This paper will discuss the following topics:

1. types of operation successfully done under AA

2. equipment and methods of restraint used
3. techniques in large and small animals
4. advantages and disadvantages of AA in animals
5. mechanisms of AA
6. other methods of SPA (vaginal stimulation analgesia, electro-restraint, electro-narcosis and
electro-sleep)
1. TYPES OF OPERATIONS UNDER AA
Since the mid 1970s, major surgery has been done in animals under AA as the sole analgesic
agent in many countries in the West. These include France, Germany, Austria, Belgium, USA,
Canada and Australia. Workers in Eastern countries such as China, Japan, Taiwan etc have
used the method for many years. The animal species involved include horses, mules, donkeys,
cattle, sheep, goats, pigs, monkeys, dogs, cats, rats, cavies, guinea pigs and mice.
Types of surgery successfully done in animals include: caesarean section, ovariohysterectomy; gastric and intestinal surgery; nephrectomy; removal of mammary and skin
tumours; surgery of the eye, ear, anal and vaginal region, limbs and teats; surgery on the lip,
oesophagus, trachea, frontal sinuses; rumen; navel hernia repair; surgery on the bladder and
urethra; orthopaedic surgery (bones, joints); removal of parotid and submaxillary glands;
castration, orchidopexy, inguinal hernia. The late Dr. Westermayer's method for reposition of
the prolapsed uterus has been mentioned already, as has AP therapy for the relief of dystocia.
(See the paper on AP effects on the body's defence systems. See also the paper on the
integration of AP into routine vet practice).
Experimental surgery under AA includes: pain responses to towel clips, incision, thermal
and electrical stimuli; thoracotomy, laparotomy, limb and skin surgery.
2. EQUIPMENT AND METHODS OF RESTRAINT FOR AA
Equipment: Most AA is done using electrostimulation (ES) through needles in the correct
points (Electro-AP analgesia = EAA). The choice of points will be discussed later. Many
different types of electrostimulator are on the market. Some are made in China, others in
Japan, USA, Canada, Europe and Australia etc.
The equipment should be strong, portable and battery-operated. It should have outputs for at
least 8 electrodes. There is little standardization of equipment. Newer models for human use
would be adequate for EAA in animals. It is safer to use models which deliver a bipolar
waveform, (+) and (-), at each electrode. This prevents the development of serious electrolytic
lesions which could arise if a monopolar waveform was used for long periods, as in prolonged
surgery.
The Model 71-3 General Purpose Electro-AP Apparatus is suitable for AA as well as AP
therapy. I had 8 teeth extracted and 8 teeth filled under EAA with the Model 71-3. I used

mainly ChiaChe (ST06) plus Earlobe "Dental Analgesia Point" on the affected side. Needles
were inserted 12-20 mm in the points. Voltage was increased slowly to maximum tolerance
(anaesthesia mode, dense-disperse waveform). Occasionally adjustable waveform at 5-10 Hz
was used. After 30 minutes of induction, the output was usually at a setting of 4-5 on a 10
point scale. When heavy needle-probing of the gum caused no pain, dentistry could begin.
Dental fillings under EAA were uneventful except in deep root fillings. If "nerve pain" arose,
turning up the voltage usually controlled it. Extraction was painless or caused minimal pain
in 5/8 cases but 3/8 extractions caused moderate to severe pain but were completed without
the use of drug analgesia. An impacted wisdom-tooth required 10 minutes of very strong
rocking to remove it from its socket. There was rather severe pressure-pain with that attempt
but I was able to tolerate it without asking for another anaesthetic. My dentist told me that
most patients could not have had the tooth removed unless they had general anaesthesia.
In human patients, Caesarean section has been done in Japan using electro-static or
electromagnetic fields around the hands and feet. The apparatus used does not appear to have
been tested in Europe or America. Childbirth has been helped in 60-80% of women treated by
transcutaneous ES analgesia (TESA) of the thoraco-lumbo-sacral region. The apparatus used
was the Travisens, available from Dan Sjo Elektronik AB, Box 144-17224, Sundbyberg,
Sweden. TESA does not appear to have been tested in animals.
Restraint for AA in animals: Surgery under AA requires adequate restraint because
consciousness and all sensations and reflexes (except those of pain) are retained.
In large animals, operations under AA may be performed with the animal in the standing
position or in dorsal, lateral or ventral recumbency, depending on the type of operation and
whether or not the animal is quiet. Horses and nervous cattle should be knocked by ropes or a
short-acting knock-down anaesthetic. Nervous animals may be given a tranquilliser i/v.
Recumbent animals should be roped securely and an attendant should ensure that the head is
kept down. A blindfold over the animal's eyes helps to avoid fright by visual stimuli.
Unnecessary noise, movement and fuss should be kept to a minimum.
The standing position may be used for surgery in quiet cattle. An attendant may hold the nose
and the animal should be restrained in a suitable cattle crate, or ropes may be used through
rings in the wall to keep the animal in one position. Kicking may be prevented by the usual
methods as applied in operations under local anaesthesia.
Small animals are normally operated on in lateral, dorsal or ventral recumbency. If a special
operation-harness is not available they are restrained by tying bandages from the hocks and
elbows to suitable anchor-points on the operating table. Dogs are excellent subjects for AA
but it is advisable to tie a tape bandage around the jaws to prevent biting. It helps if the owner
or an attendant talks to the dog and comforts the animal from time to time during surgery.
Cats are difficult animals to handle and some vets who have tried AA in cats have ceased to
use the technique in this species.
3. AA TECHNIQUES IN LARGE AND SMALL ANIMALS
Electro-AP analgesia (EAA) is the most common method used. When the animal is properly
restrained, AP needles are placed to the correct depth in the AA points related to the operation
site. The stimulator is checked to ensure that the power switch is off. The output leads are then
connected to the needles. Do not connect the leads from one output across the thoracic or

posterior cervical region. This is especially advisable if the instrument uses (+) and (-)
electrodes. In this case the correct connection would be as in the diagram on the next page. An
output circuit placed across the thorax may interfere with cardiac function and may, on rare
occasions, cause cardiac arrest.
Tape or suture the needles firmly in position. Otherwise, they are liable to become
dislodged by muscle twitches induced by the stimulation, or by struggling in nervous animals.
When the needles are in position, the output controls are checked to ensure they are set at
zero. Attach the leads and turn on the power switch. Turn up the output controls slowly until
the needles begin to twitch in time with the frequency of the stimulator. Increase the output
voltage from each control to the maximum tolerance of the patient. At that point, the animal
indicates a degree of discomfort or pain (restlessness, defensive reaction, struggling,
vocalisation etc). Reduce the output to a "strong but acceptable level" (that which can be
tolerated without obvious discomfort). Excessive stimulation reduces the EAA effect and to
weak a stimulus may induce little or no analgesia.
Note: A needle can not twitch unless it is embedded in reactive muscle. As long as one of a
pair is twitching, the paired needle is also receiving a similar stimulus. Needles may not
twitch in points such as GV26. If output voltage is too high at such points, the animal will
indicate discomfort. In that case, reduce the output to the tolerance of the patient.
Every 5 minutes or so, after switch-on, the operation site is tested for analgesia using rattooth forceps, towel clip, clamp or pin prick. Initially, full sensitivity to pain is present, as
indicated by local muscle twitch or guarding, vocalisation or defence reactions/struggling.
After 5-10 minutes, the response to pain stimulus decreases. After 20-40 minutes, in
successful cases, the animal makes no response to strong pain stimuli in and around the
operation site. The operation may then commence.
Pain stimuli may exceed the hypoalgesia (thereby inducing pain response by the animal) at
certain stages of the operation, especially during incision and suturing of the skin, serosa
(peritoneum, pleura etc) and incision of periosteum and nerves. During these stages of the
operation the frequency or output voltage should be increased. This is normally sufficient to
counteract the pain. Occasionally (in those animals which respond poorly to AA) it may be
necessary to use small volumes of local anaesthetic injection or spray at these stages.
In the first few minutes after stimulation begins it is usual for the animal to show a mild
stress reaction (dilated pupils, increased blood pressure, faster respiration and heart rate).
These quickly return to normal or near normal levels, and should remain at this level during
the operation. Studies of EEG patterns in animals under AA indicate that brain waves are in
the alpha range (8-13 cycle per second) i.e., similar to those of drowsiness or light sleep.
However, the animals are still conscious and can eat or drink and (in dogs) wag the tail if
petted by someone they know. Because sight and hearing are unaffected (pupil reflex is also
intact), unnecessary noise should be avoided and a blindfold may be desirable. Pupillary
dilation and salivation occurs in some animals. If salivation is excessive or retching/vomiting
occurs, this usually indicates that excessive traction on mesentery/internal organs is the cause.
This may be partly counteracted by increase in frequency or output of the AA stimuli.
The choice of points for AA depends on the species of animal, the operation site and
personal preference/experience. Many different combinations are effective and there is no one

combination which is agreed by all authors. In general, points are chosen according to
Channel theory of human AP.
Classic AP teaches that the Channels have a superficial course (Jing, from the first to the
last point on the Channel), a deep course (going to the organ of the Channel and possibly
linking to other organs and deep regions), a collateral course (Luo, which links up with its
Mate Channel) and other connections linking to every part of the body, interior and exterior.
For instance, the LV Channel (big toe to chest, under the nipple) also sends a branch to the
eye. (Discussion of the deep, collateral and other connections is not included in this seminar.
These concepts are covered in certain classic texts, such as those of Van Nghi and Mann).
Thus in eye operations, a LV point might be included; in tongue operations a HT point
might be included; in ear and bone operations a KI point might be included. In man, AA
sometimes uses Earpoints for the organ or region being incised, i.e. for lung operations,
Earpoint LU; for appendectomy, Earpoint LI, or Appendix etc.
The general rule is to use Local Points (near the operation site). As will be seen from some
point prescriptions below, this rule is not always obeyed. Other workers pay particular
attention to the points or nerves supplying the operation site, or related to it. In human
EAA, same workers add two needles, one on each side of the incision. The diagram shows 2
needles, 25 cm long, buried parallel to the incision:

.........................

needle 1 (25 cm)

_ _ _ _ _ _ _ _ _ _ _ _ _

25 cm incision

needle 2 (25 cm) .........................

Some workers prefer to use AP stimulation at a low frequency and to increase the frequency
gradually during the induction period. For instance, Ishizaki recommended a frequency of 10
Hz, increasing to 30-50 Hz at the start of operation in dogs. Other operators prefer faster or
slower frequencies. For instance, Matsumoto found that frequencies of less than 200 or
greater than 10000 Hz were less satisfactory in rabbits than frequencies within this range.
Points used in AA in animals: Many different workers have used many different
combinations of points in various animal species. Examples of point combinations are given
later. The following table lists the points by authors whose work is discussed later. These
points are similar in position to points of the same name and code in HUMAN AP.
Other points used in AA in animals are:
1. On the GV Channel:

BaiHui: In the dorsal midline of the lumbo-sacral space, depth 3-5 cm in horse/ox, to react
the dura mater. There is no direct equivalent in human AP.
WeiGan: In the dorsal midline between coccygeal vertebrae 2-3. Depth 1-1.5 cm in horse/ox.
There is no direct equivalent in human AP.
TianPing : In the dorsal midline, in the thoraco-lumbar space. Depth 2-4 cm in horse/ox, at
90 degrees to the surface). There is no direct equivalent in human AP.
SanTai: In the dorsal midline, between the spines of thoracic vertebrae 4-5 (some texts say
T5-6). Depth 6-8 cm antero-ventrally in horse/ox. SanTai is equivalent to GV11 (Shen Tao).
2. HuaToChiaChi Points (X 35 in my coding system). These points are located on the
paravertebral line from the first cervical to the last sacral vertebra, between the GV and inner
line of the BL Channel. One pair of points is located beside each vertebra. X 35 points lying
nearest to spinal nerves which supply the operation site may be added as secondary points.
3. ChihYi Points are on the course of the GV Channel but are not classic GV points. They
have been described recently in relation to human AA. The main ones used in vet AA are over
the dorsal spines of vertebrae: Dorsal 3,5,6,11 and Lumbar 1.
4. Para-incisional points are not often used in vet AA, as the needles may impede access to
the site.
5. ChiehKou points. These are also described in recent human texts. They are local points at
each end of the incision.
Points used in AA or EAA: The most commonly used points are
UNDERLINED:

Point

Point name

Point

Point name

Point

Point name

LU01

CHUNGFU

SP03

TaiPai

TH03

ChungChu

LU02

YunMen

SP04

KungSun

TH05

WaiKuan

LU03

TienFu

SP06

SANYINCHIAO

TH08

SANYANGLO

LU05

ChihTse

HT03

ShaoHai

TH13

NaoHui

LU06

KungTsui

HT05

TungLi

TH14

ChienLiao

LU10

YuChi

BL22

SanChiaoShu

TH17

YiFeng

LI04

HOKU

BL23

SHENSHU

TH23

SsuChuKuan

LI10

SanLi

BL40

YiHsi

GB01

TungTzuLiao

LI11

ChuChih

BL49

ChihPien

GB30

HuanTiao

LI14

PiNao

BL54

WeiChung

GB34

YangLingChuan

LI15

ChienYu

BL57

ChengShan

GB36

WaiChiu

LI17

TienTing

BL59

FuYang

GB38

YangFu

LI18

FuTu

BL60

KunLun

GB39

HsuanChung

ST06

ChiaChe

KI03

TaiHsi

GB40

ChiuHsu

ST25

TienShu

PC04

HsiMen

GB43

HsiaHsi

ST36

TSUSANLl

PC04.5

YIEYEN

LV14

ChiMen

ST40

FengLung

PC05

ChienShih

GV03a

BAIHUI

ST44

NeiTing

PC06

NEIKUAN

GV26

JenChung

6. Points described by Japanese workers also include: InKoTen (between metacarpal bones 3
and 4 in small animals); BoKoKu (between metatarsal bones 3 and 4 in small animals);
GeiKo (on the lateral margin of the naso-labial fold in mice and rats); unnamed point (in the
second interdigital space in rabbits on the hindlimb (this may correspond with ST44
(NeiTing)). The Japanese points do not appear to have equivalents in Chinese human or vet
texts.
EXAMPLES OF POINT SELECTION IN LARGE ANIMALS: Points used for AA in
horses and cattle.
a. Horse: LU01 (ChungFu) with TH08 (SanYangLo penetrating to YieYen) was one of the
first combinations used in large animals ln China (Niboyet). It was used especially in thoracic
and abdominal surgery. A needle is inserted to a depth of 3-5 cm in LU01 (behind the
shoulder in the second intercostal space). A second needle is inserted at TH08 (about 1
handsbreadth below the elbow, on the lateral side). It is driven medially and downwards
behind the radius/ulna to reach YieYen (PC04.5), just under the skin above the "chestnut".
The needles are inserted on the uppermost limb (horse in lateral recumbency).
b. Horse: In navel hernia operation, Humphries used 4 needles: Set 1: LU01 (positive) with
TH08 penetrating to PC04.5 (negative). Set 2: SP06 (positive) with ST36 (negative). The
frequency was 200 Hz, square wave, altered to spike wave during surgery. This horse was
very ill and was a high anaesthetic risk, yet the operation went perfectly and no signs of pain
were detected at any stage in the operation, which lasted 4 hours.
c. Horse or ox: Sun et al used traditional Chinese vet AP points on hundreds of large animals
(horses and cattle).
Points for abdominal, vaginal and hindlimb operations were : BaiHui (main point) plus
WeiGan (secondary point) plus TianPing (minor point). In chest operations, they used
SanTai. To each of these points they added points on or near the spinal nerves supplying the
operation site + points from the attached charts nearest the incision site.
d. Cattle: Kothbauer did many Caesarian sections in cows using EAA. In his first 2 cases he
used LV14 (8th intercostal space, at a level with the shoulder joint) with BL30, both points on
the left side. EAA was given at 40 Hz, output causing marked muscle twitch. Induction time
was 20 minutes.
e. Ox, pig: In Japan, the Akita Veterinary AP Research Unit tested many point combinations
(including the classic LU01 with TH08 penetrating to PC04.5). They concluded that the best
effective points in cattle and pigs were Tenpei (TianPing) and Hyahai (BaiHui). These points
are located in the midline at the thoraco-lumbar space and the lumbo-sacral space, as in
combinations (c) above. The depth of needle insertion would be similar to that in combination
(c) above (the Chinese combination), i.e. penetrating almost to the dura mater. They used 30
Hz. Voltage (output) was increased if the animals were recumbent.

EXAMPLES OF POINT SELECTION IN SMALL ANIMALS

Dog:
a. Kitazawa (Gifu Veterinary Faculty, Japan) did dozens of operations in which he compared
the efficiency of various point combinations. The best combination for surgery in all areas
was BL23 bilateral. Equally good was SP06 bilateral, but EAA of this point occasionally
caused convulsions.
The next best combination was 8 needles, one in each point on each limb: LI11 plus InKoTen
(Japanese point, between metacarpals 3 and 4) plus ST36 plus BoKoKu (Japanese point,
between metatarsals 3 and 4); 4 points, bilateral = 8 needles.
He also examined other combinations but his preference was for 2 needles in BL23 (left and
right). This point is paravertebral between the transverse processes of lumbar vertebrae 2-3.
b. The late Dr. Ishizaki (Japan) did over 50 major operations in dogs with 95% success.
Unfortunately, he had no simple combination of points, as he chose points according to
Channel Theory and also points near the operation site. However, in general, for operations
on the head, neck, thorax and upper limb he used points PC06 and TH08 bilateral, with the
needles penetrating completely through the limb (in one side, out the other) behind the radius
and ulna. For operations on the abdomen and hindlimbs, he used SP06 (penetrating
completely through the limb) and ST36. For anal surgery he added points lateral to the anus.
c. In a large series of toxic pyometra cases, Arambarri and Cazieux in the Toulouse Vet School
used AA at points SP06; ST36,25; plus para-incisional needles for ovariohysterectomy. Not
one case died and all recovered uneventfully. EAA was given at 2.5 Hz, rising to 3.5-4.5 Hz
during operation. Manual AA was also successful.
d. Ralston reported uneventful removal of bladder calculi and Caesarean section in high-risk
dogs using needles bilaterally in LI04 and ST36 (positive poles) and SP06, LI11 (negative
poles).
e. O'Boyle and Vajda used SP06 and ST36 (bilateral) in 15 dogs. The operations (all of which
were done successfully without other anaesthetics) included Caesarean section, removal of
abscessed mammary tumour, splenectomy, gastric and intestinal surgery and
ovariohysterectomy. They used 125 Hz, square wave, 2 seconds on/2 seconds off.
Monkeys:
Many combinations can be used in monkeys. The ones listed below are only a few of the
combinations listed in texts on human EAA.
Vierck applied an electrical pain stimulus to the gastrocnemius area of monkeys. Bilateral
electrostimulation of ST36 gave marked hypo-algesic effects. He used 200 Hz monophasic
square wave, 0.5 msec. Monkeys respond similarly to man in many aspects of AP. Thus one
should expect the following points to be effective:
Dental surgery: LI04 plus ST06 or Ear Root (Dental) point plus ST06

Oral plus lip surgery: ST44 plus LI04 (Jacobs: 15 minutes at 100 Hz gave excellent results).
Thoracic surgery: TH08 penetrating to PC04.5 +/- PC06 (or) TH05 penetrating to PC06
(or) LI14; TH14 (or) LI04; PC06 (or) LI10; TH17
Abdominal surgery: SP06; ST36 (or) ChihYi points (main point in midline at vertebra T6
plus secondary point at T3. Upper abdominal surgery: add point at T5; lower abdomen: add
point at T11).
Upper limb surgery: Choose points from LI04,11,15,17,18; LU02,5,10; TH03,4,13;
PC04,6; HT03, depending on site of surgery, Channels near the operation site and the nerve
supply.
Lower limb surgery: Choose points from SP03,4,6; GB30,34,36,38,39,40,43;
LV02,03,05,06; KI03; ST36,40,44; BL40,49,54,57,59,60; ChihYi points (main point in
midline over the 6th thoracic vertebra and secondary point over 1st lumbar vertebra; X 35 in
region lumbar 1 to sacrum 2, depending on site of surgery, Channels near site and nerve
supply.
Dorso-lumbar surgery: LI04; TH05 plus ChiehKou (local points at each end of the
incision); ChihYi points.
Cats:
The cat is difficult to work with and resents needles placed in the feet. Lambardt used EAA at
2.5 Hz on 4 cats (3 ovariohysterectomies, 1 Caesarean section). His points were: ST36; BL49;
LU01; TH08 (bilateral). The results were not satisfactory and he noted much struggling.
Three assistants were needed to restrain the animals! He concluded that cats are not the best
subjects for EAA.
Other workers have used cats very successfully in experimental work on EAA (confirmation
that the limbic and cortical potentials elicited by pain stimuli were suppressed by EAA) and
Still (1987) claimed very good surgical analgesia in cats, using EAA at pre- and postauricular points, plus GV06b, BL23,23a,24, lumbo-sacral space (GV03a) and SP06. The
choice of points and frequency of stimulation are important to good success, especially in
cats.
Rabbits:
Matsumoto reported the best analgesia from ES of a single needle placed to a depth of 3 cm in
the second interdigital space. The negative electrode was a needle placed in the thigh muscles
or at the vertex of the head. This technique at 200-10000 Hz sine wave gave powerful
analgesia of ventral aspects of the neck, upper limb, thorax, abdomen and thigh. The
analgesic effect crossed the midline, i.e. a left needle gave left and right analgesia. Chinese
workers have also used AA on Earpoints alone for abdominal surgery in rabbits.
Rats:
Toda et al have done many years of research with EAA in rats to study the mechanisms of
EAA in the treatment of dental pain and as a preparation for dental surgery. They tested

various points and concluded that the most effective points for dental analgesia were LI04
(bilateral) or needle cathode at GeiKo (Japanese points on the lateral margin of the nasolabial fold) and a 3 x 4 cm silver plate anode placed on the centre of the abdomen. The GeiKo
point was stimulated at 45 Hz, 5 msec, until the nose twitched in frequency with the
stimulator. Analgesia occurred on both sides of the mouth from stimulation of GeiKo on one
side but was better on the side opposite to the needle.
In the experiments with LI04, they did extensive trials to examine various frequencies (0.5,
1,10,30,45,100,150,300,500,1000 Hz). They found that some analgesia occurred at all
frequencies from 0.5 to 500 Hz but the best analgesia was given by frequencies between 30
and 150 Hz. 1000 Hz was unsatisfactory. Induction was about 15 minutes. They also tested
stimulation patterns using pulse durations between 0.1-5.0 msec. The pulse duration had little
effect on efficiency of analgesia.
Mice:
EAA at LI04, square wave, 4 Hz, 0.1 msec, for 20 minutes. Output level was adjusted until
muscular contraction occurred and was increased to just below the level which caused the
mice to vocalise (squeak). Under experimental conditions this had analgesic effects on the
nose. The effects were reversed by opiate antagonists (levo-naloxone, naltrexone, cyclazine,
diprenorphine) but not by dextro-naloxone (which has little opiate- antagonist effect) (Cheng
& Pomeranz 1980).
Dogs, cats, monkeys, cavies and rats:
Lynd in the San Antonio Medical School, Texas, experimented with a "standard surgical
incision and suturing" applied to the upper lateral abdomen. A lateral incision through skin
and muscle layers was used in all animals. He used only simple insertion of needles (no ES)
in the following points GB01; TH23; HT05; BL23,22; KI06. All points were needled
bilaterally and the needles were left in position. When the animal lost its reaction to pinprick
etc, the incision was made and was then sutured. He reported excellent analgesia but gave no
statistics.
4. ADVANTAGES AND DISADVANTAGES OF AA
ADVANTAGES OF AA
AA is a simple, cheap and effective preparation for surgery, especially if combined with
tranquilliser or drug anaesthesia. It may be the only method of surgical analgesia which might
be available in wartime, national disasters and other emergency situations.
Combination anaesthesia: In humans, a combination of EAA and tranquilliser or anaesthetic
drugs is used in thoracic or abdominal surgery, especially in allergic or high-risk patients
(circulation, heart, lung, kidney or liver disease). Results were compared with control patients
operated under drug anaesthesia alone. They confirmed that the amounts of narcotic and
barbiturate drugs needed to maintain adequate anaesthesia were reduced. The EAA-drug
group had less deviations from the baseline in heart rate, BP, EEG and body heat loss than the
controls during surgery. Blood levels of ACTH, cortisol and aldosterone during surgery did
not differ between groups. Recovery of consciousness in the EA-drug group was associated
with more alpha- and less beta- activity in the EEG and with less time-space-disorientation on

waking up than in the control group. The AP-drug anaesthesia was associated with minimal
depression of vital functions and maintained good adaptive reactions (Ponomarenko 1987).
EAA combined with diazepam was successful in surgery for fracture of the femoral head in
elderly high-risk patients (Glennie-Smith 1986).
Some vet acupuncturists combine EAA with drug analgesia. The dogs are given a
tranquillizer (i/v) and small doses of general anaesthetic (much smaller than would be
successful without EAA), together with EAA. The results are very good and post-operative
recovery is faster and less troublesome than after surgery under conventional anaesthesia.
a. Per-operative benefits: AA can be used in high-risk patients, who might NOT tolerate
general or local anaesthesia. These cases include shock (post trauma, haemorrhage), severe
debilitation (after chronic disease, malnut-rition or cruelty), toxaemia (renal, hepatic,
pulmonary or cardiac cases, toxic pyometra etc); obstetric surgery (Caesarean section etc). It
can also be used on very young and very old animals, and in operations lasting up to 10 hours.
The effect of AA on the autonomic nervous system prevents shock during the operation so
that deaths during or immediately after operation under AA are extremely rare. Operative
haemorrhage is also decreased.
b. Post-operative benefits: Because consciousness and reflexes (other than pain response)
are retained under EAA, the animal can walk unaided to the recovery area immediately
after surgery. There is no risk of self-injury due to ataxia, struggling or falling, as may occur
under general anaesthesia or spinal block.
Many authors, operating on animals as well as human patients, report far fewer postoperative complications after AA (less ileus, less urine retention, faster return to normal
appetite, less nausea etc). Defecation and urination occur very quickly after EAA and the
animal will eat and drink immediately after operation (if it is hungry or thirsty). It is common
practice to offer cattle some hay or concentrates during operations and many dogs will
placidly accept bits of meat during major surgery.
Post-operative pain and discomfort are almost totally absent. If they occur, AP at the AA
sites or at other points for the pain site can control the pain quickly. It is well known that AA
effects last for up to 20- 60 minutes after stimulation is ended. An extraordinary finding in
monkeys is that peaks of powerful analgesia (interspersed with periods of normal pain
sensitivity) can continue for up to 70 hours afterwards (Vierck). This finding demands
further research.
After AA, surgical incisions heal much faster, with less oedema, less wound infection and
less wound breakdown.
DISADVANTAGES OF AA
a. Analgesia is inadequate in some patients. In animals, expert technique can obtain a
success rate of 90-100% between different operators but the success rate has 3 categories:
Excellent results are defined as no indications of pain at any stage in the operation (struggling
and vocalising because of physical discomfort, restraint, fear etc must be distinguished from
pain reaction). The operation proceeds smoothly at all stages and no other anaesthetic method
is required. Slight muscle tremor or local guarding may occur.

Good is defined as short intervals of restlessness or mild struggling during traction of internal
organs, suturing of sensitive structures etc. Local muscle tremor or guarding is noted at
intervals but the operation can proceed without other anaesthetics.
Fair some pain reactions are noted at intervals during the operation and frequent, intermittent
struggling may arise. Marked local tremor and guarding may arise. The operation can still
proceed. Some of the effects can be relieved by increasing the frequency or voltage or by
relocating the needles.
Failure is defined as pain reactions (fierce struggling, vocalisation, muscle tremor, strong
reaction and impossible to proceed with the operation without some other form of anaesthesia.
Skilled operators may have excellent, good and fair rates of about 78, 19 and 3% respectively,
with failure rates of zero. However, these success rates are seldom obtained by Western
operators in the first year or two of their use of the technique, and many western operators,
despite much experience in general AP therapy have not had such good success with AA.
Failure: Western vets can expect a failure rate of 20-50% in the beginning. This is due mainly
to incorrect choice of points, incorrect location of points, incorrect needle depth, direction,
incorrect or inadequate methods of stimulation, animal factors and surgical technique.
b. Animal factors which may reduce the success rate:
Regional variation in EAA: Certain body regions are more difficult to render insensitive to
pain than other regions. Vets who specialise in limb surgery might not get success rates as
high as those who specialise in intestinal surgery. Success rates for surgery on the frontal
sinus, oesophagus, intestine or bladder may be less than for other body regions. Sex and
breed effects may interfere: female cattle respond slightly better than male cattle and
domestic cattle may respond better than buffaloes. Species differences: among farm animals
cattle and sheep are the best reactors, followed by pigs and horses. Dogs are very good
reactors but cats are difficult subjects to handle and their intolerance of morphine may be
related to their poor response to AA. Temperament differences: nervous, excitable animals
may be good responders to AA but are easily frightened by noise, smell, sight stimuli and
may be hard to restrain, despite good analgesia. Dull, depressed animals may appear to be
easy to handle but their reaction to AA may be sluggish and not of a high degree.
Recumbency: Large animals in the recumbent position need a more expert AA technique
than those which are standing. Voltage should be increased in recumbency. External and
other stimuli: Animals with an elevated pain threshold under AA can still react to disturbance
by environmental stimuli (smell of blood, noise, excitement, fearful sights, proprioceptive
stimuli/physical discomfort, clumsy surgical technique etc). These may lower pain threshold
and reduce the success rate.
c. Muscle relaxation may be inadequate if the EAA technique is not expert. This may cause
ballooning of intestines through abdominal incisions.
d. Induction time (10-40 minutes) may be inconvenient for some surgeons, who may also
complain about "electric wires all over the place".
e. Needle dislodgement: Occasionally one or more needles become dislodged, especially if
they had not been taped or sutured securely in position. Dislodgement may occur (despite

good restraint of the animal) due to strong muscle twitch induced by EAA. If needles fall out,
they must be replaced or the analgesia may be poor or absent. When reconnecting a replaced
needle, the output voltage should be set to zero and then restored gradually after reconnection.
f. Restraint must be good: This usually needs the presence of at least one assistant at all
times after the start of induction. Restraint of small animals, by tying them in dorsal or dorsolateral recumbency, may cause them some discomfort. Struggling against discomfort needs to
be distinguished from possible pain reactions to the surgery. The special EAA harnesses tend
to reduce this problem in small animals.
g. EAA demands skilled surgery. Surgical technique must be deft, light, fast and
unhesitating. Prolonged probing or manipulation of organs and slow uncertain incision reduce
the success rate. Traction on mesentery or ligaments should be kept to a minimum, as should
handling of organs and viscera. Although AA has anti-shock effects, heavy traction during
EAA can cause autonomic (vagal) reflexes (nausea, vomiting, shock, collapse etc). Where
possible, use the hands, rather than surgical retractors, clamps, forceps, probes etc. The hands
usually are more sensitive than instruments and are less likely to cause unnecessary
trauma/stimulation during surgery.
5. MECHANISMS OF AA
EAA is not hypnosis: In humans, hypnosis or self-hypnosis (deep relaxation) can induce
surgical analgesia in sensitive subjects and can be used to treat certain disorders associated
with stress. "Animal hypnosis" (the Still Reaction) is not fully analogous to human hypnosis.
It is a reversible and involuntary "Tonic Immobility" (TI), induced in many species as a
defensive reaction to sudden fright or pain. TI is disrupted easily by noise, movement or
touch. In TI, animals may tolerate mildly painful stimuli (pinprick, sound, electric shock)
without somatic (muscular) reaction. This is due to descending motor inhibition, not sensory
inhibition. They feel the stimulus (as assessed by neuronal discharges in the cerebral cortex)
but do not appear to react. There are marked differences between the physiological effects and
mechanisms of human and animal hypnosis and those of EAA. Appendix 1 compares and
contrasts TI and AA.
Sensory inhibition in EAA: Modern theories attribute the effects of EAA to inhibition of the
ascending (sensory) pain signals at three levels: peripheral, spinal and central. Some recent
research findings which support this theory are as follows:
1. Many of the most active AA points are directly over, or very close to, main nerve trunks
and branches of peripheral nerves.
2. Interruption of the sensory nerve supply proximal to the AA needle site abolishes the EAA
effect. This has been demonstrated in many species (including humans) by local anaesthesia
(procaine infiltration etc) of the AA point, by nerve block above the point and by spinal block
above the entry point of the nerve into the spinal cord. In animals, direct EAA of the isolated
nerve gives the same analgesic effect as EAA of the AP point. If the nerve is transected,
stimulation of the proximal cut end produces AA but stimulation of the distal cut end
produces no effect.
3. In monkeys, cats, rabbits, rats and other laboratory animals, pain stimuli applied at distant
regions (for example, the hind limbs) evoke electrical activity in cortical and thalamic

neurons. This activity can be monitored by electrodes placed directly into specific neuronal
centres of the brain or by surface electrodes at specific regions of the head. EAA at points
which cause analgesia of the pain zone suppress or abolish completely the evoked potentials
in the brain. (There is also experimental evidence that transmission of pain signals is inhibited
by AA at peripheral and spinal levels.
4. Experimental electrolytic lesions placed around the 3rd ventricle (midbrain) or surgical
hypophysectomy completely abolish AA effects. The midbrain and hypothalamic areas are
rich in opiate receptors. (Certain strains of mice, which have no opiate receptors because of a
genetic abnormality can not respond to AA). Levo-naloxone, naltrexone and other opiate
antagonists prevent and abolish much of the analgesic effect of AP in humans and animals.
Thus far, these facts indicate that the signals generated by needling or
ES of the AA points are transmitted via the peripheral sensory nerves to the spinal cord and
that they activate a descending brain-based pain-inhibition mechanism, especially the
midbrain and hypothalamus. There are also "pain inhibition gates" in the spinal cord. Thus,
the "ascending pain signals" are blocked at spinal and midbrain level and fail to reach the
cerebral cortex.
There is very strong evidence that the pain inhibition mechanism involves activation of
opiate and serotonin (5HT) receptors in the brain and, probably, other sites also. This
evidence is strengthened by the following observations:
AA stimulation causes release of endorphins, enkephalins (endogenous morphine compounds)
and ACTH. This has been confirmed by chemical analysis of tissues.
AP stimulation of certain points (especially Earpoint "Lung"; LI04; ST36; GB34 etc) relieves
the symptoms of narcotic and alcohol withdrawal within 10-30 minutes in human addicts and
in laboratory animals addicted experimentally to morphine or heroin. These points have major
AA effects (Patterson).
Stimulation of AA points on one side of the body may have analgesic effects on the opposite
side. In most species of animal, the stronger analgesia is usually on the same side as the
needles. However, Toda et al found a stronger effect on the opposite side when the GeiKo
point was used in rodents.
Although ES of single points such as ST06; LI04; TH08 etc may cause analgesia over a wide
area, there is some specificity between the anatomical location of the point and the area of
analgesia. For instance point PC06 or TH08 will give better analgesia of the arm and thorax
than of the leg, whereas SP06 or ST36 will give better analgesia of the leg and abdomen than
of the arm. Also, needling of "false points" usually fails to produce AA, even though the false
points can be quite near the correct points.
A certain degree of side-to-side and region-to-region specificity exists between the AA
point and "target zone of analgesia". This suggests that the AA signals are going to specific
sites in the brain. It is known already that the brain contains 3-dimensional projection areas
(both sensory and motor) for all body regions. It appears that endorphin release in these
specific areas is the main mechanism of AA.

Many years before the endorphins were discovered, the Chinese had evidence
that a morphine-like analgesic factor was released into the blood and cerebro-spinal fluid
by AA (Niboyet et al). Cross-perfusion studies were conducted in rats, dogs, rabbits and
monkeys in China. AA or EAA was established in experimental animals and cerebro-spinal
fluid, whole blood or serum was perfused directly or indirectly into animals (of the same
species) which had received no AP. Analgesia developed in the recipients but was not as
marked as in the donor animals. An extraordinary finding was that if the donor had a localised
analgesia (specific to one side or one region), the recipient also developed analgesia on the
same side and in the same region as the donor. This suggests that humoral factors are
released by EAA and that they activate specific receptors (now known to be opiate receptors)
in specific regions of the brain and spinal cord of both donor and recipient animal. Many
neurophysiologists find it difficult to accept that such specificity can exist. In the past few
years, Chinese and Western workers have confirmed that release of endorphin is involved in
AA.
As well as releasing endorphins, EAA also releases ACTH, which increases the cortisol levels
in blood. This was proved in horses by Cheng et al (1980). In these experiments, EAA was
given at 4-5 points to above the threshold of muscle twitching; biphasic pulses, 5 Hz, .25
msec duration for 30 minutes. The points were chosen from points effective in treating limb
pain in horses, BL13,65; GB26; PC09; KI01,02. The needles were 10 cm long and were
inserted to a depth of 3-5 cm. Cortisol levels before and after AP were measured. A control
group of horses received "false" AP, by the same method but at non-points 5 cm below
GB30,39; BL13,18,47 and the needles were inserted subcutaneously only (not to the deeper
levels as in the active points). EAA increased cortisol by 40% above pretrial values but "false
EAA" had little effect. (Note: If "false points" above or below the "real points" are used, some
hypoalgesia may occur because the same nerve trunk may be stimulated. If the "false points"
are lateral or medial to the "real points" (i.e. not over the nerve trunk), needling the "false
points" is usually not effective). The difference between real and false EAA was highly
significant. Recent research has also shows that serotonin (5HT) is involved in EAA and that
oral administration of 5HT precursors, such as d-phenyl alanine, greatly enhances AA and can
turn "non-responders" into "responders".
Frost reported 3 cases of human AA following needling of points below a traumatic
transection of the spinal cord in the region cervical vertebrae 1-6. Analgesia occurred
above the transection.
Terral repeated the Chinese cross-perfusion EAA studies in rabbits. He confirmed that EAA
released a humoral analgesic factor in rabbits even when the spinal cord was severed
behind the medulla oblongata.
The mechanisms of AA can be summarised as follows: Signals caused by stimulation of
AA points are carried in the peripheral sensory nerves to the spinal cord. At this level they
may activate local (spinal) pain inhibition gates. Spinal signals are also transmitted to specific
sites in the thalamus, hypothalamus and midbrain, via the ascending tracts (spino-thalamic
tracts, ventro-lateral funiculi). These signals stimulate the local (and systemic) release of
endorphin, serotonin (5HT) and other neurotransmitters not discussed in this paper. The
endorphin activates the opiate receptors, which "switch on" the pain inhibition mechanism
specific for those areas related to the needle site and its projections at brain level.
Simultaneous ACTH release from hypothalamic areas induces cortisol secretion by the

adrenal, thus preparing the animal to withstand the surgical stress and to assist (antiinflammatory effect) in wound healing.
Release of ACTH by EAA could be important in treating allergies, arthritis, inflammation and
shock. Some AA signals can reach the pain inhibition centres by routes outside of the spinal
cord, possibly by (a) cell-to-cell transmission through the skin and soft tissues (as in a beecolony); (b) by the autonomic nervous system and (c) by release of some (yet unknown)
substances from the needle-site into the bloodstream.
6. OTHER METHODS OF STIMULATION-PRODUCED ANALGESIA (SPA)
SPA originally referred to analgesia produced by direct stimulation of specific brain sites,
especially the area around the 3rd ventricle, the periaquaductal grey matter (PAG). In
humans and animals, this produces powerful analgesia over the whole body. It has many
parallels with EAA. SPA is abolished by opiate antagonists (naloxone etc). It involves
endorphin release but over a wider area of the brain than EAA. This probably explains the
more localised analgesia of EAA. Direct stimulation of the thalamus or dorsal spinal cord
roots also produces potent analgesia and ES of permanently implanted electrodes in these
sites has been used in treating severe intractable pain in humans.
Long-term direct stimulation of brain or cord sites involves some risks (possible electrolytic
lesions in brain/nerve tissue, risk of infection etc). Because direct methods were effective but
risky, researchers began to examine the possibility of indirect stimulation of the nervous
tissue, via peripheral nerves. This led to the development of various forms of transcutaneous
ES analgesia (TESA), transcutaneous nerve stimulation (TNS), transcutaneous electro-neural
stimulation (TENS) etc. These methods are widely used internationally in physiotherapy and
for personal use by outpatients of pain clinics. Workers familiar with the AP system found
that TESA, TENS etc were more effective if the electrodes were applied to the affected local
areas plus (AP points, Trigger Points, organ reflex points etc). TESA mechanisms are not
fully researched yet but there is strong evidence that they are similar to those of EAA.
Under experimental conditions, surgical intervention has been done in animals under SPA but
the main use of SPA and TESA has been in the control of clinical pain.
Other types of SPA include vaginal stimulation analgesia, electro-restraint electroanaesthesia/electro-narcosis and electro-sleep.
Vaginal Stimulation Analgesia (VSA): Mechanical (glass probe) or electrical stimulation of
the vagina in rats produces a powerful analgesia over the whole body but the mechanism does
not involve the opiate receptors in the brain because opiate antagonists (naloxone etc) do not
interfere with the analgesia. Thus, VSA is mediated by mechanisms different from SPA,
TESA and EAA.
Electro-restraint: Reports from Poland claimed that positive clamp electrodes fastened to the
ear and a negative tongs electrode fastened to the nose gives excellent restraint in cows. Using
this technique in 58 cows, the author (Szczerbac) was able to pare the hooves with no
difficulty and no defence reaction from the cows. The frequency of stimulation was 160-200
Hz and the current was 4-16 mA. Details of induction time are not available in the English
summary of the article but I believe that induction was probably very short. The Ear roots and
the nose (especially GV25 and 26) are used as EAA points in some Chinese prescriptions for

humans and animals. However, I suspect that the Polish instrument is used as a method of
restraint rather than a true analgesia. It is also interesting that stimulation of the nasal area
(the simple tongs or fingers in cattle; the rope "twitch" in horses) and of the ear-root (in both
cattle and horses) has been used internationally for many centuries as a method of restraint in
large animals. Since the Polish report, a similar instrument has been available commercially in
Australia and the USA. Its tradename is STOCKSTILL. It applies a strong electrical stimulus
to the cheek/mouth/nose and the base of the tail or other area, as required, i.e. opposite ends of
the spinal cord. To knock the animal, current is applied to the cheek and lumbar area. The
animal falls to the ground immediately and simple surgery can be done with great ease.
However, the British Veterinary Association has not accepted that this technique is humane
and painless. It seems that this method of electro-restraint has little analgesic power but
rather that it acts by a type of spinal shock which induces spastic paralysis of the motor nerves
from the spinal cord. More research is required on this method but it appears to have little or
no similarity in its effects or mechanisms of action to EAA or SPA.
Electro-narcosis and electro-anaesthesia are terms used for another type of electrically
induced anaesthesia which uses indirect electrical stimulation of the thalamus to produce
unconsciousness and total anaesthesia. The induction period in humans and animals is very
short, usually 1-5 minutes. Unconsciousness and anaesthesia can be maintained for long
periods while stimulation continues. Consciousness returns immediately stimulation ceases. In
early trials, needle electrodes were used in various sites on the head: temples, vertex, occipital
area, mastoid area, forehead etc. Contact electrodes, such as sponges soaked in saline or metal
disc electrodes were used later. Kano et al have done many experiments with the method in
monkeys. They found that needle electrodes could produce third degree burns, stretching
between the electrodes but that contact electrodes did not produce tissue damage. Their
suggestion for best results was to use high frequency current passed between B-C and B1-D,
where electrodes B and B1 are over the greater occipital nerves and C and D are over the
greater auricular nerves.
They proved that the stimuli are transmitted to the brain by these nerves by a local ring-block
around the scalp, using 0.25% lidocaine. The local anaesthetic blocked the phenomenon.
Anaesthesia produced by these techniques is sufficient for major surgery in man and animals.
In her book on AP in the treatment of drug addicts, Margaret Patterson traces the history of
these techniques. Electro-anaesthesia has a long history in western medicine dating back to
1902 (long before the development of EAA, SPA, TESA etc). It was discovered by Francois
Luduc in 1902. The first human operations using the method were in 1972 in the Necker
Hospital, Paris. Since then, more than 400 operations (including arterial grafting, kidney
transplants, urological and intestinal surgery) have been done using that method in the
hospital. Other hospitals in France are also using the method. The electrode placement is: 2
electrodes (anodes) behind the mastoids (one each) and one cathode between the eyebrows;
unidirectional high frequency current (See Patterson for details). Post-operative analgesia is
marked, lasting 6-48 hours, as in EAA. Post-operative infection, abscesses etc are rare (3%)
as compared with operations under general anaesthesia (17% abscesses) in the same hospital.
This also parallels the EAA effect but loss of consciousness during electro-anaesthesia
indicates that the mechanisms differ from those in EAA.
Electro-Sleep or Cerebral Electro-therapy (CET) has some parallels with
electroanaesthesia but it differs in other respects. It is used in therapy of various diseases with
underlying disturbances of cortical regulation of somatic function and in all disorders with

psycho-autonomic manifestations. It was widely used in the old USSR and in Austria but
there is no agreement on the mechanism of the effects or on the stimulation parameters used
to induce electrosleep. One Russian worker (Sergeer - see Patterson for other details) used
rectangular pulse, constant polarity, pulse duration 0.2-0.3 msec, current intensity 15-20 mA,
80-100 Hz, for 30-120 minutes per day. A course of treatment lasted 20-25 sessions.
ACUPUNCTURE ANALGESIA: FURTHER READING
1 Anon (1975) (Academy of Traditional Medicine). Outline of Chinese AP. Foreign
Languages Press, Peking.
1a Anon (1980) Peking, Shanghai, Nanking Colleges of Trad. Chin. Med., with Academy of
Traditional Chinese Medicines. Essentials of Chinese AP. Foreign Languages Press, Peking.
2 Anon (1974) The Principles and practice use of AA. Medicine & Health Publishing Co.,
Hong Kong.
3 Klide,A.M. and Kung,A.H. (1977) Veterinary AP. University of Pennsylvania Press,
Philadelphia.
4 Matsumoto,T. (1973) AP of physicians. Charles C. Thomas, Springfield, Illinois.
5 Niboyet,J.E.H. et al. (1973) L'anaesthesia par l'AP. Maisonneuve.
6 Patterson,M.A. (1975) Addictions can be cured. Lion Publishers, Berkhamsted, U.K. and
personal communication (1975-1980).
7 Glennie-Smith,K. (1986) Stimulation-produced analgesia for major joint surgery in elderly
poor-risk patients: a feasibility study. AJA, 1987, 15, 180, ex paper to the International
Medical Acupuncture Conference, London, May 4-6.
8 Ponomarenko,T.P. (1987) Experience of using electro-AP in combined analgesia. SJA&ET,
2, 42-45.
REFERENCES
1 Anon (1977) Akita AP Research Unit, Cattle Health Centre, 6-8 Nakadori, Akita-Shi,
Akitaken, Japan. Electrostimulation of the thoraco-lumbar and lumbo-sacral space in surgical
analgesia of cattle and pigs. Personal communication.
2 Arambarri,R. et al (1975) EAA in veterinary surgery. Revue Med. Vet. 126, 1231-1236.
3 Cheng,R.S.A. and Pomeranz,B.H. (1980) EAA is mediated by stereospecific opiate
receptors and is reversed by antagonists of type 1 receptors. Life Sciences, 26, 631-638.
4 Cheng,R. et al (1980) EAA elevates blood cortisol levels in naive horses; sham treatment
has no effect. Intern. J. Neuroscience, 10, 95-97.
5 Frost,E.A.M. and Hsu (1975) Neurophysiological pathways in AP. Amer. J. Acup. 3, 331-.

6 Humphries,V.J. (1977) EAA in abdominal surgery in a horse. Case history from

International Veterinary Acupuncture Society (IVAS).
7 Ishizaki,S. et al (1977) EAA in high risk dogs. Jap. J. vet. Anaesth., No.8, 21-28 and World
Acupuncture Congress, Paris, Summer, 1978.
8 Jacobs,S. et al (1973) EAA in the squirrel monkey. Proc. 1st International Symposium on
Pain, Seattle.
9 Kadono,H et al (1977) EEG during EAA in the dog. Jap. J. Vet. Sci., 39, 539-547.
10 Kano,T et al (1976) Electroanaesthesia (EA) studies:EA produced by stimulation of
sensory nerves of the scalp of rhesus monkeys. Anaesthesia and Analgesia, Current
Researches, 55, 536-541.
11 Kitazawa,K. et al (1975) Experimental studies on EAA in the dog. Proc. 20th World Vet.
Congress, Thessaloniki, 1657-1658 and (1975) Studies on EAA in the dog; confirmation of
the effect. Jap. J. vet. Anaesth., No. 6, 7-14.
12 Kothbauer,0. (1973) EAA in teat analgesia in cows. Austrian Med. J., 28, 1037-1039 and
EAA in Caesarean section in cows. Personal Communication (1977) and (1975) Wiener
Tierarztl. Monatsschr., 62, 394-396.
13 Lambardt,A. (1975) AA versuche bei katzen. Der Prakt. Tierarzt, 1/1975, 33-36.
14 Lynd,F.T. (1975) AP analgesia investigations in animals. Internal report, Department of
Laboratory Animal Medicine, Medical School, University of Texas, San Antonio, Texas
78284. 5 pages.
15 Matsumoto,T. et al (1974) AA in animals: selection of optimal electric stimulation.
American Surgeon, October, 558-563.
16 O'Boyle,M.A. and Vajda,G.K. (1975) AA or abdominal surgery. Mod. Vet. Pract., 56,
705-707.
17 Ralston,N.C. and Ralston,B.L. (1978) AA for cystotomy surgery in a dog. Amer. J. Acup.,
6, 75-76.
17a Still,J. (1987) AP for laparotomy in dogs and cats: an experimental study: American J.
Acup., 15, 155-165.
18 Szczerbac,J. (1977) Electric impulses as restraining measures at intervention in cattle. Acta
Agrar et Silvestria (Seris Zootvch), 17, 51.
19 Terral,C. (1975) Douleur et Acupuncture, Doc. Thesis, Med. Fac., Montpellier and
Rabischong et al (1975) Experimental basis for AA. Nouvelle Press Med, 4, 2021.
20 Toda,K. et al (1980) AA suppresses cortical evoked responses in somatosensory I & II
areas after tooth pulp stimulation in the rat. Jap. J. Physiology, 30, 487-490.

21 Sun,Y.C. et al (1980) Veterinary AA (in cattle and horses). 17th Annual International
Stockmen's School, Tucson, Arizona. Agri Services Foundation, 648 West Sierra Avenue,
Clovis, CA 93612, USA.
22 Vierck,C.J. et al (1974) Prolonged hypalgesia following AP in monkeys. Life Sciences, 15,
1277-1289.
23 Yu Chuan & Hwang Yann-Ching (1990) Handbook on Chinese Veterinary AP and
Moxibustion. FAO Regional Office for Asia and the Pacific, Bankok. 193pp.
APPENDIX
ANIMAL HYPNOSIS AND AA EFFECTS
Definition: "Animal hypnosis" is also called the "Still Reaction", "Death Feint", "Tonic
Immobility (TI)" or the "Immobility Reflex". In this discussion it is called TI. It is a specific
tonic immobility, with involuntary but reversible inhibition of spinal reflexes. It involves the
selective loss of placing, righting and supporting reflexes. The animal may be alert or drowsy,
depending on the nature of the induction of TI and the sensory stimulation during the trance.
Induction of TI: Strong emotions, such as intense fear can trigger TI spontaneously. (The
chicken/rabbit "freezes" at the sight of the hawk/weasel). Experimental induction involves
one or more of four main techniques: (a) repetitive stimulation; (b) pressure on parts of the
body; (c) inversion; (d) forcible restraint until struggling ceases. Tactile and proprioceptive
stimuli are the most important inducers but other stimuli, such as visual and auditory inputs,
enhance the effect. Visual stimuli are most important in chickens. Enhancement and duration
of TI in rabbits 2-4 kg weight is most marked if they are restrained for 5 seconds on their
backs in a holder with inside measurements: base 18" X 3.25" X 4.5" high. The effect is
enhanced by inserting a block to press slightly against the head. Using this method, duration
of TI was 15-60+ minutes, as compared with 0.2-8.0 minutes induced by restraint on a table.
TI can be enhanced greatly in duration and depth by low-level ES of certain subcortical brain
sites, or of electrodes placed across the head.
Reversibility: TI is easily disrupted by stimuli and care must be taken to avoid disruption of
the trance by stimuli , such as loud noise, sudden moves or accidental blows to the animal's
legs or body.
Human hypnosis can induce surgical analgesia in some subjects. Animals in TI are less
responsive than when awake to mild stimuli, such as sound, pinprick, electric shock. Arousal
responses are elicited readily and cerebral-evoked potentials to applied pain stimuli are intact,
indicating that sensory information is received. The lack of response to mild stimuli is due to
motor inhibition and not to sensory inhibition (analgesia).
TI mechanisms: TI is associated with sympathetic arousal. Motor centres in the brain are
inhibited but sensory cortical centres are fully active.
Young rats (up to 3 weeks of age) are good subjects but TI is difficult or impossible to induce
in adult rats. Removal of the cerebral cortex in adult rats makes them very susceptible to TI.
The difference in susceptibility between intact and decorticated adult rats suggests that, in

that species, there is a cortical centre which inhibits a hypnogenic centre elsewhere and that
the cortical centre may be underdeveloped in young rats.
Decerebration does not inhibit TI in guinea pigs and rabbits. In TI of rabbits and frogs, the
loci of descending inhibition on spinal motor neurons are located in the medullary reticular
formation (MRF), brainstem and cerebellum.
Opiate antagonists (naloxone etc) do not inhibit the lack of motor response to mild painful
stimuli in TI. In contrast, AA is inhibited by opiate antagonists.
TI and AA activate clearly different responses, use different neurotrans-mission mechanisms,
controlled by different parts of the nervous system.
Similarities between "Animal Hypnosis" (TI) and Acupuncture Analgesia (AA)

premedication, tranquillisers
meperidine

TI

AA

tranqs, atropine

scopolamine,

enhance depth &

enhance AA

duration of TI

mild electrical stimulation

enhances

enhances

motor reaction to mild pain

absent

absent if AA points

applied anywhere on the body

with wide analgesic

effect are used

drowsiness

sometimes

often

noise, sudden movement,

disrupt TI, cause

may disrupt AA, cause

strong pain stimuli

motor response

motor response

autonomic effect

sympathetic

mild sympathetic to
neutral

Differences between "Animal Hypnosis" (TI) and Acupuncture Analgesia (AA)

physiological response

TI

AA

motor inhibition;

sensory inhibition;

no sensory inhibition

no motor

inhibition

analgesia sufficient for

10% of selected cases

80-90% of selected

major surgery

in humans;

cases in humans and

< 20% of selected cases

animals

in animals

generalised response

yes

only if points with

generalised response
used; mainly

local
response

induction time

5-30 seconds

10-40 minutes

duration of effect

usually < 3 minutes;

as long as needed,

up to 60 minutes in

up to 10+ hours

optimal conditions

post-effect analgesia

no

yes

naloxone

no effect

inhibits/abolishes AA

QUESTIONS
1. One of the following statements is not correct. Indicate the incorrect statement:

a Acupuncture analgesia (AA) is a misnomer. It should really be called AP hypoalgesia. AA,

induced by electrical stimulation via AP needles, often is sufficient to allow surgery without
the use of other anaesthetics.
b Consciousness is retained throughout the operation but many animals become slightly
drowsy (as if slightly sedated) during and for a short time after AA stimulation.
c All other sensations (touch, traction, pressure, tickle etc) and reflexes (to sight or sound
stimuli, fear, traction etc) are intact.
d Simple AP (manual twirling of the needles) or acupressure can not induce the AA effect.
e Insufficient research has been done to allow a good assessment of the efficacy of with cold
lasers in inducing AA
2. One of the following statements is not correct. Indicate the incorrect statement:
a Stimuli via the AA points are carried in the peripheral sensory nerves to the spinal cord.
They reach the midbrain via the ascending spino-thalamic tracts.
b In the midbrain the ascending signals cause release of endorphin, serotonin and other
neurotransmitters which activate a "descending inhibition mechanism" and prevent the "pain
signals" from the surgical area from reaching the cerebral cortex.
c AA can be said to "close" various "pain gates" in the nervous system. These gates are
thought to be located in the spinal cord, thalamus and possibly other areas. The result is that
the human (and, presumably, the animal) patient can feel the knife, the touch and traction etc
but does not "feel pain".
d Vaginal stimulation (electrical or mechanical) can cause potent whole-body analgesia in
rats. Naloxone abolishes the effect, indicating that vaginal stimulation analgesia has similar
mechanisms to AA.
e Electro-Narcosis, Electro-Anaesthesia and Electro-Sleep (Cerebral Electro-Therapy) differ
from the other techniques, as they cause unconsciousness during Electro-Stimulation (ES)
3. One of the following statements is not correct. Indicate the incorrect statement:
a It is safer to use bipolar electrostimulators than models which give a (+) charge at one
electrode and a (-) charge at the other
b In analgesia for childbirth, <40% of women were helped by transcutaneous electrostimulation (Travisens equipment) analgesia of the thoraco-lumbo- sacral region
c In large animals, operations may be performed under AA with the animal in the standing
position or in dorsal, lateral or ventral recumbency, depending on the type of operation and
whether or not the animal is quiet

d Small animals are normally operated on in lateral, dorsal or ventral recumbency. If a special
operation-harness is not available they are restrained by tying bandages from the hocks and
elbows to suitable anchor-points on the operating table.
e A blindfold over the animal's eyes helps to avoid fright by visual stimuli
4. One of the following statements is not correct. Indicate the incorrect statement:
a Before operation under AA, the operation site is tested for analgesia using a clamp- or pin
prick-test every 5 minutes or so after the electrical stimulator is switched on. The operation
may commence when the animal gives no reaction to the pain test.
b In the first few minutes after AA stimulation begins it is usual for the animal to show a mild
stress reaction (dilated pupils, increased blood pressure, faster respiration and heart rate).
These quickly return to normal or near normal levels, and should remain at that level during
the operation.
c It usually takes less than 10 minutes of electrostimulation to induce the degree of AA
sufficient for surgery
d At certain stages of the operation, especially during incision and suturing of the skin, serosa
(peritoneum, pleura etc) and incision of periosteum and nerves, pain stimuli may induce a
pain response. During these stages, the frequency or output voltage should be increased.
e Occasionally it may be necessary to use small volumes of local anaesthetic injection or
spray at these stages.
5. One of the following statements is not correct. Indicate the incorrect statement:
a EEG patterns in animals under AA indicate that brain waves are in the high beta range (1828 cycles per second) i.e., similar to those of marked mental arousal
b Pupillary dilation and salivation occurs during AA in some animals. If salivation is
excessive or retching/vomiting occurs, this usually indicates that excessive traction on
mesentery/internal organs is the cause. This may be partly counteracted by increase in
frequency or output of the AA stimuli.
c The choice of points for AA depends on the species of animal, the operation site and
personal preference/experience. Many different combinations are effective.
d The general rule is to use local points (near the operation site). This rule is not always
obeyed. Other workers pay particular attention to the points or nerves supplying or related to
the operation site. In human EAA, same workers add two needles, one on each side of the
incision.
e AP points used in large-animal AA include: BaiHui, WeiGan, TianPing, SanTai. All of
these are on the GV Channel
6. One of the following statements is not correct. Indicate the incorrect statement:

a The most commonly used AA points include: LU01; TH08 to PC04.5; PC06; LI04; BL23;
GB34; ST36; SP06; TH17
b HuaToChiaChi points are on the paravertebral line, lateral to the outer line of the BL
Channel, from vertebra cervical 1 to sacral 4
c ChihYi points are on the human GV Channel (over vertebral spines T 3,5,6,11 and L 1) but
are not classic GV points
d Para-incisional points are not often used in vet AA, as the needles may impede access to the
site
e ChiehKou points are local points at each end of the incision
f InKoTen and BoKoKu (are between the 3rd and 4th metacarpal or metatarsal bones
respectively; GeiKo is on the lateral margin of the naso-labial fold in mice and rats
7. One of the following statements is not correct. Indicate the incorrect statement:
a BaiHui is in the lumbo-sacral space in animals
b WeiGan is the dorsal midline between coccygeal vertebrae 2-3
c TianPing is in the dorsal midline, in the thoraco-lumbar space
d SanTai is in the dorsal midline, between the spines of thoracic vertebrae 4-5 (some texts say
T5-6)
e The LU01 + TH08 (ChungFu + SanYangLo) combination is useful in small animals but
not in large animals
8. One of the following statements is not correct. Indicate the incorrect statement:
a Clinical assessment of AA can be divided into 3 main categories: excellent, good, fair/poor.
Only the excellent category is acceptable in modern western veterinary practice. This means
that AA alone is inadequate in many cases
b Cats resent needles placed in the feet. Lambardt got poor results with AA in cats but Still
(1987) claimed very good results using pre- and post-auricular points, plus GV06b,
BL23,23a,24, lumbo-sacral space (GV03a and SP06)
c Combination anaesthesia (AA plus tranquilliser or anaesthetic drugs) is safe and effective,
especially in allergic or high-risk patients. The amounts of narcotic/barbiturate drugs needed
to maintain adequate anaesthesia is reduced. There is less deviation from the baseline in heart
rate, blood pressure, EEG and body heat loss than in subjects under drug anaesthesia alone
d Recovery of consciousness after combination anaesthesia is more rapid and post-operative
complications are less than in subjects under drug anaesthesia alone

e EAA combined with diazepam gave very poor analgesia in surgery for fracture of the
femoral head in elderly high-risk patients (Glennie-Smith 1986)

1=d2=d3=b4=c5=a6=b7=e8=e

CLINICAL EXPERIENCES WITH ACUPUNCTURE: FAILURES AND

SUCCESSES
SUMMARY
1. Winter follows spring. All creatures die. In life, many suffer dis-ease through
failure/inability to adapt to external or internal challenges or stressors.
2. Accurate diagnosis is needed for optimum results to any form of therapy. The cause,
nature, location and extent/severity of the dis-ease/lesion/disorder should be known. Firstdegree therapy aims to remove/alleviate the cause, to enhance the adaptive response and to
provide supportive/symptomatic relief during recovery.
3. The adaptive response is the key to all healing. Acupuncture (AP) activates the adaptive
responses, which depend mainly on functional neuro-endocrine transmission. Physical or
chemical interruption of transmission or functional inability of the target-organs to respond
abolish or reduce the AP effect.
4. Clinical failures may be due to professional error (faulty diagnosis, incorrect choice of
points, inadequate stimulation, failure to use other supportive therapies, premature withdrawal
of therapy); patient/owner error (non-compliance with advice given); coincidental
disorders and inability of target organs to respond. Some patients may be "nonresponders".
5. Clinical success may be due to spontaneous remission or to activation of adaptive
responses (even in cases wrongly diagnosed, or in cases assessed initially as "difficult" or
"unlikely to respond"). Some patients may be powerful "responders".
6. Examples of the author's failures and successes in cases of muscular lameness or paresis,
cervical ataxia, chronic pain, are given. Some failures and successes are difficult to explain.
INTRODUCTION
Definition of therapeutic success: This is complex, as illustrated by the old joke: ... the
operation was successful but the patient died...
Many definitions are possible. Three are given here, the one chosen for discussion in this
paper being definition (c):
Definition (a), in humans, is the complete and permanent elimination of all present and past
symptoms and signs, with full return of integrated functions of the spirit/mind/body.
By definition (a), most attempts at therapy must be classed as partial or complete failures
(non-attainment of success). Permanent restoration of health is not possible: at best, death
knocks and enters uninvited at some future time.
Definition (b) substitutes "medium-term" (months or years) for "permanent" in definition
(a).

Acupuncture (AP), electro-AP (EA) or transcutaneous electrostimulation (TES), at points

such as Earpoint Lung or the mastoid process, can give complete and dramatic success within
10 days in the elimination of withdrawal signs and symptoms in the detoxification of
alcohol- or heroin- dependent patients. If combined with naloxone therapy, EA can induce
symptom-free detoxification within 4-6 days.
However, by definition (b), that detoxification success would be classed as ultimate failure in
most cases if therapy did not include adequate rehabil-itation. This entails rebuilding the selfrespect of the patient and providing the possibility of change of internal and external
environment to allow his/her growth as a full human being. Without rehabilitation, most
detoxified patients who are returned to the environment which spawned the dependence,
return to the habit within weeks.
Definition (b) is too severe to be applied to individual clinicians, who may have little control
over internal or external environments, (their own or their patients').
Definition (c) is less severe than (b). It also can be applied to animals.
It is the medium-term elimination of most of the severe signs and symptoms, with
restoration of body-mind functions to the extent possible under prevailing
circumstances.
The "prevailing circumstances" include the possibility or otherwise to activate the
body/mind adaptive responses, the physiological/pathological circumstances of the patient
(wear-and-tear on organs/joints, senile changes, adjustment of human "purposes" for the
animal patient etc).
Definition (c) allows for relapses (due to irreparable damage or weakness of organs/joints etc
or due to inability to rectify adverse internal or external environmental factors). It also allows
for coincidental disorders, for future unrelated disorders and for re-evaluation of the goals and
purposes of the patient in the context of the realistic possibilities.
In limb paralysis due to vaso-spastic or oedematous hypoxia of the motor centres postCerebro-vascular accident, AP may give marked (yet incomplete) functional and physical
improvement. For some affected patients, partial success may seem "miraculous" but would
be unsatisfactory if the patient's goal was to be a professional pianist or Olympic athlete.
In cervical ataxia in a pet dog, AP may restore limb function sufficiently to be most acceptable
to the owner but the same degree of success in a racing greyhound could be unacceptable and
could lead to a request for euthanasia.
In human arthritis, even with marked radiological signs and crepitation, AP can give marked
clinical improvement (pain relief and partial or complete restoration of joint function), even
though no change may be evident on radiological re-assessment. Sceptical surgeons and
radiologists may attribute the improvement to psycho-somatic temporary remission. However,
similar improvements following AP in canine hip dysplasia or animal arthritis can hardly be
explained as due to patient suggestibility.
FAILURES IN AP PRACTICE

Idealists may reject definition (c) as too soft, a cop-out for charlatans and incompetent
clinicians. I suggest that it is a realistic recognition of the frailty of human endeavour and of
the final and inevitable degeneration of human and animal life. In spite of decades of study of
conventional and complementary diagnostic and therapeutic methods, the most skilled,
sensitive, loving and intuitive of clinicians will still have failures, even under definition (c).
If we define success as in (c) above (medium-term elimination of most of the severe signs and
symptoms, with restoration of body-mind functions to the extent possible under prevailing
circumstances), clinical failures may be due to professional error; patient/owner error
(non-compliance with advice given); coincidental disorders and inability of target organs
to respond. Some patients may be "non-responders".
PROFESSIONAL ERROR
There are five main sources of professional error: (1) faulty diagnosis, (2) incorrect choice of
points, (3) inadequate stimulation, (4) failure to use supportive therapies, (5) premature
withdrawal of therapy.
1. Faulty diagnosis
Accurate diagnosis is needed for optimum results to any form of therapy. The cause, nature,
location and extent/severity of the dis-ease/lesion/dis-order should be known. First-degree
therapy aims to remove/alleviate the cause, to enhance the adaptive response and to provide
supportive/symptom-atic relief during recovery.
In practice, many of us have not the training, skill or equipment to make a precise and
detailed diagnosis in a conventional sense. Even if we have back-up services, we may put
undue emphasis on laboratory or radiological findings. For instance non-clinical mineral
deficiency and non-clinical radiological lesions are commonplace and their correction will
not improve the health/productivity of the "patient".
I am a Vet who has worked in nutritional/metabolic research (herd or flock disorders) for
over 32 years. I think that I am very good at this ! My greatest weakness as a clinician is in
the area of diagnosis of individual cases and my failure to keep abreast of developments over
the past decades in practice general diagnostics, medicine and pharmacology.
My AP practice is extra-mural (after-hours, weekends). Most of my animal patients are horses
(plus a few dogs), usually presented with pain or lameness. About 30% are referred by a
colleague and 70% are referred by owners/trainers. Many of my equine cases are not
clinically lame but have a history of poor limb action, reduced stride at the gallop, "hanging"
to one side or poor racing performance. Most of these would have been seen by one or more
colleagues who had made no specific diagnosis. As a result, unless there are visible or
palpable lesions, my diagnosis is doubtful in many cases. If the patient has been referred by a
colleague who has made a specific diagnosis (based on X-ray, nerve block etc), I usually
accept that diagnosis. However, most of my cases have some abnormality of the muscular
system (with 1-8 TPs present). Some have bone, joint, periosteal or tendinous problems. Less
than 10% have definite muscle atrophy (poor prognosis; see below).
Some of my clinical failures (due to faulty diagnosis on my part) were: in carpitis (carpal
chips missed); in septic tendinitis (sesamoideal chips missed); in canine posterior ataxia

(degenerative myelopathy missed); in equine cervical ataxia (irreparable myelopathy

missed); in equine severe hindlimb lameness (sacroiliac subluxation missed).
Carpitis (carpal chips missed): A gelding was treated successfully for sacro-iliac lameness by
injection of AP points in February 1989. In late February, chip-fractures of the both carpi
developed. A colleague used arthroscopy on both carpi to remove the chips. The horse was
rested until August, when training recommenced. By early September he was in full training
and was working well. Suddenly his action became poor and tenderness in the left lumbar
area was noted.
Hoof marks on the wall of his box suggested that he had been cast in his box before the
lumbar injury. Point injection of TPs and AP points for lumbar lameness between 5/10 and
17/10 had little effect. On 17/10, laser was used on the points, plus the arthroscopy scars.
Marked and visible relaxation of the back muscles occurred within 5 minutes. On 18 and
19/10, his hind action was improved but his front action was short and he was hanging on the
rein. Further sessions between 20/10 and 4/11 eliminated all TPs but, meanwhile, the carpal
area became swollen and hot. X-rays were not taken at the time. Between 4/11 and 11/11,
laser (local points plus Ting points) did not help the carpitis. Advised carpal X-ray and
Animalintex plaster. On 18/11, X-ray by colleague showed carpal chips. Colleague operated
to remove chips. Prognosis poor (second time surgery done).
Septic tendinitis (sesamoideal chips missed): On 11/11, horse with severe lameness due to
tendinitis, with marked infection and oedematous swelling of the lower part was presented.
The condition had been treated by poulticing and parenteral ampicillin and other antibiotics
over three weeks. Laser was applied for 12 seconds to many points over the tendon (medial,
posterior and lateral) and to ST36, LI11, LI 4, VG14 and SI, HC and LU Ting points. Five
sessions of laser between 14/11 and 18/11 gave a definite decrease in soft tissue swelling but
the infection persisted. On 23/11, X-rays showed bone sequestra in the sesamoid area. They
were removed surgically. On 9/12/89, the referring vet reported that the prognosis was poor
and euthanasia was being considered. Laser gave initial success in reducing soft tissue
swelling in < 9 days (6 sessions) but necrotic bone sequestra required surgical operation and
laser was discontinued.
Canine posterior ataxia (degenerative myelopathy missed): A German Shepherd was
referred in 1986 by a colleague for gold-bead implant treatment of hip dysplasia. (There was
pain on compression of the hip area). I assumed that the diagnosis was correct and did not
conduct a full clinical/neurological examination. Gold bead (1 mm diameter) implants were
inserted "between 9 and 3 o'clock" around the acetabulum, under general anaesthesia. (In hip
dysplasia, the response to this treatment is usually marked in the days following implants). In
this case, there was no improvement and the dog's ataxia deteriorated in the next few weeks.
On re-examination, a diagnosis of degenerative myelopathy was made and euthanasia was
advised.
Equine cervical ataxia (irreparable myelopathy missed): In my early days of equine AP, I
attempted to treat cervical ataxia (wobbler syndrome) in horses. Diagnosis of the degree of
pathology was not attempted. Treatment consisted of needling (usually with electrostimulation) of TPs, neck points (including GB20, 21, TH and SI points) plus distant points
(including SI 3, BL23, VG 3, GB34). In foals with recent signs, the outcome was good to
excellent. However, in cases with long-standing clinical signs (> 3 months duration) in older
animals, the outcome (in spite of initial and stable improvement, which would have been most

welcome if the case was a human or family pet) was unsatisfactory. Most cases were shot
eventually. If race-horses cannot race their future is grim, unless they are very well-bred
mares. I attribute failure in older horses/chronic cases to irreparable myelopathy.
Equine severe hindlimb lameness (sacroiliac subluxation missed): In 1988, a horse with
recent severe bilateral hindlimb lameness following a race and transport in a horse-box was
found to have marked tenderness over both sacro-iliac joints. I diagnosed muscular strain in
the sacro-iliac area. (In the previous months, I had treated successfully 2-3 similar clinical
cases by point injection (5 ml of 0.5% procaine-saline) at 3-4 points over both sacro-iliac
joints, plus all TPs, plus BL23, VG 3, GB30). 2-3 sessions of point injection was not
successful in this case. I changed the diagnosis to sacro-iliac subluxation and recommended
manipulation of both joints. Within days of one session of manipulation (by a human "bonesetter"), the horse became sound. (In April 1990, I met another case. I treated it with laser on
presentation, in an attempt to provide some temporary analgesia, but recommended immediate
manipulation. The result was dramatic improvement within days).
Now, in cases of sacro-iliac pain, if the height of the sacro-iliac area is the same on both sides
(as the horse stands square), I diagnose the case as muscle-strain (likely to respond to AP). If
the height is not the same, I diagnose sacro-iliac subluxation (poor prognosis to AP) and I
suggest manipulation as the best option.
2. Incorrect choice of points
Failure to locate AHSHI/Trigger points: Experienced clinicians search carefully for TPs at
each session. Even experienced clinicians miss them occasionally. It is not uncommon to find
TPs on the second or third session which were not present (or were missed) in the first
examination. Failure to treat and eliminate TPs can mean that the clinical signs persist in spite
of correct use of other (regional and general) AP points.
In patients located far away from base, the cost of time/travel may allow only one visit from
the vet acupuncturist, who must rely on the local vet to continue treatment. At the first
session, every attempt is made to diagnose the case and to select the best points, as indicated
by the first examination. The local vet is advised as to how to treat the points (for instance by
point injection) in 2-5 subsequent sessions at intervals of 3-7 days. This may not be very
satisfactory, as it is usually impossible for the local vet to re-assess the case (from an AP
viewpoint) each time. Therefore, he/she is unable to find/use the most appropriate AP points
(especially new TPs) as the case develops.
In difficult cases, AP must be adapted to the individual needs of the patient. Experienced
clinicians modify Cookbook prescriptions or include Classical methods in their selection of
points in later sessions if the clinical result is not satisfactory after session 2 or 3. Practitioners
who rely too rigidly on Cookbook prescriptions (because they have not grasped the basics of
Classical AP) often use incorrect or less effective AP points.
3. Inadequate stimulation
A good response to AP needs an adequate stimulus applied to the correct AP points.
Needling: In human AP, failure to place the needle in the correct position, at the correct depth
and angle, and failure to obtain DeQi may produce poor clinical results. DeQi is the classical

"Needle sensation" (para-esthesia, "pins and needles", numbness, heaviness, sensations

running proximally or distally along the course of the meridian; occasionally the sensation
may spread to the related organ or body part). In human practice, those who overstimulate in
order to ensure strong DeQi may cause more "needle shock" (fainting, nausea etc). Shock
may be induced easily in some patients. This may frighten them and they may discontinue
therapy.
In Vet AP, it may be very difficult to recognise whether or not DeQi is obtained. In treating
difficult animals (especially dangerous horses or dogs), clinicians may not place as many
needles as they would wish. They may not be able to place the needles deep enough, may not
maintain stimulation long enough, or may not replace needles which fall out before the
session is over.
Electro-AP (EA): Some horses react violently to EA. (In those cases, point injection or
manual needling/pecking/twirling can often elicit good clinical results).
Laser (especially lower power, used for too short time) may not be as effective as classical
needling, EA or point injection. For maximum effect the light beam should be almost parallel
and the light-spot should be small (concentrated). Lasers of less than 10 mW/cm sq have little
penetrative power and may not reach AP points or TPs in deeper tissue. For large-animal
work, output in the range 30-50 mW/cm sq is recommended. Unpulsed lasers do not penetrate
as deeply as lasers pulsed at 2000-5000 Hz or more. Dirt on the glass at the probe-tip may
limit output. This may not be noticed if the beam is invisible (infra-red). Infra-red lasers with
an in-built optical sensor to monitor output power are preferable to those without a sensor.
Faulty lasers may not emit at the stated power or may have too wide an angle of irradiation.
Some "laser" instruments are not real lasers and offer little more therapeutic power than a
domestic flashlamp !
4. Failure to use primary or supportive therapies
AP can help to control pain and other signs and symptoms in life-threatening disorders, such
as acute surgical conditions, acute pneumonia, toxaemia, septicaemia, poisoning etc. But in
such conditions, it should be used as a secondary treatment, in combination with primary
and supportive treatments.
AP may need to be supplemented by conventional therapy also in less severe conditions, in
which there is no immediate threat to life. Two examples are given: infected tendon and
incontinence/urinary-faecal retention in disc disease.
In treating an infected tendon, in which there is pus or sesamoideal bone sequestra, antibiotic
therapy, drainage and/or surgery may be indicated as primary therapies and AP as a secondary
therapy once the infection is controlled and the bone/pus removed.
In disc disease, with paresis/paralysis and urinary-faecal retention, enemas or manual
evacuation of the rectum or catheterisation of the bladder may be necessary until
rectal/bladder control is established. In cases with faecal-urinary incontinence, general
nursing (to try to keep the body/hair-coat dry) helps to prevent excoriation and secondary
infection of skin. Reliance on AP alone in such cases may give poor results.

5. Premature withdrawal of therapy

The number of AP sessions needed to elicit the optimal therapeutic response depends on the
condition being treated and the ability of the adaptive mechanisms to respond. In acute simple
cases, such as myofascial syndromes, 1 to 3 sessions may suffice. In chronic cases, 3 to 10
sessions may be needed. In severe chronic human cases, such as limb paralysis in
poliomyelitis, post-CVA etc, therapy may continue for 10-60+ sessions.
A good response to AP may be gradual (i.e. continuous improvement after each session) or
sudden (i.e. no change for the first few sessions, then a marked response after (say) the 5th
session. Occasionally, little change may be seen until after AP has been discontinued.
Following the first 1-3 AP sessions, there may be one of three responses: no change,
improvement in signs, or exaggeration of signs. Exaggeration is usually due to overstimulation of points. In my opinion, exaggeration is a better response than no change. It
suggests that therapy is activating some response and that alteration of the points or a lesser
degree of AP stimulus is indicated.
Because the cost of AP therapy must be weighed against the financial value of animal
patients, AP may not be attempted in cases with a difficult prognosis. Premature withdrawal
of therapy occurs more commonly in Vet AP than in human AP, if acceptable clinical
responses are not seen after 2 to 5 sessions in cases which could possibly respond to further
sessions.
NON COMPLIANCE OF OWNER/HANDLER
Failure to use supportive methods: In large stables, owners and trainers frequently have
little to do with individual horses. They delegate day-to-day responsibility for the care and
management of patients to a groom/ handler who may be over-worked, under-paid,
incompetent, apathetic, or (rarely) malevolent. It often happens that handlers are changed
frequently, i.e. different handlers may be responsible for the patient from day to day or week
to week. Instructions given to one handler may not be passed on (or carried out) by other
handlers. As in orthodox vet practice, even when only one handler is involved, instructions to
administer specific supportive treatment (medical, homoeopathic or physical), or to exercise
the patient in a specific way, may not be carried out.
Failure to give physiotherapy between AP sessions: If other physiotherapy (for instance
TENS) is not available, I usually ask that TPs in muscle be fisted (thumped gently but firmly
with the closed fist) for 4-6 minutes each day between AP sessions. In my experience, when
this is done, fewer AP sessions are needed and clinical recovery is faster. I attribute most of
my failures in simple TP cases to non-compliance with that request or to the owner/trainer
refusing to have further sessions of AP if 2 or 3 sessions had not been able to restore
locomotor function on its own.
Failure to accept advice re use of "Allweather" tracks: A famous trainer was advised by
three different vets not to use the "Allweather" track for speed-work for a potentially great
colt. (Each time the colt was galloped on the "Allweather", he came in lame). AP at TPs and
regional points successfully treated a long-standing back muscular lameness in 2 sessions,
after which the colt won an Irish Classic race. One week after the win, the trainer insisted in
using the "Allweather" and the horse came in acutely lame again, this time with TPs in the

scapular muscles. (The colt was to run in an English Classic within 14 days). Four days after
the injury, one session of AP at the TPs and regional points restored locomotor function in 36
hours. The manager was instructed to examine the colt daily for TP tenderness at the clipped
points and to inform me within 3-4 days if tenderness persisted there. The training speed was
so good that the trainer instructed that AP was not necessary, even though the TPs were still
tender and his manager had told him of my advice. On the day before the second race, the TPs
were still present. The colt ran a poor last in that race.
Failure to rest horses with strained tendons: In treating horses with
tendinitis/bowed/strained flexor tendons, rest is very important when the tendon is "hot" or
painful. In all my cases in which laser treatment for simple tendinitis failed, the owner/trainer
refused to rest the patients and to re-introduce them gradually to full work, as I had instructed.
OTHER REASONS FOR FAILURE
Coincidental disorders
Ideally, AP therapy aims to normalise all the functions of patient, not just the presenting
signs. In practise, however, this ideal may not be attainable. Coincidental problems may be
present at presentation, or may arise during the course of successful AP therapy for a specific
complaint. These coincidental problems may (or may not) be helped by further sessions of AP.
For example, a human patient may present with acute sciatica (in which AP could be highly
successful) but may have a coincidental history of Parkinson's disease, chronic cardiac
insufficiency or diabetic neuropathy (in which AP might have little to offer). In practise, one
might treat the sciatica but advise the patient to seek specialist help for the other disorders.
Early in 1990, a horse was presented with a history of poor hind action since purchase some
months before. The horse had been rested, except for walking and cantering exercise. On
examination, TPs were found in the sacral area. Laser and needling of TPs and points such as
BL23, VG 3, GB34,44 eliminated the TPs by the 3rd session. During therapy, mild exercise
continued and the horse developed abrasions on both hind fetlocks. Acute inflammation of the
fetlocks ensued. It was treated with antibiotics. Exercise was stopped and the horse was sent
home to allow the inflammation to subside.
Inability of target organs to respond
The adaptive response is the key to all healing. Acupuncture (AP) activates the adaptive
responses, which depend mainly on functional neuro-endocrine transmission. Physical or
chemical interruption of transmission or functional inability of the target-organs to respond
abolish or reduce the AP effect. Loss of function due to severe fibrosis of lung, liver, kidney
can not be reversed by AP. Paralysis due to large-scale cerebral or spinal motor-neuron
necrosis or due to section of the spinal cord can not be reversed.
Muscle atrophy in human patients usually has a poor prognosis if associated with motorneuronal pathology. In spite of intensive physiotherapy 3-5 times/week for 6-12 months,
many patients do not respond.
My experience of muscular atrophy in animals is limited mainly to horses showing atrophy of
the sacral or rump area in association with myofascial syndrome or a history of lumbar or

sacral injury and to dogs with German Shepherd syndrome. The prognosis to AP in such cases
is poor, even if it can eliminate muscular pain and TPs. AP therapy usually fails to resolve the
muscle atrophy and to restore full function and proper placement of the affected limb. This
may be a minor drawback in pets or non-athletic animals but can eliminate any possibility of
success as regards top competitive performance (racing, show-jumping, competitive dog
shows etc).
Infertility due to blocked oviducts: In some cases of female sterility, the cause may be
bilateral oviductal occlusion due to previous inflammation or adhesions. AP may not restore
patency of occluded ducts.
Ovarian pain: I have treated a few fillies with recurrent hind-limb lameness arising within 10
days pre- to 10 days post- ovulation. In all cases, TPs were present in the area L2 - L4 (and
occasionally in other reflex areas for the ovary-uterus), usually ipsilateral to the affected limb.
In some cases, a colleague had found severe pain on ovarian palpation on the same side as the
TPs. I diagnosed hind-limb pain referred from the ovary in association with ovulation
pressure-pain/haemorrhage. AP at TPs and ovary-uterus points eliminated the TPs and gave
good short-term clinical response but the condition (and TPs) recurred at the next ovulation. I
would be reluctant to attempt AP in such cases in future.
Psycho-somatic dependence in humans
"Miraculous cures" in terminal or hopeless cases are well known in human medicine. They
are attributed usually to inexplicable spontaneous remission. A positive attitude, a deep
religious belief, the "will to live" or a "fighting spirit" are often involved. In other cases, with
relatively minor pathology, patients may deteriorate rapidly and may die. Such cases are often
associated with negative attitudes, pessimism or depression. Medical hypnosis is used
successfully to treat organic as well as functional problems. Thus, the psyche may modulate
the pathogenesis and resolution of many human somatic disorders.
The psyche is also important in human social interactions. Patients may use their illness" to
attract attention" from loved-ones, to excuse their failure in family or work activities etc. For
such patients, AP alone may be of little help, as they may not "want" their illness to be cured.
Cure in such cases would need psycho-therapy/counselling etc to help the patient face up to
(and defeat) the reasons for their psycho-somatic dependence on their clinical disorders.
Failure due to unknown causes (in spite of AHSHI points)
In many clinical cases, it is possible to make only a partial diagnosis. For example, hindlimb
lameness in a horse may be attributed to muscular pain referred from clinically detected TPs
in the lumbo-sacral area. But the precise cause of the TPs may remain unanswered. (Are they
due to primary muscle strain, or are they recruited as secondary TPs to primary TPs
elsewhere, or to pathology elsewhere (referred from spinal nerve pressure/entrapment, or
referred from irritation of associated organs etc ?)). AP (including TP therapy) in such cases
may lead to some failures, even though the TPs may disappear during therapy.
Carpal oedema: On 24/11/89, a foal was presented with marked oedema of the left carpus.
No pain or heat was obvious. The foal had been bought about 2 weeks before that and the
swelling had been present for some weeks before purchase. The cause was thought to be
traumatic. X-rays were negative. Poultices had been applied without success. The foal was

due for resale in 14 days. Between 24/11 and 6/12, 6 sessions of laser (local points plus points
for the region) gave dramatic results. Daily massage was used to try to disperse the skin folds
left after the oedema disappeared. On 7/12, the left carpus looked fine but on 8/12 it had
swollen up as bad as before. The cause of the relapse is unknown.
Some patients may be "non-responders"
Genetic or acquired damage to neural circuitry may produce "non-responders" to AP therapy.
Apart from the ability of target-organs to respond, the clinical response to AP depends on
intact transmission of stimuli from the periphery, to the ascending tracts of the spinal cord, to
the CNS, to the descending spinal tracts. Synaptic transmission of stimuli depends at each
level on neuro-transmitters and their receptors.
Defective synthesis of neuro-transmitter or reduction in the number of receptors can block
transmission. Certain strains of mice (CKBX) are genetically deficient in opiate receptors.
These mice respond poorly or not at all to opiate analgesics or AP analgesia.
Karma ?
The concept of Karma teaches that the main events of our lives are pre-destined, as part of an
overall Divine plan for our (and human) personal growth and maturity. In this concept, we
must all suffer pain, loneliness, hunger etc as well as pleasure, companionship and plenty.
In the concept of Karma, one's disease may be part of the growth process and will not be
cured until the reason for the lesson is learnt. In the end, we all die, in spite of every human
physical and intellectual effort to save us.
The concept of Karma is scorned by most westerners. But those who scorn are not always
correct.
SUCCESSES IN AP PRACTICE
AP successes (even in cases undiagnosed, wrongly diagnosed, or assessed initially as
"difficult" or "unlikely to respond") may be explained by (a) spontaneous remission or (b)
activation of adaptive responses.
a. Spontaneous remission: Some AP "successes" may be due to spontaneous remission (Vix
Naturae) rather than to AP therapy. Temporary or cyclical remissions are common, for
instance in human multiple sclerosis. Many clinical problems may appear to respond initially
to therapy, only to recur later. For instance, "back lameness" in humans, dogs and horses can
recur.
Clinicians may attribute relapses to an inherent weakness in the patient. Congenital or
acquired deformities of the vertebrae (misalignment, disc disease, spondylosis etc) or limbs
(toeing in or out, "back at the knee", sickle or straight hocks etc) may throw abnormal strain
on limb or back muscles, predisposing to relapse following apparent successful therapy. In
humans, incorrect lifting (using the bent back rather than the knees and hips) or incorrect
sitting posture etc is thought to justify the phrase: Once a back, always a back"!

Inadequate "follow-up" after apparently successful therapy would miss the recurrence of the
disorder and a temporary remission could be erroneously classed as a "successful clinical
response".
In the absence of controlled trials, it is not possible to quantify these spontaneous remissions.
However, in clinical trials published by other workers, the "Placebo Effect" (apparent
remission in the negative control group) can run from 10 to 60%. In human trials, a common
Placebo Effect is of the order of 30-35%. However, remission rate depends on the disorder
being examined. Spontaneous remission in motor neuron disease, for instance, would not be
as high as in Grade 3 disc disease (motor paralysis with intact deep pain sensation).
Spontaneous remission in typhoid would not be as high as in E. coli enteritis.
b. Activation of adaptive responses: The basic tenet of Holistic Medicine is that the body
heals itself and that all effective therapies enhance the adaptive/homoeostatic/self-healing
responses.
There is ample research evidence that AP activates the adaptive responses via segmental,
inter-segmental and suraspinal reflexes, activation of autonomic, neuroendocrine, endocrine
and immune responses (Rogers et al 1977, Lin & Rogers 1980, Rogers & Bossy 1981; Rogers
1990).
TP successes: Many chronic pain-disorders are associated with TPs in humans and animals,
as discussed. TP elimination can eliminate pain and other disorders rapidly.
Most of the horses treated successfully for myofascial lameness had 1 to 7 TPs present in the
affected muscles. Simple or electro-AP, point-injection or Laser (plus "fisting" or TENS
between sessions) at the TPs and main AP points for the region usually eliminated the TPs and
restored function within 1 to 7 sessions (usually 2-4 sessions).
Very chronic cases can respond. One such case was an 83 year-old woman with severe pain in
her lateral thorax for more than 12 years. All previous assessments had failed to locate the
cause of the pain and all previous attempts at treatment had failed. I located a single TP in an
intercostal space on the mid-axillary line. Pressure on the TP caused her to scream. One
needle in the TP and one in GB34 (same side) eliminated the pain in 2 sessions. She remained
free of the pain until she died 7 years later.
Success in strained flexor tendons in the horse: I have had very good success with Laser
therapy (30-50 mW pulsed infra-red laser) if the horse is rested for 1-2 weeks, followed by 1
month walking, 1 month trotting and 1 month cantering before return to full training (as
advised by Emiel Van Den Bosch, Belgium).
In chronic cases, with visible "bowed tendons", laser was used 1-2 times/ week for 3-5
sessions. In some of these cases, the owner used a "blister paste" over the tendon and waited
until all heat and pain had disappeared before requesting laser therapy. The horse was rested
in the box, or let out to grass, until the the bow disappeared. Gradual return to training is
advised, as in acute cases (above).
Powerful "responders": Some patients are powerful responders, i.e. respond
symptomatically to 1-2 sessions of AP and remain well for weeks or months afterwards. When
they present later (with recurrence or with a new problem), they usually respond rapidly to

ssubsequent treatment. This can be dramatic, as in rapid response in some dogs with hip
dysplasia or chronic hip osteoarthritis.
Success in spite of severe lesions: Moderate to severe vertebral or joint lesions may exist in
elderly human and animal populations, many of whom have little or no history of pain or
lameness associated with the lesion.
AP can produce marked clinical results in spite of severe lesions, such as severely dysplastic
or arthritic hips. One example was a man who had broken both knees in a motor-cycle
accident some years before. He developed severe osteoarthtitis, with pain, stiffness and
"locking" of both knees. Knee movement produced crepitation which could be heard 4 metres
away. Two sessions of AP restored limb function. Six months later, he phoned for another
appointment: he had to hop down a ladder on one leg, as the other knee had locked again!
Further AP gave relief within days.
Similarly, AP can be helpful in some cases of rheumatoid arthritis. An airport technician
with severe RA came for AP. He had prosthetic hips and was on crutches. He said that the
surgeons were thinking of recommending surgery on his elbows. He was in constant pain and
could work only 1-2 days/fortnight. After 6-8 AP sessions he missed work about 1-2
days/fortnight. However, I was unable to help him enough with AP, so I referred him to a
physician (Dr. Liz Ogden, Dublin). She prescribed a strict diet and homoeopathic remedies.
Eighteen months later, I heard my name called as I walked accross the lobby in Kennedy
Airport, New York. It was "my patient". He strode accross the lobby, hale and hearty without
the crutches to thank me for referring him to Dr. Ogden!
Unexplained success in the absence of specific diagnosis: Occasionally, one may attempt to
treat symptomatically a condition for which there is no specific diagnosis.
One such case was a very valuable thoroughbred filly with a history of lameness for some
months in the fore-limbs. The lameness was intermittent, lasting 4-10 days, and shifted
between the left and right limbs. Top-class equine vets had examined her before I was called.
Clinical and other tests failed to locate the location or cause of the lameness. Pressure on the
cervical nerve roots was suspected. I found nothing on examination, but was told she had been
typically lame the day before. I needled the main points for neck and forelimb, once/week on
three occasions. She was not seen lame after the first session of AP and was sold to France
within 2 months.
CONCLUSIONS
Causes of clinical failure include: professional error (faulty diagnosis; faulty AP
knowledge (incorrect choice of points, inadequate stimulation, failure to use primary or
supportive therapies, premature withdrawal of therapy); non-compliance of owner or
handler (failure to use supportive methods, failure to give physiotherapy between AP
sessions, failure to accept advice re use of "Allweather" tracks, failure to rest horses with
strained tendons etc). Other reasons include: coincidental disorders; inability of target organs
to respond; psycho-somatic dependence in humans; failure in apparently straight-forward
cases, in spite of AHSHI points; some patients may be "non-responders"; Karma ?

A less obvious and highly controversial factor is the mental state and "Energy Status" of
the therapist. Many schools of Complementary Medicine teach that, to obtain the best clinical
results, the therapist should be in good health and at peace with the self.
Modern Chinese Communists do not believe in a soul (a personal energy/ memory that exists
independent of the body) that survives death. However, recent (unconfirmed) reports from
China indicate that research in CH'I KUNG is producing exciting results. Mental and physical
focusing/control of body Qi is possible. It can be learned and used for many purposes,
including healing. Acupuncturists who are Masters of Qi Gong can often "sense" the location
of disturbed Qi in the patient and can treat the disorder, without touching the patient, by
directing their own Qi to the correct AP points.
Imbalanced Qi in the therapist may reduce clinical success. Focused intention (compassion,
Tender Loving Care ?) has therapeutic value. Some clinicians with great knowledge (but little
love) may prove inferior to those with great love (but little knowledge). And all of us have
"down time", which may last days, weeks or longer.
In my opinion, top clinical success depends on the correct application of deep theoretical and
intuitive knowledge, compliance of the patient/owner, ability of the defence systems to
respond and the will of God that we (and our animals) be healed. In most cases, God is
willing but we are weak !
REFERENCES

Lin,J.H. & Rogers,P.A.M. (1980) AP effects on the body's defence systems: a

veterinary review. Veterinary Bulletin, 50, 633-640.
Rogers,P.A.M., White,S.S. & Ottaway,C.W. (1977) Stimulation of the AP points in
relation to analgesia and therapy of clinical disorders in animals. Veterinary Annual,
17, 258-279. Wright Scitechnica, Bristol.
Rogers,P.A.M. & Bossy,J. (1981) Activation of the defence systems of the body in
animals and man by AP and moxibustion. ARQ, 5, 47-54.
Rogers,P.A.M. (1990) Activation of the body's adaptive responses by peripheral
stimulation. IVAS Annual Congress, Netherlands.

QUESTIONS
In these questions, we define clinical success as medium-term elimination of most of the
severe signs and symptoms, with restoration of body-mind functions to the extent possible
under prevailing circumstances.
1. One of the following statements is not correct. Indicate the incorrect statement:
Clinical failures may be due to:
(a) professional error
(b) patient/owner error (non-compliance with advice given)
(c) coincidental disorders

(d) inability of target organs to respond

(e) refusal of an animal patient to allow acupuncture treatment
2. One of the following statements is not correct. Indicate the incorrect statement:
There are five main sources of professional error in AP therapy:
(a) faulty diagnosis
(b) incorrect choice of points
(c) inadequate point stimulation
(d) the use of supportive conventional therapies
(e) premature withdrawal of therapy
3. One of the following statements is not correct. Indicate the incorrect statement:
One can expect poor clinical success to AP in:
(a) equine carpitis (with carpal chips)
(b) equine septic tendinitis (with sesamoideal chips)
(c) canine posterior ataxia (with degenerative myelopathy)
(d) equine cervical ataxia (in older horses/chronic cases)
(e) equine hindlimb lameness (with sacroiliac muscular pain but sacro-iliac height similar on
both sides when the horse is stood square)
4. One of the following statements is not correct. Indicate the incorrect statement:
(a) Experienced clinicians search carefully for Trigger Points at each session
(b) Even experienced clinicians miss TPs occasionally. It is common to find TPs on the
second or third session which were absent (or were missed) in the first examination
(c) Failure to treat and eliminate TPs can mean that the clinical signs persist in spite of
correct use of other (regional and general) AP points
(d) It may be necessary to rely on a colleague (who may not know AP) to continue treatment
after the first session. The colleague is advised (at the first consultation) as to which points to
use, and how to treat them in 2-5 subsequent sessions at intervals of 3-7 days
(e) In all cases, the colleague should be able to get the same therapeutic results as the
acupuncturist if he/she uses the points discussed in the first consultation

5. One of the following statements is not correct. Indicate the incorrect statement:
(a) In Vet AP, it may be very difficult to recognise whether or not DeQi is obtained
(b) In treating difficult animals (especially dangerous horses or dogs), clinicians may not
place needles as they would wish
(c) All horses accept Electro-AP (EA) calmly
(d) Laser (especially lower power, used for too short time) may not be as effective as classical
needling, EA or point injection
(e) For large-animal work, pulsed lasers with output in the range 30-50 mW/cm sq are
recommended
(f) Some "laser" instruments are not real lasers and offer little more therapeutic power than a
domestic flashlamp

1=e2=d3=e4=e5=c

ACUPUNCTURE IN ROUTINE VETERINARY PRACTICE

ABSTRACT
Acupuncture (AP) is a reflex phenomenon with diagnostic and therapeutic value. AP points
(APs) and Channels (AP meridians) have many applications in routine veterinary practice.
AP has diagnostic and therapeutic value.
Irritated organs/functions cause reflex changes in sensitivity (usually hypersensitivity to
pressure, heat and electrical current) at specific zones (the AP points (APs)) on the body's
surface (diagnostic effect). Adequate stimuli (needling, injection etc) applied to the APs can
influence the pathophysiology of the affected organs/functions (therapeutic effect).
Most of you are Vets whose main source of income comes from private practice. If you hope
to integrate AP into your day-to-day practice, you must keep certain considerations in mind:
1. You must study AP in reasonable detail. A few weekend seminars may be enough to get
you started but are only the beginning of mastery of AP.
2. The AP technique which you use routinely should require a maximum of 10-20
minutes/session, otherwise the number of cases which you can treat/week will fall. Unless
your fee for treatment includes a cost for the time involved, your income will fall in
proportion to the fall in cases/week. Point injection is the fastest method and gives good
results.
3. Having studied AP, you should present it in a scientific way to your clients and your
colleagues. This is essential if you wish to preserve your reputation as a vet and a scientist.
This paper discusses AP point injection; methods of adapting ultrasonic, faradic, laser and
other physical therapies along AP principles; some of the best indications for AP therapy in
large and small animals and possible uses of AP analgesia in surgery. It also discusses options
for AP training; continuing study and development of intuitive powers in relation to an
Holistic "total view" of health and disease and some of the methods of fostering public
awareness of AP.
ACUPUNCTURE (AP): REFLEX AND ENERGETIC CONCEPTS
AP has diagnostic and therapeutic value. It has many applications in routine veterinary
practice (1,2,11,12,13,14).
In its simplest form, AP is a reflex phenomenon: irritated organs/functions cause reflex
changes in sensitivity (usually hypersensitivity to pressure, heat and electrical current) at
specific zones (the APs) on the body's surface (diagnostic effect). Adequate stimuli (needling,
injection etc) applied to the APs cause reflex responses in the pathophysiology of the affected
organs/functions (therapeutic effect). The reflex (neurally-mediated) mechanism is easily
demonstrated by experimental chemical or surgical interference with neural transmission in
the peripheral nerves, spinal cord or midbrain or by sympathectomy.

In its purest form, AP involves a concept of interacting external and internal energy fields
(5,6,7,8). It involves an holistic concept of the organism in relation to its internal and external
environments. It involves the manipulation of Vital Energies (Qi), some of which are known
(defence reactions) and some of which are only hinted at in occult or esoteric literature (the
Aura, the Etheric body, Kundalini, Prana etc). Western science has much to learn about the
Energies of Life! We are far behind Soviet and Eastern Block science in this research. They
are already well advanced in research on "Bioplasma", mitogenic cell radiation, weak
electrical and EMF radiation etc.
AP: NOMENCLATURE AND POINT SELECTION
Each AP point has a Chinese name, an alpha-numeric code and an anatomical location. For
example TsuSanLi (ST36) means FootThreeMiles, is the 36th point on the ST (stomach)
Channel and is situated 3 cun (body inches) below the patella, 1.5 cun lateral to the tibial
crest in adult humans. Details of the point nomenclature and points for particular conditions
are given elsewhere (3,4,9). AhShi points and Trigger Points (TPs) are discussed elsewhere
(3,4,12,14,17).
Novices should note that many different nomenclatures are used for the APs. Before using the
point combinations listed below, novices should consult those references and cross-compare
the codes with those in their standard reference textbooks.
The AP-based applications (below) use some or all of the Laws of Choosing Points for
therapy. Let us recall some of these Laws:
* Sensitive points (AhShi points/TPs, Motor points etc)
* TianYing points (centre of the swelling) and sensitive area
* Local points
* Distant points along affected Channels
* Combination of Local and Distant points
* Points along affected Channels
* Points on related affected Channels
* Selection according to symptoms
* Selection according to nerve supply
* "Fore and Aft" points
* Master Points: Mu-Shu (Alarm-Association); Yuan-Luo (Source-Passage); Xi (Cleft)
points etc
* Ear Points and APs not on the main Channels

These laws and methods of selecting APs for therapy are discussed elsewhere
(8,9,11,12,13,14).
METHODS OF STIMULATING THE AP POINTS (APs)
There are many different methods of stimulating the APs to activate the AP response. These
are discussed elsewhere (10).
AP POINT INJECTION: The injection of APs can be tried by all practitioners. It is the
fastest and most practical method. It requires no sophisticated equipment, stimulators etc. It is
fast and takes little more time/session than the routine vet treatment requires. The technique is
described in detail elsewhere (10).
If the client can accept the fact that AP is applicable in vet medicine, the practitioner inserts a
hypodermic needle in a correct point, stimulates the needle manually (by pecking and twirling
for 10-15 seconds before the syringe is attached), attaches the syringe and injects the point,
manipulates the needle again and removes it. Then he/she proceeds to the next point, and so
on.
If the client is very conservative and would not accept AP treatment for his/her animals, the
needles are not manipulated by pecking or twirling. If the client asks why so many points are
being injected, he/she can be told that the results are better when many points are injected.
Alternatively, he/she can be told that different compounds are being used. (For this purpose
the practitioner should have a number of bottles with 0.9% saline, 0.5% procaine (or
xylocaine or lignocaine) solution in 0.9% saline, B12, Sarapin, homoeopathic solutions or
other injection material. Preferably non-toxic, non-irritant colouring agents can be
incorporated in the solutions).
Point injection is ideal in those cases in which the practitioner considers intramuscular
injection of therapeutic agents to be desirable. If the therapeutic dose is calculated as 20 ml of
drug solution and the vet needs to inject 8 points with 10 ml each (large animals), the 20 ml
drug solution can be diluted to 80 ml by adding 60 ml sterile water or saline.
In emergencies (such as anaesthetic collapse, coma which has not responded to orthodox
therapy etc) the GV26 + KI01 combination may be needled or electro-stimulated. In cattle
and horses, KI01 is not transposable but the interdigital cleft (cattle) or the hollow at the back
of the hoof (horses) may be tried instead. If the owner asks why the animal is being stimulated
in the nose/foot he/she can be told that: "It is a new resuscitation technique which I have read
about and it is worth a try".
ULTRASOUND, FARADISM, TENS, LASER AND OTHER PHYSICAL THERAPIES
Vets whose clients already accept these types of therapy have a few problems adapting these
methods to treat the many conditions responsive to AP. The main differences between the
"orthodox" and AP-based application of these methods are:
a. orthodox uses are limited to a few conditions whereas AP based applications have a much
wider scope and
b. orthodox use of these methods is usually confined to the problem area (muscle, joint, etc).

If the vet wishes, the client need not know that the animal is being treated by AP principles.
For example, in low-back syndrome, the electrode of the transcutaneous stimulator can be
moved first over the problem area. Then the other sensitive points are identified in the
lumbosacral (and possibly low-thoracic) area, the heavy muscles of the thigh and
gastrocnemius and their locations are noted for future reference. They are stimulated for a few
minutes. Electro-stimulators with multiple outputs allow faster therapy during a session, as
multiple points can be stimulated together. Finally, a few classic points for the low-back
region (BL23, GV03, GB34) are stimulated. If the owner asks why so many points (and
especially distant points) are being stimulated, he/she can be told: "They are nerve zones with
beneficial reflex effects on the back".
SOME PRIME INDICATIONS FOR AP THERAPY
The following conditions are suggested as prime indications for beginners. The points
suggested are taken from the transposition method (anatomical transposition from human to
animal models). APs may also be taken from the traditional vet texts (3,4,9).
In all cases, search the patient carefully for points which are tender/hypersensitive to
palpation or electric current (AhShi points, TPs (17)). Animals can not tell us where they
"feel" referred pain when a tender point is pressed. Therefore, it is usually not possible to
distinguish locally sensitive AhShi points from genuine TPs (which refer pain elsewhere)
with certainty in animals. I assume that the most painful AhShi points are TPs. For the
purposes of this paper, I use the term AhShi point to include both types of points, causing
local and referred pain. If AhShi points are found, mark their position and use them.
1. Cows: dystocia, especially due to relative oversize of the foetus: The method was used
by Kothbauer the late Erwin Westermayer. Their main points are: GV02,03,04,
(sacrococcygeal space, L4-L5 space and L2-L3 space) and BL32,53. Any AhShi points
among BL23,24,26,31,33,34,54 are added. AP at these points helps to relax the pelvic
ligaments, helps uterine contraction and cervical relaxation. It greatly facilitates parturition.
On arrival, the vet inserts the needles and instructs the farmer as in (2) below. Electrostimulation is not essential. Having prepared him/herself, the instruments and the cow, the vet
proceeds with the delivery. This method is recommended strongly.
2. Cows: reposition of prolapsed uterus: The main points are: GV02,03,04; BL23,26,31,53.
Occasionally, BL24,32,33,34,54 might be substituted for the other BL points (Westermayer).
First thing on arrival, before other preparations, AP needles or hypodermic needles 5 cm long
and 19 to 23 gauge are placed to a depth of about 3 cm in GV02,03,04 and to a depth of 4-5
cm in the BL points, bilaterally. The farmer or an assistant is shown how to twirl and
manipulate the needles and is instructed to continue twirling them in sequence for 10-15
seconds each. Two needles can be twirled together. Alternatively, an electro-AP stimulator is
attached to the needles and the frequency is set for about 5 Hz. The output voltage is increased
until the needles are pulsating in rhythm with the outputs.
The vet then proceeds to reposition the uterus and to ensure that it is fully back. A uterine
pessary may be inserted. The vaginal lips are sutured as usual and a special harness to apply
perivulval pressure is applied for a few days. Normally the whole procedure takes only 15-20
minutes and there is seldom any straining or re-expulsion of the uterus by the cow. Spinal

anaesthesia is seldom necessary. The late Erwin Westermayer (Germany) made a superb
video-film showing this method in eight random cases.
3. Cows: hormonal infertility/functional pituitary, ovarian, uterine pathology: Infertility
in cows is often associated with anoestrus, persistent corpus luteum, pyometra and cystic
ovary. Main points are traditional points YungQi (near BL26, bilateral), 9-10 cm from the
midline between the transverse processes of 5th & 6th lumbar vertebrae. Any AhShi points in
the lumbosacral area (in the area BL23-34 and BL52-53) are added. AP can be by point
injection, manual needling + electro-stimulation for 10-15 minutes, repeated every few days
until the cow comes into oestrus.
Alternatively, point injection with 5-10 ml solution of 0.25-0.50% procaine, vitamin B12,
homeopathic agents etc can be used. Anoestrus usually responds to 1-2 treatments, cows
coming into oestrus within 3 weeks. Cystic ovaries may need up to 4 sessions, with the
formation of a corpus luteum by the 10th day and the appearance of oestrus by 3-5 weeks
after the last treatment.
Some vets apply moxa to the needle handles (when the needles are inserted) and allow the
moxa to burn itself out. Kothbauer also uses paracervical injection, via a very long needle.
4. Small animals: conjunctivitis, rhinitis: Main APs for these disorders are: Conjunctivitis:
LI04: BL01; GB01 / + / GB20: ST01,02; LV03; TH23. Rhinitis: LI04,20; Z 03,14; GB20;
GV23,25. The animals may be needled with fine human AP needles, 10 mm long and 30-32
gauge. The needles are inserted to a depth of 2-3 mm on the face points; 12-25 mm on GB20
and 12 mm on LI04. In acute cases, quick needling (a few seconds/point) is sufficient. Repeat
daily for 2-3 days. In chronic cases, sessions should last 10-20 minutes, repeated once every
3-7 days for 4-6 sessions.
Alternatively, APs may be injected with 0.1 to 0.5 ml of solution using a dental syringe and a
very fine needle. In severe conjunctivitis, if the animal is quiet, pricking the everted eyelid in
3-6 places is recommended in large animals, or injection of 0.1 ml 0.25-0.50% local
anaesthetic into a few subconjunctival areas. One may also try laser or ultrasound using the
same APs, but avoid irradiating the eye.
In chronic cases of conjunctivitis, warn the owner not to allow the dog to poke its head out of
the car window while the car is moving.
5. Small animals: gastrointestinal disorders: Main points for vomiting, inappetance,
gastritis etc are PC06, ST36, CV12, BL21. For enteritis, gastroenteritis, diarrhoea,
constipation, colic etc, add points from TH06, BL25,27, CV04,06, ST25. Other points are
listed in the Appendix to the paper on the "Choice of Points for Therapy" (9).
Acute gastrointestinal conditions are treated every 12-24 hours and should respond in 1-2
days. Chronic conditions are treated every 1-7 days, depending on their severity. They may
require up to 4-5 sessions. Point injection, needling + moxa, electro-AP, ultrasonic or
transcutaneous electro-stimulation methods may be tried in these cases.
6. All species: hip lameness: This may be associated with arthritis, muscular injury, trauma,
metabolic diseases, hip dysplasia, low-back syndrome + etc. If dislocation of the hip is
involved, this must be corrected. If metabolic causes are involved, appropriate adjustments to

the diet and adequate mineral supplements are required. Once fracture is excluded, the AP
treatment is similar, irrespective of the cause.
First, search the muscles of the lumbosacral area, buttocks, hip, thigh and gastrocnemius to
identify AhShi points. (Note: In humans, pain may be referred to the hip/gluteal area by TPs
in the paravertebral muscles as far away as the posterior edge of the scapula). Clip the points,
or note their position carefully. Choose as main points from the following: AhShi points;
GB30,31,34; BL23,40; LV08,11. Point injection, needling + moxa, electro-AP, electrostimulation, ultrasonic, injection, laser etc may be tried. If needling is chosen, peck the
periosteum of the femoral neck when GB30 is needled.
Treat acute cases every 1-2 days. Expect results by 2-4 sessions. Treat chronic cases every 3-9
days. Expect results by 2-8 sessions.
AP can help greatly the lameness in hip dysplasia in dogs. (The implantation technique is
especially good, especially in dogs which respond well to AP or electro-AP in a preliminary
test-session (10, 14). Advise the owner not to breed from affected dogs/bitches.
7. All species: shoulder lameness: This is tackled in a similar manner to hip lameness.
Identify, clip or note all AhShi points in the neck, upper limb and upper thoracic area. Choose
as main points from the following: AhShi points; LI11,15; TH14; SI09,11 / + / TH05,15;
LI04,16; BL11; GB21; SI10,12,13,14.
8. All species: low-back syndrome (lumbosacral lameness; "disc syndrome", arthritis,
spondylitis etc in lumbosacral area; rheumatism, myositis, myalgia in the area). This is
tackled in a similar way to hip lameness, as above. Identify, clip or note all AhShi points from
the lumbosacral area to the hock (tarsus) and note their positions carefully. Choose as main
points from the following: AhShi points; X 35 (HuaToJiaJi, paravertebral points) in region
first lumbar to last sacral vertebrae; BL23,25,27,31,52,40,60; GB30,38; GV02,03,04. The
choice of points is discussed elsewhere (9,12,14,18).
9. All species: muscle cramp, soft tissue lameness: Where causal factors are known (trauma,
exposure to cold and damp, metabolic upsets and mineral vitamin deficiencies etc) correct
them. AP treatment consists of careful palpation to reveal all AhShi points. If the problem is
in the forelimb, search from the knee (carpus) to the shoulder, neck and upper thorax. If the
problem is paravertebral, search the whole paravertebral and intercostal area. If the
problem is in the hindlimb, search the lumbosacral area and the hindlimb to the hock (tarsus).
If the problem is in the flexor tendons, search these areas and the area behind the scapula
(BL13,14,15 = LU, PC, HT Shu points) and the lumbosacral area (BL22,25,27 = TH, LI, SI
Shu points) also. Note carefully and treat all sensitive areas.
In therapy, choose main points from: AhShi points plus main points for the affected regions
(9,12,14,18). Treat acute cases every 3-7 days for up to 8 sessions. Expect results by the third
session in acute cases and by the 4th-5th session in chronic cases.
In tendinitis, local APs along the affected tendons are added. In bursitis, local points and
TianYing points (penetration of the bursa or cyst) are added. (I have had poor or no results
with AP in tendinitis until I used a 30 mW pulsed infrared Laser, applied to many points over
the medial, posterior and lateral edge of the tendon, with other APs). Laser gives better results

than AP in tendinitis but the longterm benefit in seriously trained/torn tendons is

questionable, unless the owner/trainer lays the horse off work for 10 months.
10. All species: anaesthetic emergencies (apnoea, respiratory arrest, cardiac arrest). The
main point is GV26, in the midline at the lower extremity of the nostrils. Occasionally, KI01
is added in small animals.
Immediately the emergency is noted, insert a needle, 19-30 gauge (depending on species),
into GV26, directing the needle towards the nasal septum. Stimulate the point by strong
twirling, rotation and pecking of the needle. (Some colleagues who were disappointed with
AP at GV26 in emergencies did not stimulate the needle adequately. Strong stimulation is
needed). In apnoea and respiratory arrest, expect a response in 10-60 seconds. Remove the
needles when breathing recommences. If there is no response in 60 seconds try artificial
respiration for a few minutes and needle again. The response in apnoea and respiratory arrest
is almost 100% if the heart continues to beat.
In cardiac arrest however, the response may be as low as 40% and stimulation of the point
must continue for up to 10 minutes. The method is very good in neonatal asphyxia, coma,
shock, traumatic shock and haemorrhagic shock. Remember GV26 + KI01 in shock,
collapse, coma, emergencies. Remember PC06 for cardiac cases, thorax, lung disorders,
nausea.
11. All species, nephritis, cystitis: Nephritis: BL22,23,58; GV03,04; SP06,09; ST25;
GB25; KI03 / + / BL24,25,27,28,31,32; ST28; TH09; SP14; LV08; KI07; CV06. Cystitis:
BL28,38,58; CV03,04; KI02,03; ST28 / + / BL23,25,26,31,32,33,54; GB26,29; SP06,09;
CV02; ST27. Main points for treatment are drawn from these lists, depending on the
symptoms and diagnosis. Also check for AhShi points in the lumbosacral and low abdominal
area and include these points.
Treat acute cases daily for 4-6 sessions, expecting a response by third session. Treat chronic
cases once/week. (Chronic nephritis, with marked fibrosis may have a low success-rate). If
vomiting or other signs are major signs, include points according to the symptoms (9). Point
injection, needling + moxa; electro-AP; electro-stimulation or ultrasound techniques may be
used.
AP ANALGESIA FOR SURGERY
Before AP analgesia is attempted, the practitioner should have a good AP electro-stimulator.
You are advised not to use AP analgesia in the presence of your clients until you have tried
the technique many times (to your satisfaction) in the privacy of your surgery. Even then, the
disadvantages of AP analgesia may prevent its use in routine surgery. However, it is worth
consideration in highly toxic, debilitated or weak patients which present a high risk of
intolerance of general anaesthetic, or in Caesarian sections (all species) and in routine
dystocia and prolapsed uterus in cows. (The latter two cases do not require a stimulator). It is
ideal for use with reduced doses of local or general anaesthetic.
The client should be informed (in those cases which are operated on in his/her presence) that
AP analgesia is being used and that supplementary local anaesthesia may be required in 10-30
% of cases. For this purpose, an indwelling i/v catheter is placed before surgery is attempted.
The points for use in AP analgesia are discussed elsewhere (9,11).

VETERINARY AP TRAINING
Vets who want to study AP have 3 main options: (a) self-study of good human and veterinary
AP texts; (b) formal, long courses in human AP, followed by shorter study of veterinary AP
abroad (UK, USA, Europe, Far East etc) or (c) formal, short veterinary courses, such as
those organised by IVAS (International Veterinary AP Society) or national groups in Europe
(especially Belgium and Denmark), combined with guided reading. Short courses are also
available in UK. However, because of our isolation from mainland Europe, it is difficult for
Irish vets to study AP. There are no formal training courses here and a lot of time and expense
is needed to follow courses abroad.
It takes more than a few weekend seminars to transform a novice into a master. You must
study for at least 60 hours of formal lectures and >400 hours of guided reading in the next
year or two if you hope to become a really competent acupuncturist. Even then, your skill and
success rate will improve with further study and practice of the technique, especially if you
combine it with other methods of healing.
The student of AP is advised to concentrate on a few clinical conditions, rather than attempt
to treat dozens of clinical conditions in the beginning. When the approach to a few responsive
conditions has been mastered and the vet is satisfied with the results, he/she may study the
approach to other conditions.
If you study it seriously for a year or two, it is relatively easy to learn the mechanical
approach to AP (the Cookbook method plus the Classic Laws of choosing points). Those of
you who regard medicine as a mechanical or physical therapy will get good results with
"mechanical AP". Your results will improve further when you combine different therapies
(including AP), as each new case indicates.
THE HOLISTIC APPROACH TO DIAGNOSIS AND THERAPY
The aim of all medicine should be to heal by the best methods available or, if these are
impracticable, by any method which gives the desired result with minimal side-effects.
The bases of effective healing are:
a. accurate diagnosis of the causes of the diseases and their removal, if possible and
b. enhancing the defence systems of the body to cope with the various challenges that the
organism meets.
a. Orthodox medicine has a very limited view of the causes of disease. Therefore, its
diagnoses are equally limited.
The concepts of holistic medicine have been discussed more fully elsewhere (5,6,7,8). The
holistic approach tries to assess how the external or internal environment may be changed
to help the health of the patient. Harmful electromagnetic fields may be neutralised or
eliminated; scars "obstructing the Channels" can be mobilised etc; diet can be altered or
supplemented; management errors in animal handling can be corrected etc.

b. By its nature AP is holistic, especially if practised in the more classical method, using the
laws of Choosing Points or the laws of Energetic AP (Pulse Diagnosis, Five-Phase Theory,
the Eight Principles etc (5,6,7,8).
AP works not only on the affected region, organ or symptom, but on the defence system of
the whole organism. It can not be compared validly with suppressive or symptomatic therapy
(aspirin/ analgesics/tranquillizer), nor with the diabetes-insulin dependence approach. In mild
diabetes, AP (at the correct points) helps to counteract any infection or mild inflammatory
changes in the pancreas, assists pancreatic function and helps the body to produce its own
insulin. The outcome of a successful course of AP in this case would be a patient who is kept
reasonably healthy by its own defence response. The patient is not dependent on exogenous
drugs or further AP ad infinitum to keep it healthy.
In our therapy, we must be ready to use whichever system or combination of systems which
we feel are necessary. In many instances, we will use the well-tried and usually successful
orthodox methods first. Only if they fail would the unorthodox methods be considered. In
other cases, where we know from past experiences that orthodox methods give unsatisfactory
results, we should be ready to try the unorthodox. AP is indicated in many of these cases.
One may decide to combine AP with medical therapy, say in acute infections. For example, in
acute pneumonia with fever, diluted antibiotic solutions may be injected at APs for the lung
(BL13; PC06; CV17; NX04; LU01 or 05 or 06) and at AP points for fever (GV14) and
immune response (LI04 or 11; ST36), so that the total dose of antibiotic is correct but many
active APs are also treated.
In the beginning, it is safer to use this combination method until one is reasonably advanced
in one's AP study. (From a research viewpoint, the combination method is not so satisfactory
as is makes it difficult to assess the value of AP in relation to the orthodox therapy). Later one
can use AP alone in suitable cases.
Drugs which may antagonise or reduce the effects of AP include: large doses of narcotics,
methadone, analgesics, corticosteroids, opiate antagonists (naloxone, naltrexone etc), alcohol,
tranquillizers or sedatives.
These drugs may antagonise or reduce the neural effects of AP at the level of the specific and
non-specific receptors in the brain, spinal cord and other target areas. Where possible, a
period of 24-28 hours abstinence from these drugs is advisable before AP treatment. Patients
on corticosteroid therapy should be weaned off steroids for some weeks before AP. Care
should be taken not to terminate steroid therapy too abruptly.
In certain circumstances, it may be necessary to administer sedatives or tranquillizers to
facilitate AP, for example in difficult patients (such as cats, vicious dogs or horses). The
alpha-2 agonist (opiate substitute) detomidine or medetomidine (Pharmos, Finland) is said to
enhance AP effects in horses and dogs. Administration of D-phenyl alanine (DPA) for some
days before AP analgesia in humans is said to enhance the depth of analgesia and to turn
"non-responders" into "responders".
Similarly, in AP analgesia, intravenous sedatives (diazepam etc) can be very useful
supplementary drugs. Also, small doses of general anaesthetic can be used with AP
analgesia (doses which would not adequate for good anaesthesia if AP was not given also).

In the treatment of withdrawal from cigarette smoking, a Dublin physician (Tom Elliott)
combined a mild dose of tranquillizer (Ativan, 1 mg/day) with press needles in the Earpoints
LU and ShenMen. His results were >80% successful at 4-5 weeks after commencement) as
compared with 45-65% success by other acupuncturists using the same points but no
tranquilliser.
In the treatment of human narcotic addiction, electro-stimulation of Earpoint "Lung" or the
mastoid processes has been very successful in detoxification without withdrawal symptoms,
but detoxification requires 4-8 days before urine tests are "negative" for the drug. A new
development (pioneered by H.L. Wen, Hong Kong) is to combine AP stimulation with
repeated i/v injection of naloxone. This reduces the detoxification period to about 10 hours.
(Naloxone displaces the drug very rapidly from the opiate receptors and AP prevents the
withdrawal symptoms by stimulating the release of endorphin, which had been inhibited by
the exogenous drug).
DEVELOPMENT OF INTUITIVE DIAGNOSIS AND HEALING
As I wrote the first version of this paper (1980), I was on holidays with my family in Fethard,
a fishing village on the South East coast of Ireland. A 7-year-old boy was drowned in a large
river a few miles away. The river is tidal and the drowning occurred while the tide was rising.
Dozens of fishermen with nets, grappling hooks, fishing lines etc dragged the river for 5 days.
They had the assistance of a diver also. The body was not recovered. A friend of the boy's
father knew of my unorthodox interests. He asked if I could suggest a diviner who might
locate the body. Next day, I brought the boy's father and his friend to Sgt. Neil Boyle, an
instructor in the Garda Training School, Templemore. This man is one of the most famous
diviners in Ireland. He does most of his divining in his own house by divining over a map!
Within minutes of our arrival, and working over an accurate navigation chart of the river, the
diviner got a reaction some 75 metres west of a fixed marker-buoy in the river. He said that
the body would be found there. The boy's father then exclaimed that the boy's teacher had
dreamed that the body was near there but the search party had not acted on this dream!
The search was switched to that area at 1900h on Friday night but was disrupted 3 times by
ships passing up the river. At about 2300h, one of the fishermen hooked a submerged object
but lost it. Early next morning, the body was seen floating on the surface of the river within
10 metres of the mark as indicated on the map by a man about 120 km distant from the spot!
The search was over. Was the diviner's mark a coincidence? Definitely not! This man has
located dozens of missing persons, alive or dead, using this technique. He usually knows
immediately if the missing person is dead. He has located them in lakes, rivers, the sea and on
land.
Development of intuitive diagnosis and healing was discussed in more detail elsewhere (7).
Those of you who already have some ability in this area (or who may be interested) will find
it very helpful to join groups or societies of professional colleagues (medical and vet) who
discuss these topics. Discussions with colleagues who know this reality can accelerate your
own growth in the area. AP is only one system! There are many others and combinations are
possible.

One such group is the Scientific and Medical Network, c/o: David Lorimer, Lesser
Halings, Tilehouse Lane, Denham, Uxbridge, Msex UB9 5DG, UK. (Fax: +44-1985835818; Email: Scientific and Medical Network @smnet.demon.co.uk, or,
100114.1637@compuserve.com)
If one wishes to grow in skill as a healer, one must continue to study many different methods.
Study must be a routine part of one's profession, despite the great difficulties that this poses to
private practitioners (and their partners and families!). What to study? There is so much in
orthodox literature that one could study specialist journals in one small area and never get
to the end! I would urge you, however, to read some unorthodox concepts, such as those on
osteopathy/chiropractic, homeopathy, food allergy, psychic phenomena, radiaesthesia. Even if
you can not yet accept their scientific validity, you will find them highly entertaining! Some
of you will know by "gut reaction" that their main claims are valid and you may be stimulated
to continue this aspect of your study in greater depth.
Special Interest Groups (SIGs) on Email and WWW: Those who want to explore the more
esoteric aspects of the psyche in healing can subscribe to SIGs on Email Lists (such as
CAM&VM, Holistic, INDHN etc; details on request), or visit specialist Home Pages on the
Internet (WWW), such as AltMed, AltVetMed, Dowsing Pages etc.
If one can improve one's intuitive or divining ability, it can be of great value in reaching a
detailed and accurate diagnosis as to the causes and nature of the problem. This gift alone
would be of great value. However, if one can also develop ones psychic (transmitting) healing
power, the healer and the patient are doubly blessed. There are a few who have these gifts. If
they are latent in you, please do not waste them. If (like me) you have mediocre talent in the
intuitive/psychic field, don't worry! The more rational pragmatic methods may be slower in
day-to-day use but they also give good results.
FOSTERING PUBLIC AWARENESS OF AP
TV and press coverage in recent years have informed most people that AP therapy and
analgesia for human surgery have definite roles in medical science. However, few people
know that AP is equally applicable in vet science. Research in humans and animals has shown
that AP is a powerful physiotherapy which involves reflex effects, humoral and
neuroendocrine effects (1,2,5,11).
While vets are learning the system and trying to integrate it into their approach to animal
diseases, they may not wish to enter into much discussion on the topic. Later, as they grow in
experience, they should gradually let their clients know that AP is just one more modality in
the fight against pain and illness. The mystique and magical image of AP, so often
exaggerated in the public press, should be dispelled. In its place, the concept of reflex
therapy (activation of the normal defence and healing systems of the body by the stimulation
of reflex points) should be fostered. If used properly, AP is the most powerful form of
physiotherapy. In incompetent hands, AP may give poor results and in the wrong hands, may
spread viral diseases (AIDS, hepatitis etc in humans; swine fever etc in animals).
Practitioners new to AP should replace the temptation to be over-enthusiastic with a more
pragmatic approach ("let us try it in this case"). Over-enthusiasm can lead to great
disappointment when failures occur.

AP, like every other attempt to fight disease, has its failures (2,15). It also can be a costly
system in terms of professional time. With orthodox vet medicine, many cases can be treated
by one or two visits, leaving appropriate medicines to the owner to administer when the vet
has diagnosed the case. This is not applicable with AP therapy, unless the owner has a TENS
instrument or Laser and is instructed in their use, or unless he/she is shown which points to
massage between sessions. In chronic cases, AP therapy often requires repeated therapy
sessions and these cost money. The owner should be warned of this, as some people expect
miraculous cures after one or two sessions!
In many western countries, physicians and vets, especially those in the academic life, have a
strong scepticism towards AP. Some are definitely prejudiced against AP. This is largely due
to lack of knowledge on the types of conditions which respond to AP and to the mechanisms
involved. We should discuss these topics with our colleagues when suitable opportunities
arise and we should be prepared to assist them in their search for factual data and research
information, should they require this.
It is very helpful to the practitioner and to those colleagues who may require clinical
information to keep accurate records of all cases treated by AP. These records should
contain details of the clinical examination, the diagnosis, the AP method and the APs used,
any other medication used, the dates of treatment and the outcome of the case. If 20-40 vets in
each country kept notes of their cases, very valuable information could be made available to
their AP society as well as to their State Vet Schools after 1-2 years. I strongly urge you to
organise such a study as a group.
CONCLUSIONS
Integration of AP into your practice will take time and patience. You will need to study AP
well and to foster public awareness of its value and mechanisms. Explanation of AP
mechanisms in terms of reflex action via the neuroendocrine system is more acceptable to
academic colleagues than those based on theories of intangible, undefined Life Forces (Qi).
In your early attempts at AP, it is advisable to choose just a few conditions which interest
you. Learn the approach to these in depth before you attempt to treat new conditions.
If you do not wish your clients and colleagues to know that you are attempting AP methods,
you can adapt ultrasound, electrostimulation and laser therapy with little difficulty. You can
also use point injection with good success. As you grow in experience, it will be better for you
(and for the acceptance of AP as a valid system) if you let your clients and colleagues know
that you are using the Chinese system.
Integration of AP analgesia as a routine preparation for surgery is not likely to become
popular in the West. However, it may be considered in high-risk patients, shock victims and
Caesarian section. The analgesia and obstetric effects of lumbosacral points in bovine
dystocia and bovine prolapsed uterus require no electro-stimulation and could become
routine.
A Chinese parable says: "What can a frog in a well know of the outside world?". There is a
mighty universe around us! Can we see it all? Can we feel it, taste it , touch it and smell it all?
Can we "weigh" (measure) the Energy of Life? I don't believe it! I believe that there are other
ways of knowing reality. To grow in knowledge and skill requires study and practice. I urge

you to study unorthodox as well as orthodox concepts. In particular, I urge you to read on
psychic methods of diagnosis and healing and to experiment with these systems together with
your orthodox methods and other therapeutic systems.
Therefore, I urge you to continue your studies, especially in areas of unorthodox concepts.
Study and experiment with the area of psychic phenomena such as dowsing or divining in
relation to healing. These methods are as applicable to animals as they are to humans. Some
of you may possess ability in these areas. I believe that the best therapy will consist of a
sound mechanical approach plus the extra benefits of the psychic approach.
REFERENCES
Further details of AP are in other lectures by the author. These and other manuscripts are
based on material presented in 1980 to the teaching seminar at the Veterinary College in
Helsinki, organised by Jukka Kuussaari. Most have been updated since 1990.
AP is a highly integrated system whose concepts and philosophies are strange to Westerners
at first. Thus, Western students of AP should read and re-read these concepts until they
become familiar with them.
The lectures, listed below, cover many traditional (classical) and modern (scientific) aspects
of AP and related topics. This set of lectures will help students of AP to get the "feel" for
subject. They complement lectures given at IVAS, BVAS and other organised training courses
on AP.
Vet or Medical colleagues are most welcome to use this material for study or teaching
purposes but the author reserves copyright and does not wish others to use this material for
commercial publications. All the papers starred (*) are in one publication (Acupuncture in
Animals, Proc 167, 548 pp) available from The Postgraduate Committee in Veterinary
Science, University of Sydney, 280 Pitt St., Sydney South, NSW, Australia 2000. Those not
starred are available from the author:
1*. A brief History of AP and the Status of veterinary AP outside mainland China
2*. Effects of AP on the Defence Systems and conditions responsive to AP (1980) and AP for
immune-mediated disorders (1991).
3*. The Study of AP: Points and Channels in Animals.
4*. The Study of AP: Sources and Study Techniques.
5*. Traditional versus modern AP.
6*. Holistic Concepts of Health and Disease.
7. Psychic methods of Diagnosis and Treatment in AP and Homeopathy
8*. The Theory of the Five Phases and its uses in medicine.

9*. The Choice of Points for AP Therapy (1980) and the Choice of AP Points for Particular
Conditions (1984).
10*. Techniques of stimulation of the AP Points.
11*. AP analgesia for surgery in animals.
12*. Clinical AP in the horse (2 papers + appendix).
13*. AP in Cattle and Pigs.
14. AP in Small Animal Practice.
15*. Clinical Experiences with AP: Failures and Successes.
16. Physiotherapy, Homeopathy and AP in the Treatment and Prevention of Lameness and the
Maintenance of peak Fitness in Horses
17*. Advances and instrumentation in the diagnosis and treatment of trigger points in human
myofascial pain: veterinary implications
18. Treatment of Back Pain in the Horse and Dog by AP
19*. Computer Applications in the Study and clinical Use of AP
20*. Serious complications of AP... or AP abuses?
21. Clinical use of low level Laser therapy.
QUESTIONS
Channel codes used in these questions are: LU, LI, ST, SP, HT, SI, BL, KI, PC, TH, GB,
LV, CV, GV.
1. One of the following statements is not correct. Indicate the incorrect statement:
(a) Acupuncture (AP) is a reflex phenomenon with therapeutic value.
(b) AP points (APs) and Channels (AP meridians) have many applications in routine
veterinary practice.
(c) AP has little or no diagnostic value.
(d) Irritated organs/functions cause reflex changes in sensitivity to pressure, heat and
electrical current at specific zones on the body surface (the APs).
(e) Adequate stimuli (needling, injection etc) applied to the APs can influence the
pathophysiology of the affected organs and functions.
2. One of the following statements is not correct. Indicate the incorrect statement:

(a) A 16-hour intensive crash-course is enough to allow you integrate AP fully into your dayto-day practice.
(b) Point injection is the fastest AP method and gives good results.
(c) The reflex (neurally-mediated) mechanisms of AP are easily shown by experimental
chemical or surgical interference with neural transmission in the peripheral nerves, spinal cord
or midbrain or by sympathectomy.
(d) In its purest form, AP involves an holistic concept of the organism in relation to its
internal and external environments.
(e) TCM involves the manipulation of Vital Energies (Qi), some of which are only hinted at
in occult or esoteric literature (the Aura, the Etheric body, Kundalini, Prana etc).
3. One of the following statements is not correct. Indicate the incorrect statement:
(a) Each AP point has a Chinese name, an alpha-numeric code and an anatomical location.
(b) The cun is half of distance between the nipples
(c) TsuSanLi (FootThreeMiles, ST36) is 3 cun below the patella, 1.5 cun lateral to the tibial
crest in adult humans.
(d) Trigger Points (TPs) are always AhShi points AhShi points are not always TPs.
(e) Many different nomenclatures are used for the APs. Novices should cross-check the
nomenclature in each new reference with that in their standard reference text.
4. One of the following statements is not correct. Indicate the incorrect statement:
(a) Laws of Choosing APs for therapy include: sensitive points; TianYing points;
combination of Local and Distant points; points along affected and related Channels; Ear
Points and APs not on the main Channels
(b) Laws of Choosing APs for therapy include: symptomatic points; points along the affected
nerve path; "Fore and Aft" points; points encircling the area; a point on each of the 4 limbs;
Master Points
(c) Master Points include Mu-Shu, Yuan-Luo and Xi points
(d) The Mu-Shu is the Source-Passage combination and the Yuan-Luo is the AlarmAssociation combination
(e) Point injection is the fastest and most practical method of AP
5. One of the following statements is not correct. Indicate the incorrect statement:
(a) DeQi (Teh Ch'i, the Arrival of Qi) is the classical sensation of paraesthesia induced by
needle manipulation in the correct points

(b) Where possible, to obtain DeQi, one should peck-twirl the needle for 10-15 seconds, at
least after needle insertion and before withdrawal
(c) Solutions suitable for injection-AP include 0.9% saline, 0.5% local anaesthetic solution in
0.9% saline, B12, Sarapin or homoeopathic solutions.
(d) Injection-AP is ideal for cases in which need intramuscular injection of therapeutic agents
(e) Strong stimulation of GV26 + KI01, in combination, can not resuscitate comatose cases
refractory to orthodox therapy
6. One of the following statements is not correct. Indicate the incorrect statement:
(a) Before AP-treatment of animals, the patient is searched for pain-points (points which are
tender to palpation)
(b) All pain-points should be marked or noted for future reference
(c) It usually is possible to distinguish locally sensitive AhShi points from genuine TPs in
animals
(d) Prime indications for novice vet-AP therapy in Cattle are hormonal infertility, dystocia,
and repositioning of uterine prolapse
(d) Prime indications for novice vet-AP therapy in Small Animals are conjunctivitis, rhinitis
and gastrointestinal disorders
(f) Prime indications for novice vet-AP therapy in All Species are hip lameness; shoulder
lameness; low-back syndrome; muscle cramp, soft tissue lameness; anaesthetic emergencies;
nephritis, cystitis
7. One of the following statements is not correct. Indicate the incorrect statement:
(a) Main APs for obstetrics/uterine reposition are: GV02,03,04, BL32,53, AhShi points at or
near BL23,24,26,31,33,34,54
(b) Main APs for hormonal infertility are: YungChi (near BL26); AhShi points in the
lumbosacral area (in the area BL23-34 and BL52-53)
(c) Main APs for conjunctivitis/rhinitis in small animals are: LI04,20; BL01; GB01,20:
ST01,02; LV03; TH23; Z 03,14; GV23,25.
(d) Main APs for small animal indigestion are: PC01, ST45, CV01, BL07.
(e) Main APs for small animal gastroenteritis, constipation and colic include TH06, BL25,27,
CV04,06, ST25
8. One of the following statements is not correct. Indicate the incorrect statement:

(a) Main APs for hip lameness are: AhShi points in lumbosacral area, buttocks, hip, thigh and
gastrocnemius muscles; GB30,31,34; BL23,40; LV08,11.
(b) In hip dysplasia in dogs, gold-bead implants are excellent but simple needling gives no
worthwhile results
(c) Main APs for shoulder lameness are: AhShi points in the neck, upper limb and upper
thoracic area; BL11; GB21; SI09-14, LI04,11,15,16; TH05,14,15
(d) Main APs for low-back syndrome are: AhShi points from the lumbosacral area to the
hock; X 35 (HuaToJiaJi points) near vertebrae L1-S4; GV02,03,04;
BL23,25,27,31,52,40,60; GB30,38
(e) Main APs for muscle cramp, soft tissue lameness are: AhShi points + main points for
the affected regions. Treat acute cases every 3-7 days for up to 8 sessions. Expect results by
the 3rd session in acute cases and by the 4th-5th session in chronic cases
9. One of the following statements is not correct. Indicate the incorrect statement:
(a) GV26, the most important emergency point, is in the dorsal midline at the occipitoatlantal
junction
(b) KI01, another emergency point, is behind the hind toes, between the pad and toes in dogs
and between the claws in cattle
(c) In apnoea and respiratory arrest, strong stimulation of GV26 + KI01 for 10-60
seconds gives >90% response
(d) Main APs for nephritis are: BL22,23,58; GV03,04; SP06,09; ST25; GB25; KI03 and for
cystitis are: BL28,52,58; CV03,04; KI02,03; ST28. In both cases, add AhShi points in the
lumbosacral and low abdominal area.
(e) In cardiac arrest, strong stimulation of PC06 + GV26 + KI01 for 10 minutes gives
>70% response
10. One of the following statements is not correct. Indicate the incorrect statement:
(a) AP is clinically successful in >60% of chronic nephritis, with marked fibrosis
(b) In nephritis, include symptomatic APs for major symptoms (vomiting etc)
(c) The disadvantages of AP analgesia may prevent its use in routine surgery, except for
patients with high anaesthetic risk, or in Caesarian sections on very valuable dams.
(d) AP analgesia for surgery may need supplementary local anaesthesia in 10-30 % of cases
(e) An indwelling i/v catheter should be placed before surgery is attempted under AP
analgesia
11. One of the following statements is not correct. Indicate the incorrect statement:

(a) One may decide to combine AP with medical therapy, say in acute infections
(b) In acute pneumonia with fever, diluted antibiotic solutions may be injected at APs for
the lung (BL13; PC06; CV17; NX04; LU01 or 05 or 06) and at AP points for fever (GV14)
and immune response (LI04 or 11; ST36)
(c) Until well advanced in one's AP study, novices should use AP combined with other
therapy in serious cases
(d) Drugs which may reduce the effects of AP include: large doses of analgesics,
corticosteroids, narcotics, methadone, opiate antagonists, alcohol, tranquillizers and sedatives.
(e) High-dose steroid therapy should be terminated abruptly 2 days before AP therapy
12. One of the following statements is not correct. Indicate the incorrect statement:
(a) It may be necessary to administer sedatives or tranquillizers to facilitate AP, for example
in difficult patients (such as cats, vicious dogs or horses)
(b) The alpha-2 agonist, detomidine or medetomidine, is said to enhance AP effects in horses
and dogs.
(c) Administration of D-phenylalanine for some days before AP analgesia in humans
abolishes the analgesic effect of AP and turns "responders" into "non-responders"
(d) In AP analgesia, intravenous sedatives (diazepam etc) can be very useful supplementary
drugs
(e) Use of AP analgesia for surgery greatly reduces the doses of general anaesthetic needed

1=c 2=a 3=b 4=d 5=e 6=c 7=d 8=b 9=e 10=a 11=e 12=c

THE TAIWAN REPORT

SUMMARY
Section 1 summarises the trip schedule between November 13-28th, 1982.
Section 2 summarises the present status of Chinese medicine in Taiwan. Acupuncture (AP) is
only one part of Chinese medicine, which also includes "Western" medicine, moxibustion and
herbal medicine.
AP and allied techniques, as seen there, are discussed under various headings: simple
needling versus electro-AP, the use of AhShi ("Ah Yes!", sensitive) points, myofascial
syndromes and AhShi points, Earpoints, Local points, Distant points, methods of needling,
quick needling of AhShi points, the DeQi (Teh Ch'i) phenomenon, personal experience of
"needle sensations", moxibustion, cupping, AP in paralysis/paraplegia. Scar therapy was not
seen during this trip. It is discussed in the hope that it may stimulate interest in this valuable
therapy.
Section 3 discusses 49 of the clinical cases observed at the Veterans' General Hospital, Taipei
(VGH) and China Medical College, Taichung (CMC). Many other cases were observed, but
details were not noted. Most of the cases presented for treatment involved pain syndromes but
I was assured that many syndromes other than pain are also treated successfully. The great
majority (69%) were helped markedly or moderately by AP in 1-20 minutes.
Cases are discussed under: multiple aches and pains, tension, insomnia, neurasthenia, pain
following traumatic injury, head and neck stiffness/ pain, shoulder pain/stiffness, upper limb
pain, respiratory difficulty, lowback pain/stiffness + sciatica, lower limb problems, post-CVA
cases.
Section 4 discusses AP research in Taiwan under the main centres and topics for research
listed in the literature and Symposium abstracts, which were made available to me.
Section 5 discusses AP training in Taiwan. Courses in English are available for foreign
professionals. Emphasis ranges from classical (traditional) concepts to modern concepts of
neurophysiology and trigger point therapy, depending on the teaching body and the type of
course chosen.
What one sees and hears during a 2-week trip is automatically biased by the observer and by
the people and places visited. It may not represent the real day-to-day situation of the whole
country. Nevertheless, my report may interest open-minded Westerners to go and see for
themselves.
1. SCHEDULE
Nov 13th: Aircraft Dublin-London-Dubai-Hong Kong.
Nov 14th: Landing in Hong Kong Airport was exciting ! Had I not known that this is one of
the world's most tricky landing places, I might have thought we were crash-landing in the
centre of the city! Coming in, after dark, the aerial view of the city, with its millions of street

lights and multi-coloured advertisements, was astonishing. After a 2-hour stop, I got the China
Airlines flight to Taipei.
On arrival at Taipei, I heard my name called. What had I done ? No! It was to report to the
Airport Authority for VIP treatment! I was whisked through Customs and Immigration before
I could say "Jack Robinson".
Dr. Jen-Hsou Lin met me at the Arrivals Hall and he had arranged transport to the city. My
first impression of the city was the chaotic traffic. Thousands of motor bikes, cars, trucks,
bicycles and pedestrians seemed to converge on intersections. Drivers who stay accident-free
in Taipei must be among the best in the world.
Then Dr. Lin pointed to the Grand Hotel. It is a wonderful sight, a huge hotel in magnificent
Chinese style, perched on top of a hill and fronted by a beautiful Chinese gate. So this was
Taipei! The car swept up to the main door. We entered the lobby. What a sight! It must have
been 50 m x 50 m - the most impressive hotel lobby I have seen. The architecture, sculpture
and decoration was quite unlike anything in my previous experience.
Nov 15th: A lazy day, spent relaxing with Dr. Lin, his wife and children. We visited Yang
Ming Mountain, in beautiful sunshine. The weather was like high summer in Ireland. (I had
left Dublin in wet cold November weather).
Nov 16th: Down to business. Discussions with Dr. Lin about his work in the Department of
Animal Husbandry, National Taiwan University. Introductions to his colleagues and some of
his students. Afternoon with Dr. Chien Chung in the AP Department, Veterans' General
Hospital, Taipei (VGH).
Nov 17th: Attended lectures by Chung at the Chinese AP Research Foundation (CARF)
Headquarters, Taipei. The lectures were on his research and clinical effects of needling AhShi
points, and on his use of YangLingQuan (GB34) in pain control in acute traumatic injury.
These were excellent lectures and were listened to attentively by a group of visiting M.D.'s on
a CARF training course. Lunch with Chung. Afternoon in the AP Department, VGH.
Nov 18th: Discussions with Dr. Lin at his laboratory. We attempted our first AP analgesia test
in the cow. It was 90% successful (see later). Afternoon in the VGH. Lectures to Dr. Lin's
students.
Nov 19th: Opening of the Taipei AP Symposium. Evening Banquet and Kampe!
Nov 20th: Symposium. Banquet and more Kampe!
Nov 21st: Symposium closed at 1700h. Banquet and still more Kampe
Nov 22nd: Trip to China Medical College, Taichung (CMC). Stayed at Lucky Hotel. Banquet
and Kampe, Kampe!
Nov 23rd: Veterinary AP Seminar, Taichung Vet School. Another banquet. Kampe, Kampe,
Kampe! I'll never survive this!

Nov 24th: Visit AP Department, CMC. Return to Taipei. Farewell to Drs. Ha, Hand,
Pomeranz. Stay at YWCA! Dinner at the home of Dr. Lin and his family.
Nov 25th: Pig Research Institute, Chunan. Lecture to Institute staff and local vets. Evening
meal with Dr. Lin's co-workers (Chang Chia, Shieh Meei Hwa, Tsou Li Mei, Ms. Wang and
Chin Sun).
Nov 26th: Visit Dr. Sun at the Yang Ming Medical School. See Dr. Ha's research facilities
there. Afternoon in Chung's Department, VGH.
Nov 27th: Very relaxing day, driving around the Northern coast of Taiwan. Fishing and
seafood. Our host was Eddie Tsang. Sulphur baths at Yang Ming Mountain. Final banquet
(Mr. Tsang).
Nov 28th: Sad farewell to Jen-Hsou and Li-Fei Lin. Flew Taipei-Singapore-London-Dublin.
Composed my poem "Taiwan" on the back of the Qantas menu card, leaving Singapore. This
poem is dedicated to Jen-Hsou and Li-Fei Lin as a gesture of thanks for their friendship and
hospitality and as a memory of a beautiful land and its people.
2. CHINESE MEDICINE IN TAIWAN
Four afternoons were spent at the AP Department, VGH, one morning session at CARF, two
sessions at the AP Department of CMC and one morning at the Yang Ming Medical School,
Taipei. The case load for AP in VGH and CMC clinics was said to be 100-150 patients/day.
The following section is based on personal observations in the clinics and on discussions with
Drs. Chien C. Chung, Han Ping Lee, Ming T. Lin and Wei Tse Hsiung (VGH), and Drs. Hong
Chien Ha, Chung-Gwo Chang and R.T. Chiang (CMC) and Dr. Albert Sun, Yang Ming
Medical School, Taipei.
1. Chinese medicine, as practised in Taiwan, combines the best of "Western" and
"Traditional Chinese" medicine. Some doctors are trained in "Western" medicine, some in
"Chinese" medicine and some in both systems.
2. Traditional Chinese medicine (TCM) involves study of AP, moxibustion and HERBAL
MEDICINE. The latter is most important. Although medical theory (Yin-Yang, Five Phases,
Perverse Causes of Disease, Disease Syndromes and Diagnostics) is the same for all
branches of TCM, some herbalists do not know AP and some acupuncturists do not know
herbal medicine.
The Chinese herbal pharmacopoeia is very extensive. Some of the plants are cultivated locally
and processed in special pharmacies, such as in the CMC. Some of the herbal medicines are
imported in crude or processed forms. I did not witness the use or efficacy of these medicines,
but I was told by many doctors that they are very powerful and (when used by experts) are
extremely valuable in conditions as diverse as CVA, hypertension, neurasthenia and many
other internal diseases. Western doctors (and vets!) have much to learn about these medicines.
3. AP and allied techniques in clinical practice: Considerable variation exists in the choice
of points for therapy and in the methods of manipulating the needles. In general, I saw very
little use of electro-AP (although the stimulators were freely available in every clinic visited).

There was general agreement that manual needling alone was as good as, or better, than
electro-needling for most conditions requiring AP. Exceptions are (a) in AP analgesia
before surgery (not witnessed) and (b) in certain chronic conditions, especially
paralysis/paresis after CVA or nerve injury.
3.1. AhShi points: AhShi means " Ah Yes, or Ouch!", the exclamation from the subject when
a painful point is pressed. The best AhShi point for therapy is the Trigger Point (TP), i.e.
palpation pressure on the point causes a pain sensation to radiate to the problem area,
muscle, or organ. It is seldom located in the area of pain. Patients usually are unaware of its
presence until it is palpated. Other pain-sensitive areas (motor points, "fibrositic nodules",
local pain-points etc) may be useful in therapy but they are not as powerful as the TPs (the
"real AhShi" points).
Great emphasis is placed on a careful search for AhShi points. These are usually present in
pain conditions, such as headache (esp. neck and shoulder muscles), joint pain (shoulder,
elbow, lowback syndrome, hip, knee) and myofascial syndromes. They may also arise in
some cases of internal disease (lung, heart, liver, gall bladder, g/i/t, g/u tract). In internal
disease the Shu points (organ reflex points on the BL Channel (paravertebral)) are carefully
palpated, as are the Mu points (Alarm points on the abdominal/thoracic area). All pressuresensitive areas are AhShi points but AhShi points are not always Trigger Points (TPs)!
AhShi points may be located near to or far away from the problem area. AhShi/TP points can
recruit new triggers elsewhere, usually in the muscles. Painful areas in scarred tissue may
also act as powerful TPs and these areas must be treated to obtain optimum results. Little
emphasis was placed on this fact (see section 9 below).
AhShi therapy is the best introduction to the value of needle therapy. Unfortunately,
AhShi points are not present in every case, and Western doctors who know only the AhShi
method are unable to help by needle techniques in such cases. AhShi points disappear when
the condition resolves and the disappearance of AhShi points during a course of therapy
indicates a good prognosis.
Chung did extensive clinical research with AhShi points and published the English version of
his book (C. Chung (1983) "AH SHIH Point: The pressure pain point in AP: Illustrated guide
to clinical AP", Chen Kwan Book Co., Taipei). This book alone would enable Western MD's
(and vets) who know little or nothing about AP to begin AhShi therapy immediately and to
get very good clinical results from it. (Although AhShi therapy sometimes gives better results
than traditional AP, it was agreed that even better results can be got if a proper study of the
AP system is made).
3.1.1. Myofascial syndrome and AhShi points: Chung defines the syndrome as one
involving muscle pain/stiffness, especially around joints. The joints often are stiff, but show
no inflammatory or X-ray lesions. There often is a history of intermittent recurrence. AhShi
(TP) points often are present, but the patient is unaware of them until they are pressed. The
diet usually is satisfactory and the neural causes of the pain are obscure.
The AhShi points usually show decreased electrical resistance and decreased local skin
temperature. Local vasomotor abnormalities and dermatographic changes occur in the AhShi
area.

Histology of the AhShi area shows local cell infiltration and non-specific inflammatory
changes. There is sometimes a fibrous infiltration of the AhShi area (ropy muscle sign).
Pressure on the AhShi often refers pain to the "problem area". Needling the AhShi often
causes the "Jump Sign"; local muscle contractions cause the needle to jump.
Chung emphasises that some acupuncturists needle the problem (local) area i.e. the area of
referred pain. This is inferior AP (although it can help). Much better results can be obtained
by a careful search for the TP (AhShi point). In myofascial syndromes, AhShi therapy can
give dramatic (and often immediate) relief of pain. AhShi therapy in these cases can give
better results than traditional AP using local and distant points.
AhShi points may arise anywhere in the muscles, but they are often near the problem area.
The most important muscles to search for upper body problems are: the neck muscles,
infraspinatus and GB21 area. For lower body problems search the gluteus, vastus medialis,
soleus, gastrocnemius. In upper limb pain (shoulder, elbow, arm, etc) the AhShi is often in
the infraspinatus of the affected limb. In shoulder pain, the AhShi may be in the GB21 area,
or scalenus muscle. In bilateral anterolateral shoulder pain, the AhShi is often in the
sternalis muscle. In such cases, one needle in the sternal AhShi can give immediate pain
relief. In abdominal and intercostal pain, check the back and sides for AhShi. In heel pain,
the AhShi is often in the soleus area, left or right of BL57. In plantar pain, the AhShi is
often in the gastrocnemius. In middle finger pain, search muscles near TH08. In
lowback/leg pain, search the gluteus muscle.
About 33% of all cases of aching pain are myofascial in origin and respond fast and reliably
to AhShi therapy. Expect excellent results in 38% and good results in 60% of cases (98% total
cases). Disappearance of the AhShi is an excellent prognostic sign.
Chung's AhShi findings agree well with Western experiences of TP therapy, as described by
Ronald Melzack (Canada), Pekka Pontinen (Finland) and Alex Macdonald (UK).
Miscellaneous (Chung):
Renal colic pain/spasm: GB34, LV03, SP04,06
Gastric colic/pain/spasm: ST36, CV12
Biliary colic/pain/spasm: GB34
3.2 Earpoints
I did not observe a single case of ear-AP. However, I was told by some local doctors that
earpoints are sometimes used alone or in combination with body points, with good success
(see Symposium report also).
3.3 Body points
a. The most commonly used points seen in use were the Channel points, especially LU07,
LI04,10,11,15, ST25,36,37,38, SP04,06,09, HT07, SI03,06,09,11,19,
BL10,11,23,40,57,60,62, KI03, PC06, TH05,14,15, GB20,21,30,31,34,39, LV03, CV04,12.
(GV points were seldom seen used. GV15 (YaMen), needled 2" deep in one patient, appeared

to cause a very severe left-sided headache, needle shock and some loss of power in the legs.
The patient, an elderly lady, was being treated for facial paralysis and slurred speech
following a minor CVA. She was most unhappy when questioned by me about one hour after
treatment. (See CVA, later).
b. Extra-Channel Points (points not on the main Channels): These points often were used
for their local or distant effects. The most commonly observed were Hand Points "Loin &
Leg" between the proximal heads of metacarpals 2-3 and 4-5 respectively. These Hand Points
gave immediate relief in some cases of lumbago and lowback/leg pain. Hand Point "Neck"
(between the knuckles of fingers 2-3 with fist tightly closed, needled 1" deep towards the
wrist. This point gave immediate relief of neck pain/restricted movement in one patient.
Other Extra-Channel points used were: LanWei (Appendix point) in abdominal
pain/constipation, XiYan (Knee Eyes) in knee pain, YinTang (between eyebrows) and
TaiYang (temporal fossa) in headache, sinusitis.
c. Distant points: Distant points are often used in VGH (and to a lesser extent in CMC). The
clinical response to needling distant points (when no local points are used) can be dramatic
and cannot always be explained by short reflexes. It is known that a stimulus via one spinal
nerve may activate reflex responses in areas innervated by up to 6 segments above or below
the input nerve. Examples are the use of the points "Loin and Leg" or "Lumbar Area" (on
the dorsum of hand) or SI06 to treat lowback/leg problems; ST38, GB39 or GB34 to treat
shoulder or neck problems; LU07 in headaches. The use of TH03, SI03, Hand point "Neck"
is not so inexplicable in neck/shoulder problems because the innervation is related to these
areas.
In myofascial and some arthrotic syndromes, Chung prefers to use Distant rather than Local
points. If patient is not helped within 20 minutes, the needles may be left in situ for up to 40
minutes and other points (AhShi, local points) may be tried also.
4. Needle Manipulation
All operators were very careful to cleanse the skin (alcohol swab), use sterile needles
(disposable in VGH) and to touch only the handle (not the body) when inserting the needle.
Styles of inserting the needle varied between operators. In general, staff at VGH inserted the
needle while twirling vigorously clockwise and anticlockwise until the skin was penetrated,
and then the needle was advanced with less twirling. "Sparrow pecking" (up and down
movement) was fast and strong, often combined with some twirling.
Vigorous needle twirling and pecking was continued for 5-30 seconds until definite "DeQi"
was reported by the patient and the visible signs were observed by the operator.
In contrast, Dr. R.T. Chiang (CMC) inserted the needle through the skin with one, deft halftwirl and push. He then advanced the needle with minimal, if any, twirling to its correct depth.
His sparrow-pecking and subsequent twirling was slower and more deliberate than in VGH.
He also scratched the handle vigorously and "went around the clock" (moved needle handle
like the hands of a clock through 360 degrees) once or twice, to get DeQi. He told me that the
classic (traditional) methods of needle manipulation ("tonification" and "sedation"
manipulation) are very important in difficult cases. (Staff at VGH do not appear to put
importance on the classical needle manipulations used to tonify or sedate Qi).

In both hospitals, needles usually were left in position for 15-30 minutes (estimated average
20 minutes). In VGH, some twirling and pecking was repeated just before needle removal.
This was mainly to ensure that the needle was not "caught" in the tissues and to avoid rough
removal of a "caught" needle. In contrast, at CMC, a quick check that the needle was "free"
was followed by gentle removal of the needle.
At VGH, a cotton-bud was used to apply pressure at the point for a few seconds after removal,
to prevent local pinpoint bleeding.
4.1. Needling AhShi/TP points: This was one exception to the 20-minute needling time.
Chung twirled the needle and pecked very strongly for 15-60 seconds. The patient often had
very strong reaction to this (grunts, slight groans, facial grimaces etc). In many cases, the
needle was removed within the 15-60 seconds. To my amazement (and that of other
observers) the pain or stiffness which the patient had reported before needling seemed to have
disappeared (as judged by the consternation or smile on the patient's face and/or visible and
marked improvement in neck/shoulder/lumbar/knee movement)!!
The immediate responses seen after AhShi needling in some patients at VGH were hard to
believe but I witnessed them many times (see case notes later). This is certainly similar to the
Huneke "Sekunden phanomen" (instantaneous phenomenon) and is a typical reaction to TP
therapy (Melzack, Pontinen, Macdonald, Lewit ). See Section 9. I was told that similar
responses are not uncommon at CMC but I did not witness any there, probably, because the
total number of cases I observed there were much less than in the VGH, due to shortage of
time to stay at CMC.
5. DeQi
All experts agreed that it is essential to get DeQi if the best results are to be obtained in
needle therapy. In Chinese medical experience, DeQi is known to have subjective (patient),
subjective (operator) and objective characteristics.
5.1. Patient's sensations: The patient reports strong sensations running, proximally, or
distally from the needle. Sometimes the sensation is said to travel proximally and distally.
The sensations are described as: "sore", "heavy", "tingling," "electric shock-like", "running",
"aching" (but not painful). The observable reactions of the patient at this time included grunts,
groans, flinching of the limb or part being needled, explosive intake or expulsion of breath,
facial grimaces and occasionally (in strong reactors) sudden jerks involving all or part of the
body, and occasional expletives.
During the Symposium, I was needled at left LI10 by a Master. This man claimed that with
really expert needle use, the PCS sensation should be felt not only along the needled Channel
(LI Channel goes from index finger to nose) but also into its following Channel (ST follows
LI, goes from eye to second toe via nipple and anterolateral knee). I felt the classic DeQi
sensations and reacted as a typical strong reactor, as described above and in 5.3 below.
However, the sensation travelled a maximum of 6" upwards, whereas it travelled distally to
the dorsum of the hand and was most marked in the 6" below the point. After 3-4 minutes, the
palm of my left hand became very cold and sweaty. My right palm was (normally) warm and
was sweating less than the left. I had no queasiness, nausea or other signs of needle shock.
The dull ache (6" above, to 6" below LI10) persisted about 2 hours afterwards. The point was

slightly sensitive to local pressure for 2 days afterwards. I have needled many AP points on
my body, obtained DeQi most times but without such a strong PCS reaction.
5.2 Operator's sensations: The operator usually has the sensation that the needle is being
gripped by the tissue, i.e. especially on withdrawal of the needle, (when a definite "nipple"
seems to form at the skin surface) or on twirling of the needle (when the needle seems to
"lock" at the end of each twirl).
5.3 Objective signs of DeQi are the "nipple" and the patient's reaction. After a few minutes, a
definite zone of hyperaemia (1-3 cm diameter) may appear around the needle in some
patients.
5.4 Propagated Channel Sensation (PCS): When needled correctly, certain ("sensitive")
patients claim to feel the sensation (PCS) radiating along most or all of the Channel. Some
also report sensations radiating to the organ controlled by the Channel! Chung stresses that
correct needling of the AhShi point almost always sends strong sensations to the problem
area, muscle or organ.
5.5 Over-stimulation of points such as LI04, ST36, etc can cause "needle shock" (weakness,
dizziness, nausea, vomiting, fainting, syncope, etc).
6. Moxibustion
Although Moxa was available in all clinics, it was not seen in use except once or twice. This
is because (a) the smell of moxa smoke is a nuisance in a crowded clinic, and (b) patients are
shown by the nurse how to apply moxa at home. The points for moxibustion (if required) are
circled with biro or felt pen. Moxa is considered helpful in: Asthma, chronic G/I problems,
general malaise, physical development problems (ill-thrift), arthralgia, rheumatism, obstetrics
(to turn the baby in-utero) moxa BL67.
7. Cupping
Was not observed in VGH. It was seen in two cases in CMC. It was applied for 1-3 minutes
(over the needles) until the skin became red-purple. The cups were then removed but the
needles were left in situ for the usual 20 minutes. Both were cases of lowback syndrome and
the cups were applied bilaterally in the area of BL23-34 (4 x 2 cups in one patient and 3 x 2 in
another).
8. AP in paralysis/paraplegia
At both VGH and CMC, workers told me that AP and herbal medicine can greatly help many
patients suffering from paralysis as a sequel to CVA or in peripheral paralysis due to trauma.
They also mentioned facial paralysis as being a good indication for AP. The number of
patients which I observed being treated for post-CVA paralysis was small - one in VGH and
two in CMC. There was general agreement that sensory paralysis on the affected side
abolishes the needle sensation (DeQi) and there is little value in needling the affected side. In
that case, needles are put in the unaffected side at key points such as GB34, ST36, BL40,
GB30, LI04, TH05, LI11, GB20,21. Facial paralysis, slurred speech or absence of speech,
etc are treated by local needles. GV15 (YaMen) is a dangerous point (mutism) if needled too
deeply. Scalp motor points on the contralateral side are often combined with body points.

9. Scar therapy
"Anything that happens along or near the course of a main Channel influences that Channel
and the organ that bears its name" (Felix Mann).
Many authors emphasise the role of scars as causes of referred pain, functional disorders and
(in late stages) organ disease in man (1,5,6,7,8,9) . Scars also may cause similar problems in
animals (2,3). In Germany, scar therapy (especially scar infiltration with procaine solution)
has been used for decades to relieve pain and other disorders triggered by the scar (4). The
relationship was observed quite independently of AP. The reaction to scar injection was often
instantaneous. Problems which had existed for months or years disappeared in seconds, the
"Sekunden Phanomen" of Huneke (4).
Acupuncturists have noted that injuries, bruises, or bad scars (especially if heavily fibrosed,
twisted or keloid) along the course of a Channel may cause functional symptoms associated
with the Channel or its organ. If the scar remains untreated, the symptoms may progress to
physical (organic) pathology of the organ. Furthermore, the Channel above and below the
scarred Channel ("mother" and "son" in the Qi cycle: LU - LI - ST - SP - HT - SI - BL - KI
- PC - TH - GB - LV - LU) may be involved as a secondary effect. For example, I treated a
man who had a very twisted scar across the BL Channel on the right thorax. He complained
of recurrent intermittent symptoms over 8 years including: haematuria, haemorrhagic cystitis,
right sciatic area pain and lumbar pain, right scapular and shoulder area pain in the area of BL
Channel, right headache near the BL Channel, right eye conjunctivitis, right ear tinnitus,
right arm pain/spasm in the SI Channel area and pain in the little finger. Orthodox treatment
by eye-, ear-, orthopaedic-, cardiac- and internal disease specialists over years had only
temporary effects and symptoms continued to recur (usually singly) at intervals. All the
symptoms related to KI, BL, KI, Channels, but mainly to BL. (In the Qi cycle, the sequence
is SI->BL->KI. A block in BL would give excess in SI and deficiency in KI, as well as
excess in the upper part and deficiency in the lower part of BL Channel). Scar therapy
(physiotherapy, massage and needling of the scar), with needling of the BL Channel,
eliminated all the symptoms and the patient remained well.
This is a most important concept! Bruises, injuries and scars may cause disease. The
blockages include: moxa scars, surgical scars (external and internal), injury (external and
internal), cuts, local fibrosis (cicatrization due to abscess, carbuncle, etc. Reinhold Voll taught
that individual tooth sockets relate to specific areas and that socket inflammation/scars, dental
caries, etc may cause reflex pathology in the associated Channels and organs.
A routine part of anamnesis should be to question the patient or client as to the existence of
any scars, bruises or injuries on the body and to examine the location of these injuries in
relation to the location of the other symptoms and the time of occurrence of the injury in
relation to the time of onset of the symptoms.
Not all scars need cause problems. Longitudinal scars are not as serious as transverse (they
are less likely to cut as many nerves or Channels). Well healed (clean) scars are not as
dangerous as thickened, twisted, keloid scars, or scars which have painful spots to pressure.
Scar therapy can use simple needles (under the scar, or at each end), ultrasound,
physiotherapy, laser or procaine injection or B12 injection along the scar. The concept is to

restore energy flow through the scarred area and to reduce size, thickness and adhesion in the
scar. One to three treatments are usually sufficient.
Seeing many scars on patients in Taiwan, I was amazed that I did not see a single case of scar
therapy. On questioning my colleagues in the Clinics, I was told that the concept of scar
therapy was not widely known in Taiwan. Perhaps this section may awaken interest in this
valuable therapy ?
SCAR THERAPY REFERENCES
1) Austin, Mary (1974). AP therapy. Turnstone Books, London, 290 pp.
2) Cain, Marvin (1981,1982) Effects of superficial scars in horses. Personal communication.
3) Gilchrist, David (1981). Manual of AP for small animals. Box 303, Redcliffe, Queensland
4020, Australia.
4) Huneke, F. (1961). Das Sekunden Phanomen (The Instantaneous Phenomenon) Karl F.
Haug Verlag, Ulm, Donau, Germany.
5) Kajdos, V. (1974). Neural therapy: its possibilities in everyday practice. Amer. J. Acup. 2,
113-.
6) Khoe, Willem H. (1979). Scar injection in AP: Huneke's "Sekunden" neural therapy. Amer.
J. Acup., 7, 15-.
7) Lewit, Karel (1979). The neural effect in the relief of myofascial pain.
Pain, 6,3-.
8) Mann, Felix (1973). AP cure of many diseases. William Heinemann Medical Books,
London, 123 pp.
9) Rogers, Carole (1982). AP therapy for postoperative scars. Amer. J. Acup., 10, 201-.
3. CLINICAL CASES OBSERVED AT VGH AND CMC
I attended 4 long clinics at VGH and two short clinics at CMC. I observed over 100 clinical
cases presented for their first treatment. (Repeat treatments were being given in other clinics,
but I wished to see each case, as presented, for the first time and to assess the response (if
any) to AP at that treatment. The patients, nursing staff and doctors were most helpful and
friendly. They discussed freely each case history, allowed me access to the medical records
and discussed why a particular combination of points was chosen. I wish to thank these
generous people most sincerely for helping me to learn more about AP and human nature.
Most cases involved pain syndromes (headache, neck, shoulder, elbow, wrist, hand pain +
stiffness, back and lowback rain + stiffness, hip, thigh, knee, ankle or foot pain + stiffness,
chest or abdominal pain). A few cases with constipation, asthma, numbness of extremities,
muscle tremor, facial paralysis and post CVA paralysis were also seen.

The cases were scored from 0 to (+++) on the result obtained at the end of the first session:
(0) = no improvement was noted or reported; (+) = slight improvement; (++) = good
improvement; (+++) = excellent improvement; (?) = result unknown.
It should be noted that selection of points is not a routine, standardised procedure. It depends
on the doctor, the patient and on the response obtained. Furthermore, most of these patients
would require further treatment sessions before they could be said to be cured or stabilized.
My notes are not complete and many other cases observed were not detailed in writing.
Table 1 shows a summary of the responses noted at the end of the treatment session (usually
about 20 min) in 39 cases for which my notes had a result indicated (0 to +++). The notes did
not record a result in 9 patients. Good or excellent relief occurred in 69.2% of the cases.
Slight relief occurred in 23.1%. Only 7.7% reported no relief. In the 39 recorded responses,
13 (33.3%) had a marked response within two minutes (cases 11-14,16,17,24-26,34,40,43 and
45). These rapid responses are comparable to those reported in the Huneke Phenomenon.
These results are most impressive, especially when one realises that they were responses to
the first session of AP. Most disorders require 1-6 or more sessions of AP to obtain
maximum response. A good initial response is usually an excellent prognosis for a satisfactory
outcome. Many patients with a poor response to the first session can be helped by further
sessions.
TABLE 1
Summary of responses noted (0 to +++) and unknown (?) in 48 cases from my notes.
(Case 4 was included twice).
Problem area
and case No.

Response
++

Total

+++

(?)

Total

Recorded

14

13

General and CVA

1,2,4,45-47
Head/neck
6,8-11
Upper limb
5,7,12-23

Thorax
24

Lowback
3,25-34

11

11

Lower limb
4,35-44

Total

23

48

39

7.7

23.1

10.2

59.0

100

% success in
recorded cases

Details recorded in my notes

1. Aches and pains "all over the body"
Some patients report "wandering pains" or static pains in head, neck, back, upper limbs, lower
limbs or "all over the body." These cases would be difficult to treat (too many needles) if each
area had to be treated separately. In such cases, the VGH clinic uses needles in LI04 and
LV03 (bilateral) for 2-3 sessions, at which time the pain usually "localises" in 1-2 areas and is
easier to treat then. In the early stages, many TP/AhShi areas may be found but the real TPs
can be isolated after 2-3 sessions of LI04, LV03.
Female: "aches and pains all over": (GB area of head, legs, shoulders) with insomnia and
malaise. LI04, LV03 (bilateral) needled. Doctor was very gentle and caring with this patient
and the "Tender Loving Care" (TLC) had marked effect on her reaction to the staff. Response
(?).
Tension, insomnia, neurasthenia: In VGH, I was told that AP can help these problems. Main
points included LI04, HT07, ST36, LV03. However, many sessions may be required and
other causes and therapies must be considered. I saw few such cases during my visits. None
could be assessed as to the outcome.
2. Insomnia, tension for 10 years: LI04, LV03 (bilateral). Response (?)
AP in pain following local trauma: Many of the pain syndromes presented for AP therapy
are caused by local trauma (falls, industrial accidents, car crashes, athletic injury etc). In acute
cases, presented soon after the injury, AP is a highly efficient method of controlling the pain.
It also has anti-inflammatory and restorative effects which speed up the resolution of the
injury, especially where this involves soft tissue injury, bruising, oedema and swelling. Chung
has done extensive clinical research in this area.
Acute traumatic injury: Ipsilateral GB34 is the pain-point par excellence. On its own, it
often controls the pain (and reduces swelling). Sometimes, ipsilateral BL62 or an AP point
near the local area may improve the effect. Chung reports that pain relief is more efficient if
AP is given on or after day 2 (rather than day 1) of the accident. About 70% of acute
traumatic pain (including fracture pain) may be relieved following one 20-min session of AP.
Treatment 1-2 times/day for 3 occasions gives pain control in > 95% of cases.
In contusions GB34
In abrasions GB34
In fractures GB34 (66% excellent results)
In costal trauma, especially lateral GB34

GB34 (ipsilateral) is the key point for traumatic pain anywhere in the body. Because of the
marked analgesic effects it is most important to diagnose the cause of the pain and to give
supplementary treatment (for example, plaster cast in simple fractures). It is possible to do
severe damage in the region of a broken bone if one uses it following AP analgesia, unaware
that the fracture was present.
To obtain complete relief from chronic pain, caused by trauma some weeks or months
previously, AP may be required 1-2 times/week for 1-2 months. GB34 (ipsilateral) is also
used in chronic cases, but other points are often added. These include AhShi points, when
present.
Chronic traumatic pain of:
head and neck:GB34 + LU07 + BL62
lumbar area :GB34 + BL40 + SI06
elbow area :GB34
ankle area :GB34

GB34 is also useful for joint and muscle stiffness which often follows removal of a plaster
cast. GB34 controls the muscles and sinews.
3. Left lowback pain following trauma: Needling ipsilateral GB34 caused radiating sensation
to flank and costal area. SI06 (contra- lateral) needled. 20 min. Pain was greatly eased but not
completely gone (+++).
4. Knee and shoulder pain (bilateral) following car accident some weeks previously. Scar on
anterior thigh. Bilateral TP/AhShi were located in infraspinatus. Needled AhShi, GB34,
BL40,57,62, TH05. Twenty minutes. Pain slightly improved. (+)
5. Elbow pain following local trauma: GB34, LI11 ipsilateral. Twenty minutes. Pain gone
completely (+++).
6. Eye pain and swelling following local trauma: GB34 ipsilateral. Within minutes, patient
opened eye, Pain gone when needle removed at 20 min. (+++). (One treatment is often
sufficient in "black eyes": C.C. Chung).
7. Pain in left palm near HT07, due to local trauma (fall from bicycle) one month before.
Left GB34 needled. Marked pain relief in 20 min.(+++)
Head and neck problems
Many patients are treated for headaches, neck pain and whiplash. (Facial paralysis and
trigeminal neuralgia is also treated but few such cases were seen by me).

Headache: In VGH, LU07 is used often as the main point, often combined with GB20 +
TaiYang (Z 09), YinTang (Z 03), GV20 (depending on location of headache).
Neck pain and stiffness: The Hand point "Neck" is very effective. The patient is asked to
close the fist. The point is between the knuckles at the lower end of metacarpals 2-3. It is
often combined with SI03.
8. Pain and stiffness in neck, with intermittent headaches (headache not present at
presentation). Needled: "Neck" point (knuckles 2-3) plus LU07 (bilateral). Twenty minutes.
Great improvement. (+++).
9. Throbbing pain and sensation of tightness in occiput and behind temples for 2 weeks.
Worse at night. AhShi found (bilateral) near GB10. Needled. Points GB20, LU07, BL40
needled bilaterally for 20 min. Slight improvement was reported. (+).
10. Tinnitus (Side and duration and causes not recorded). Needled TH17, GB20, ST36,
ipsilateral. Response (?). (Note: many authors report poor results with AP in tinnitus).
11. Acute neck pain and rigidity in an in-patient (developed overnight). Hardly any rotation
or other movement of neck was possible. One needle was put in the point "Neck" between
knuckles 2-3 and was strongly pecked and twirled for one minute. Patient was then asked to
try to move his neck slowly. The consternation on his face when he found he had full
movement and no pain after 1 minute was hilarious! Immediate result. (+++).
Shoulder pain, stiffness, "frozen" shoulder
Many patients had these symptoms for up to 5 years before AP treatment. Careful searching
of the scapular muscles (especially infraspinatus) often shows up AhShi points. Sometimes
AhShi also occur near GB21. The most important distant points for shoulder are SI03, GB34,
ST38, plus AhShi points.
12. Frozen shoulder: Very restricted right shoulder movement with pain and stiffness.
Duration 5 years. Two AhShi points located in infraspinatus Strong deep needling for one
minute. Patient lifted arm much higher immediately. AhShi had disappeared in one minute!
Then ST38 was needled (right side) strongly for one minute. Further improvement in arm
movement. Then SI03 (right) needled strongly. Needles left in SI03 and ST38 for 20 min.
Great improvement in arm movement and pain was much less. However, patient could not put
arm behind his head or behind his back and some pain and stiffness remained (++).
13. Shoulder-joint pain/limited movement, with pain in the hand, especially metacarpalphalangeal joint of index finger for 3 months before AP. Left side. AhShi in infraspinatus
(left) and AhShi in front of shoulder joint. Both AhShi needled strongly. All pain was gone
and movement markedly improved in two minutes. A further AhShi near SI09 was needled.
The amazement on the patient's face, on discovering the dramatic improvement within 3
minutes, was a joy to watch! (+++).
14. Pain in shoulder, elbow and wrist, with marked hand tremor which interfered with use
of chopsticks and made writing impossible. (Tremor appeared only when pen or chopsticks
were grasped). Little limitation of joint movement. Duration two years before treatment.
AhShi located in right infraspinatus. Needled strongly for one minute. All pain had

disappeared. Chung asked the patient to write his name. The tremor was gone! No further
treatment at that session. (+++ immediate).
15. Shoulder area and neck pain: Needled at GB21, SI09,11, 20 min.
Slight relief only. (+).
16. Pain and pulled scapular muscles (right) with difficulty raising, arm for 7 months
following golfing incident. (Pain in right temple had been present earlier, but was gone now).
No AhShi points located. ST38 caused "sensation of electricity travelling from foot to side of
face!" The pain was gone in 1 min. GB34 was added for added effect (2 needles only: ST38,
GB34, right side). Patient "could not believe the effect"!
(+++, immediate).
17. Shoulder pain (anterior muscles) when arm brought behind body. Duration 1 month.
Strong needling at SI03 gave total relief of pain in 1 min. Strong needling at GB34 and LI04
added for extra effect. All needles left in situ for 20 min. (GB34 referred sensations to the
shoulder area!). Total pain relief. (+++, immediate).
18. Frozen shoulder: Pain and severe restriction of raising right arm. Needled: right ST38,
BL40, GB34 plus left LI15. Twenty minutes. Some improvement in pain but little change in
movement. (This case was long-standing and had muscle atrophy) (+).
19. Stiff shoulder: Left side, limitation of movement, with feeling of heaviness to the wrist
and also some lowback pain. Duration unknown. AhShi point in infraspinatus needled plus
left ST38 and TH03 (for the shoulder). "Loin and Leg" points added for lowback. Response
(?).
20. Scapular area pain, left. Duration unrecorded. AhShi not found. Needles in GB34,
TH03 , BL40, GB20 (left). Twenty min. Marked improvement (+++).
21. Scapular area pain, with degenerative lesions in cervical spine plus facial palsy. Duration
unknown. Needled AhShi (infraspinatus) and TH03 (for shoulder) plus LI04,20 (for the
face). Scapular pain greatly improved in 20 min. (+++).
Upper limb problems
22. Pain in forearm muscles below lateral epicondyle of humerus on both arms for 6 months.
AhShi located in right infraspinatus, also below left GB20 and (bilateral) in forearm muscles
near LI10. Needles in all AhShi plus GB34 (bi). Less pain after 20 min. (+).
23. Elbow pain and muscular stiffness: Duration and cause not noted. GB34 + local AhShi
point needled, 20 minutes. Good response reported (++).
Respiratory difficulty
AP is used often to help patients with respiratory problems, such as asthma, dyspnoea, tight
sensation in chest, shortage of breath. The main points include: PC06, LI11, BL13, SP04,

ST40. Few such cases were seen during my visit. AP at PC06 was said to be very useful to
help to control angina pectoris and improve cardiac microcirculation.
24. Difficult breathing and shortage of breath, with sensation of tightness in chest in
patient with history of asthma. Needles put (bilateral) in PC06 and SP04 gave relief within 2
minutes. Left in situ for 20 min. Patient was delighted with response. (+++ immediate).
Lowback pain and stiffness + sciatica
Lowback pain is often caused by unaccustomed back exercise (lifting, twisting etc).
Sometimes it is associated with degenerative disc disease, spondylitis, disc prolapse. The new
points "Loin and Leg" (dorsum of hand between the upper heads of metacarpals 4-5 and 2-3)
often give immediate or rapid pain relief. Other useful points include: BL23,40,57,60,
GB30,31,34, AhShi, SI06, LV03, LI04.
25. Right lumbar and posterior thigh pain associated with X-ray evidence of degenerative
disc disease. Had been treated unsuccessfully for 5 months in the Orthopaedic Dept. of the
same hospital. Needles in: "Loin and Leg" points (right), SI06 (left). Pain improved within 2
min but extension of leg still caused some pain. After 20 min pain was "95% gone". (+++,
immediate).
26. Pain radiating from left thigh to lower leg: Intermittent over 1 year. Left face pain.
Worse at night. Slight degeneration of lumbar spine on X-ray. Pain in both shoulders for 3
months. Needled (for lowback/leg): "Loin and Leg" (left). Pain relief was immediate (but not
complete) in one minute! AhShi found in left gluteal muscle. Massaged, then needled, plus
BL62. For the shoulder pain, SI06 (bilateral) needled. AhShi near GB20 (bilateral) also
needled. 20 minutes. Pain in shoulder and lower limb "greatly improved!" (+++ immediate).
27. Lowback and sciatica pain (right thigh, radiating to lower leg) for one month. X-ray
indicated degenerative disc disease of low lumbar spine. Straight leg raising test (SLRT) 90
degrees left, 45 degrees right. Disc disease diagnosed in lumbar area. Needled: "Loin and
Leg" and GB34 (right side) 20 min. No improvement in pain or SLRT at this session (0).
28. Severe lumbar pain and stiffness following back strain about 1 week previously.
Needled: "Loin and Leg", LV03, LI04 bilateral). Greatly improved back movement and pain
almost gone in 20 min. (+++).
29. Acute lumbago for past few days. No history of back strain. "Loin and Leg", GB34
(bilateral) needled. 20 min. Stiffness and pain greatly improved. (+++).
30. Acute sciatic-area pain (right). Duration unknown. Suspected lumbar disc on SLRT.
Needled: BL23,40,60, GB30,34 (all on right). Response (?).
31. Acute lumbar sprain: Duration unknown. Needles placed in BL23,26,30,34,40 bilateral.
The lumbosacral area was cupped (bilateral) over the needles. Good pain relief after 20 min.
(CMC). (++).
32. Sciatic area pain (left). Duration unknown. SLRT unknown. Needles in left BL40,60 plus
AhShi below wing of left ilium. 20 min. Pain relief reported. (++).

33. Sciatic area pain (right) in patient who earlier complained of numbness and ache in lower
leg for one year. Lumbar vertebrae showed bridging on X-ray. AhShi (very sensitive) at
GB31 (control point of the tensor fascia lata - Chung). Needles in AhShi plus GB30,
BL40,60. Response (?).
34. Lowback stiffness, pain and inability to bend forward: Duration about 3 days. Needles
(bilateral) in "Loin and Leg" points, strong stimulation for about 30 seconds each. Patient was
then asked to try to bend forward. There was marked improvement in movement and less
pain. BL40 and GB34 added (bilateral) 20 min. Marked improvement (+++, immediate).
Lower limb problems
35. Ache and tenderness over right lateral ankle following a fall (ballet dancer) 8 months
previously. Needled: right SI06 plus left GB34. 20 min. Slight improvement reported (+).
36. Weakness in both legs for 13 years following cystectomy. "Loin and Leg", BL40, GB34,
LU07 needled bilaterally. Response (?).
37. Ache in anterior aspect both thighs for one week. AhShi points in muscles of medial
and anterior thigh. Needles in AhShi points for 20 min. Marked improvement in pain (+++).
38. Pain in and under left heel for 10 years. Earlier X-ray (some years previously) showed
soft tissue calcification behind ankle joint. AhShi located above BL57. Needling sent
sensation to gastrocnemius tendon area. Slight improvement in pain after 10 min. (+).
39. Pain in sole of the foot: Duration not recorded. Needled ipsilateral GB34, BL57.
Response (?).
40. Pain, spasm in both knees in 74 year old woman. Duration > one month. Also tightness
in right gluteal muscles. Needles were placed in LI11 to relax knee muscles. The response
was immediate and dramatic (knee movement improved markedly). Then GB34, SP09
(bilateral) added. Marked improvement in movement and pain in 20 min. (+++, immediate).
41. "Cold knees": For some months patient had cold sensations in both knees and used knee
warmers in an attempt to "warm" them. Needles in GB31 and ST36 (bilateral) for 20 min.
Patient reported "warm sensations" in knees during needling (+).
42. Multiple joint pain in lower limbs, worst in knees, with some lumbar pain. Needles in
the hand point "Sciatic area" (between distal heads of metacarpals 3 and 4 on dorsum of hand)
plus GB34, SP09, SI06 (all bilateral). Response (?).
43. Pain and swelling in knee and ankle (left), intermittently over 6 months. AhShi found
near left SP10. Strong needling of AhShi for one minute gave marked relief of pain. A second
AhShi found 2.5 inches below and behind left GB34, bilateral. Needled 1 min. Patient could
hardly believe the result! (+++, immediate).
44. Left knee pain (no details). Needles GB34, SP09 (left). Twenty minutes. Good relief of
pain (++).

Post CVA cases: Note: If there is sensory paralysis, there is little value in needling that side.
In such cases, the "good" side would be used plus the Motor points on the scalp.
45. Right facial paralysis, slurred speech and poor control of tongue in elderly woman.
Minor stroke 3 months before. GV15 was needled 2" deep. Within one minute, she had
marked improvement in speech and tongue control! CV23 was then added, plus LI04, HT07,
GB34 (bilateral). All needles were left in situ. After 10 minutes, patient went pale, developed
cold sweat on face/forehead, yawned a lot and complained of severe headache behind right
eye. On attempting to get up, she nearly collapsed. She had to be helped to lie down. She felt
very tired and weak. (When I saw her one hour later, she was still complaining of leg
weakness and a headache) (+++ immediate).
46. Right hemiparesis arm-leg after stroke (hospitalised in CMC). Simple needling on right
LI04,11, TH05, GB34, SP06, plus left LI04, GB34. No improvement noted (0).
47. Hemiplegia (left side) (CMC hospital): left LI04, TH05, BL40, GB34, GB20,21, GV16.
No improvement noted (0).
4. AP RESEARCH IN TAIWAN, R.0.C.
During my visit, I received reprints of their research in AP from medical and vet colleagues.
Abstracts of the 1982 International AP Symposium (1982), the Vet AP Seminar (1982) and
the National AP Symposium (1979) were also given to me. From these sources, the addresses
of the main centres of AP research in Taiwan were compiled. They are:
1. Taipei
Chinese AP Research Foundation (Box 84-223). This group attempts to integrate and
disseminate the medical and vet AP research in Taiwan. This group produces "AP Research
Quarterly", in which some of the current AP research is published.
National Taiwan University, College of Medicine (Depts. Physiology and Neurology).
National Taiwan University Hospital (Depts. Medicine a Physiology).
National Taiwan University, Depts. Animal Husbandry & Zoology.
Yang Ming Medical College (Depts. Anatomy & Microbiology and Institute of
Neuroscience).
National Defence Medical Centre (Depts. Physiology, Biophysics and Biomorphics).
National Institute of Preventive Medicine (Dept. Serology).
Academia Sinica (Institute of Physics)
Taipei Medical College (Pain Clinic)
Taipei City Hoping Hospital (Pain Clinic)

Taipei Municipal Drug Addiction Centre

Airforce General Hospital (Aerospace Medical Research Laboratory)
Tri-Service General Hospital (Depts. AP Research & Pathology) VGH (Depts. AP,
Ophthalmology, Obstetrics and Gynaecology).
2. Taichung
China Medical College (AP Research Centre; Institute of Chinese Medical Science and Dept.
Physiology)
Chung Shin Hospital (Dept. Urological Surgery)
Veterinary College (Dept. Vet Medicine, and Vet Teaching Hospital)
3. Lungtan Institute of Nuclear Energy Research
4. Hsinchu National Tsing Hua University (Institute of Radiation Biology)
5. Changhua Success Clinic of Chinese Medicine.
I visited the research facilities of Yang Ming Medical College (Taipei), VGH (Taipei) and
CMC (Taichung). The equipment in these centres was impressive and modern. It included:
electron microscopy; automated scintillation and isotope counters; modern histological
processing and microscopy; automated spectroscopy; HPLC apparatus; microcomputercontrolled integrators.
Yang Ming Medical College also had sophisticated multichannel electronic recorders for
physiological monitoring; stereotactic surgical equipment and primate/rodent handling
facilities for experimentation in pain research.
I was told that Government funding for AP research had been somewhat limited until recently
but that increased funding was expected in future, due to (a) positive research results from
Taiwanese projects, and (b) a growing awareness of international advances in the field of AP,
neurophysiology and neuroendocrinology.
Since 1976, or so, the main areas of AP research in Taiwan can be divided into experimental
and clinical research.
Experimental studies:
Experimental AP research in Taiwan is based largely on researching the physiological effects
of stimulating some of the Master Points, especially LU07, LI04,11, ST25,36, SP06, HT07,
BL23,52,40, PC06, GB20,34, LV03, GV14,26.
Drug interactions and the pathways activated in the nervous system are also being studied.
The approach is pragmatic. There is great awareness of the need for properly controlled
observations.

The ancient concepts of Five Phases, Pulse Diagnosis, the Perverse External Insults, etc
receive little (if any) credence from medical or veterinary scientists trained in the "Western"
method. These concepts are still held by those doctors whose training is solely in traditional
Chinese medicine. However, since few of the Traditionalists are active in AP research, I
conclude that current research in Taiwan largely ignores the esoteric aspects of traditional AP
and concentrates on the physiological effects and the mechanisms involved from a "Western
Scientific" viewpoint. Research areas include:
a. AP analgesia: In experimental pain in animals (rats, monkeys), using tail flick test, Jaw
opening reflex, Naloxone effects on AP analgesia in animals, Long-term abolition of AP
analgesia by severing the dorsolateral funiculus in the cervical 2-3 area in monkeys, AP
effects on stimulation evoked potentials in the human cortex - the importance of DeQi (needle
feeling), The role of Dorsal Root Antidromic Activity in AP analgesia, AP effects on pain
threshold in normal and paraplegic humans.
b. Brain sites activated by AP: Sensory projection of AP sites in the cortex of monkeys, AP
effects on brain membrane changes, AP effects on the feeding and chewing centres in rabbits.
c. Cord sites activated by AP: AP effects on Dorsal Root Antidromic Activity in animals,
Horseradish peroxidase retrograde transport to label cord sites activated by AP.
d. Brain stimulation effects: Effects of raphe nucleus stimulation on cardiovascular function
during painful stimulation, Stimulation-produced analgesia in periaqueductal grey area effects of naloxone.
e. AP effects on cardiovascular function, metabolic rate and thermoregulation:
AP effects in cardiac function,
AP effects on experimental cardiac abnormalities in animals,
AP effects on skin temperature/vasomotor responses in normal/paraplegic humans;
AP effects on metabolic rate and human body temperature;
ST36 implants on thyroxine levels and pulmonary function in rabbits;
AP at GV14 on thermoregulation in experimental fever in rabbits.
f. The DeQi Phenomenon:
The role in DeQi of reflex muscle contraction around the needle;
The role in DeQi of mechanical twining of connective tissue around the needle tip;
The induction of DeQi in "non-points."
g. Miscellaneous physiological effects of AP:
at GB20 on bile flow in rabbits and on high density lipoproteins in blood;

on levels of cholesterol and lipoproteins in normal and hyperlipoproteinaemic humans;

at GB34 on cholesterol levels in rabbits fed high cholesterol diets;
on blood sugar in alloxan-induced diabetes in mice;
on experimental alcoholism in pigs & mice;
on Kirlian auras in man;
on pupil width in cats;
on phagocytosis, leucocytosis and lymphoid cells in animals;
in recovery from experimental x-irradiation sickness in animals (red cells, white cells; spleen,
thymus and bone marrow metabolism);
on antibody production to various antigens including cobra toxin in animals.

Clinical studies include: Many studies on effects of AP in clinical pain syndromes in man;
Comparison of simple needling with low-frequency electro AP in pain control in man;
Comparison of TP/AhShi therapy and AP therapy using distant points in control of clinical
pain syndromes; Earpoint AP in control of clinical pain in man; AP analgesia for human
surgery; Studies of AP in withdrawal symptoms from narcotics and tobacco; AP effects on
blood pressure of normal and hypertensive patients; AP and moxibustion effects in asthmatic
patients; Earpoint AP in the treatment of refractive disorders of the eye; EA at SP04 in the
prevention of threatened abortion or premature labour in women; Earpoint AP in disorders of
the G/I tract; reproductive disorders and psycho-neurological disorders; Effects of AP on T4,
LH and IgE levels in blood of human patients; AP in piglet diarrhoea - comparison with
antibiotic therapy; AP in bovine infertility (repeat breeders, anoestrus, cystic ovaries).
Vet AP research projects planned for the future:
Pig production is most important to the agricultural economy of Taiwan. Clinical AP research
will be aimed at control of three major problems in pigs:
1. Delayed puberty in gilts;
2. Postpartum anoestrus and infertility in sows;
3. Postpartum agalactia.
Milk and beef are less important to the Taiwan economy. However, because of very positive
results in preliminary trials, further work will be conducted on AP effects on bovine fertility.
These projects will be carried out under the direction of Jen-Hsou Lin from the Dept. Animal
Husbandry, National Taiwan University (Taipei) and H.P. Fung, of the Vet School (Taichung),
in co-operation with other vets and commercial stockmen.

5. AP TRAINING IN TAIWAN, R.0.C.

The quality of AP training in Taiwan varies widely. It ranges from weekend "crash-courses"
(which are usually intended as an ongoing part of an integrated study of AP) to formal
courses lasting one month to three years. As well as this, one may opt for "self- study" from
the human AP textbooks, with or without formal course work.
Unscrupulous people who attend one or two weekend crash-courses (and who may happen to
be medical or vet graduates!) may use this as their "qualification" to practice AP. Poor
clinical results by such people brings AP into disrepute and unsuspecting patients suffer as a
result of the incompetence of the charlatans. This problem is not confined to Taiwan - it is
now an international problem.
Each teaching centre has its own methods of assessing its students but the course content and
duration vary widely. Taiwan, as is the case in most other countries, appears to have no
standard Examination or Assessment Board at State (National) level to assess and certify
the level of competence of AP practitioners. Thus, the level of competence varies from
excellent (as observed in the VGH and CMC) to poor.
The content (orientation) of courses varies with the teaching centre. In VGH (Taipei) the
course content is mainly "Western" oriented - little emphasis is placed on the ancient
traditional concepts of Pulse Diagnosis; Five Phase Laws and Points; the Perverse Causes of
Disease etc. Because of its closer ties to traditional medicine, CMC (Taichung) places more
emphasis on traditional concepts and on traditional needling techniques
(tonification/dispersion etc). However, CMC is also very "Western" oriented in its basic
undergraduate medical training. Students from this college understand both Eastern and
Western concepts. CARF (Taipei) because its faculty numbers include both "traditional" and
"Western" doctors, also teaches the two differing concepts. There are many other centres for
AP training in Taiwan, but I have no information on them.
The foregoing three organisations accept foreign medical graduates and vet surgeons on their
courses. Students attending any of these courses can expect to have extensive exposure to
clinical material, because VGH/CMC have their own (large) clinics, and CARF can provide
clinical instruction in co-operation with Taipei hospitals. The cost of tuition depends on the
duration of the course. For example, medical or vet graduates (who have already studied basic
AP techniques elsewhere) may enrol for a 1-month intensive advanced course, including
clinical work, at any of the above 3 centres. The cost of tuition plus lectures notes etc is
approximately 1200 US $. Specialised courses (for example in E.N.T. diseases; internal
diseases; myofascial pain, etc) can be arranged by negotiation with the Faculty.
The concession to allow vets to attend these courses was granted by CMC and VGH in 1982
on the understanding that the techniques learned there would be used primarily in vet practice,
or for research purposes. It is recognised and accepted throughout China, Taiwan, Japan and
other Far Eastern countries that knowledge and skill in AP is not confined to medical or
traditional doctors. Many people learn it as part of their cultural training in the martial arts,
TaiQi, QiGong and other mental and physical disciplines. It is also common that one may
have a basic knowledge of AP for self-help, or for use in "First-Aid" in minor problems and
for family use, for example, the AP or massage techniques to relieve tension headaches;
teething problems in babies; indigestion in children; pulled muscles; tension insomnia etc.

I recommend these courses to vet colleagues who may have the opportunity to take an
extended holiday-cum-study trip in a most beautiful country. I would advise them to ask for
an outline of the course material (and the fees involved) and to make their reservations in
plenty of time. Those interested may contact the AP Dept., VGH, Taipei, the AP Dept., CMC,
Taichung or CARF, Box 84-223, Taipei.
Accommodation in Taiwan and travel to and from the course is the responsibility of the
candidate but each organisation offers assistance and advice, if required.
ACKNOWLEDGEMENTS
My first trip to the Far East was made possible by Drs. Hong Chien Ha and T.C. Hsu of the
Committee of the First International Symposium on AP and Moxibustion, Taipei, and by JenHsou Lin of the Committee of the Veterinary AP Seminar, Vet School, Taichung. These men
arranged for my travel to and accommodation in Taiwan. Great credit and thanks are due to
them for their organisation of the scientific sessions and their fantastic hospitality during my
stay, from 14th to 28th November 1982.
My sincere thanks are due to all who helped to make my visit enjoyable and educational; the
Taiwan Government, for funding the trip; the organisers of the International Symposium and
the Veterinary Seminar, for inviting me; medical colleagues at VGH, Yang Ming Medical
College and CARF (Taipei) and CMC (Taichung); vet colleagues, staff and students at the Vet
College (Taichung), the Pig Research Institute (Chunan) and the Dept. Animal Husbandry,
National Taiwan University (Taipei) for their patience in answering so many questions, and
for showing me their skills; to the Tsang brothers for their time, car and generosity; to my
friend and colleague, Jen-Hsou Lin, who made it all possible; his wife Li Fei, who fed me,
and to their little girls I Chen and I Chien, who made the red-haired barbarian laugh on Yang
Ming mountain.
AP ANALGESIA (AA) IN COWS
Summary from Sheila White's article (1982) Murdoch Vet. School, West Australia 6150.
White has recently had good analgesia for 2 abdominal operations in cows. #1 was
rumenotomy for rumen/omasal/abomasal impaction.
#2 was large (45 cm) abscess with adhesions in the spiral colon (right incision below the
paralumbar fossa).
Three points were used. Cows were >600 kg.
A: BaiHui (GV03, lumbosacral space), depth 5 cm;
B: MingMen (GV04), in the space between lumbar 2-3, depth 4 cm;
C: YaoPang (Veterinary point, at tip of transverse process of Lumbar 1. A long needle (12 cm)
was inserted anteriorly (pointed at body of last thoracic vertebra) and angled downwards, to
slide under the wing of the transverse process, aimed at body of last thoracic vertebra. Depth
5.5-6 cm.

Needles B and C were joined by copper wire and connected to one lead of 73-10 stimulator.
Needle A was connected to the other lead. Frequency 15-28 Hz, square wave.
Analgesia in #cow 1 at 20 minutes.
Analgesia in #cow 2 not good at 20 minutes. Needle removed and replaced. Good analgesia
30 minutes later (i.e. at 50 minutes).
Both operations were satisfactory under EA, with no other anaesthetic required. The
operations lasted 2-3 hours. Both cows recovered uneventfully.
Note, for right flank operation, right YaoPang was used. For left operation, left YaoPang was
used.
AA ATTEMPT IN A COW IN TAIPEI
by J.H. Lin and P.A.M. Rogers
We attempted to induce AA in a Friesian cow at the Dept. Animal Husbandry, NTU. We have
used BaiHui, MingMen and left YaoPang, as described above. The stimulator used was
made locally. The frequency was approximately 15 Hz.
The pain stimulus used was to (attempt to) transfix a fold of skin grasped between thumb and
index finger using a 1.5", 21 gauge needle. The cow had a very nervous temperament. Any
quick touching of the skin (of either flank) by the needle, evoked strong, immediate reflex
muscle twitch, and defensive action.
After 20 min. of stimulation, the cow reacted as before to quick needle stimulus and no
penetration of a skin fold was attempted because of this. After 30 min. of stimulation, the
reaction to quick stimulus was less active but still present on most sites. Then we realised that
(because of the nervous temperament of the cow) the reaction to quick needle stimulus might
have been due to touch (rather than pain). We then applied slow, gradual and firm pressure on
the needle to a skin fold. There was no reaction and it was possible to completely transfix the
fold. In c. 9/10 sites tested on the left flank, perinaeum, vulva and upper (posterior) aspect of
the udder, no defensive reaction or rapid muscle twitch was elicited on transfixing the fold.
Full sensitivity was still present at this time on the right flank and on the right and left thorax.
We concluded that the attempt (our first, using these points) was about 90% effective to the
slow transfixion and that the hypoalgesia was limited mainly to the left flank area.
TAIWAN

WOOD - BEGINNING
0 terrible orgasm of Mother Earth,
Awesome power in aeons past,
With mighty roars she came and cameNo pleasure here, no slippery thighs,
No gentle fingers, no trembling sighs

But bowels churning with white heatGushing, pouring, spewing, heaving

Sulphurous molten rock:
Taiwan.

FIRE - BIRTH
Alone and unattended She,
Her bearing closed by sand and sea,
Through gaping wound across Her belly
Expelled Her screaming child.
Up, up it rose from ocean floor
To tower high o'er boiling shore:
Taiwan.

EARTH - GROWTH/DEVELOPMENT
O'er Yang Ming peak I saw you born.
Fierce winds and waves and whistling sprays
Scraped and shaped your wondrous bays.
On Chunan plains you saved the corn.
From little junks you hauled your nets.
In alleyways you placed your bets.
On crowded streets you hurried by,
By taxis, cycles nearly killed.
0 slant-eyed beauty of black eye !
You caused my semen to be spilled
Ten billion times:
Taiwan.

METAL - MATURITY
Young girls proud in country free,
Young men summoning TaiQi,
Army alert constantly
Face the threat from o'er the sea:
Taiwan.

WATER - DEATH/REBIRTH
Little jewel of the East
May your people live in peace.
May they never have to see
Obscenity like Nag'saki.
May the West learn what you teach:
Hard work, honour, close family,

Pride of self and history:

Taiwan.
QUESTIONS
Channel codes used in these questions are: LU, LI, ST, SP, HT, SI, BL, KI, PC, TH, GB,
LV, CV, GV.
1. One of the following statements is not correct. Indicate the incorrect statement:
(a) Chinese medicine, as practised in Taiwan, combines the best of "Western" and
"Traditional Chinese" medicine.
(b) TCM involves study of AP, moxibustion and Herbal Medicine. The latter is most
important.
(c) For all branches of TCM, the medical theory (Yin-Yang, Five Phases, Perverse Causes
of Disease, Disease syndromes and Diagnostics) is the same.
(d) In Taiwan, all herbalists are trained in AP and all acupuncturists are trained in Herbal
Medicine.
(e) Chinese Herbal Medicine is very valuable in CVA, hypertension, neurasthenia and many
other internal diseases.
2. One of the following statements is not correct. Indicate the incorrect statement:
(a) "The Red Book of Chinese Medicine" (by Mao Tse Tung) was the basic text used by most
Taiwanese experts in acupuncture.
(b) Methods of selecting AP points for therapy, and of manipulating the needles, were highly
individualistic in Taiwan.
(c) There was general agreement that manual needling alone was as good as, or better, than
electro-needling for most conditions requiring AP.
(d) Though electrostimulators were freely available in every clinic visited, Rogers saw very
little use of electro-AP. Exceptions were: AP analgesia before surgery and in certain chronic
conditions, especially paralysis/paresis after CVA or nerve injury.
(e) Great emphasis was placed on a careful search for AhShi points.
3. One of the following statements is not correct. Indicate the incorrect statement:
(a) AhShi points usually are present in pain conditions, such as headache, joint pain and
myofascial syndromes.
(b) AhShi points may also arise in some cases of internal disease (lung, heart, liver, gall
bladder, gastrointestinal and urogenital tracts).

(c) The Shu points (T3 to S4 on the inner line of the BL Channel) are palpated carefully in
internal disease, as are the Mu points (Alarm points on the abdomen/thorax).
(d) AhShi points often arise in joint pain (shoulder, elbow, lowback syndrome, hip, knee)
(e) Headache seldom arises from AhShi points in the neck and shoulder muscles
4. One of the following statements is not correct. Indicate the incorrect statement:
(a) All pressure-sensitive areas are AhShi points but AhShi points are not always Trigger
Points (TPs).
(b) The best AhShi point for therapy is the Trigger Point (TP), i.e. palpation pressure on the
point causes a pain sensation to radiate to the problem area, muscle, or organ.
(c) The AhShi point seldom occurs within the area of pain. Patients usually are unaware of its
presence until it is palpated.
(d) AhShi points always occur far away from the problem area.
(e) AhShi/TP points can recruit new triggers elsewhere, usually in the muscles.
5. One of the following statements is not correct. Indicate the incorrect statement:
(a) Painful areas in scarred tissue may act as powerful TPs and these areas must be treated to
obtain optimum results.
(b) Taiwanese acupuncturists placed great emphasis on searching for (and treating) TPs in
scarred areas.
(c) Other pain-sensitive areas (motor points, "fibrositic nodules" etc) are useful in therapy but
they are not as powerful as the TPs.
(d) AhShi therapy is the best introduction to the benefits of needle therapy.
(e) Unfortunately, AhShi points are not present in every case, and Western doctors who know
only the AhShi method are unable to help by needle techniques in such cases.
6. One of the following statements is not correct. Indicate the incorrect statement:
(a) AhShi points disappear when the condition resolves and their disappearance during a
course of therapy indicates a good prognosis.
(b) Dr. Chien Chung did extensive clinical research with AhShi points and published the
English version of his book ("AhShih point: The pressure pain point in AP - Illustrated guide
to clinical AP (1983)".
(c) AhShi therapy consistently gives better results than traditional AP.

(d) Myofascial syndrome involves muscle pain/stiffness, especially around joints. The joints
are often stiff, but show no inflammatory or X-ray lesions. There is often a history of
intermittent recurrence. The diet usually is satisfactory and the neural causes of the pain are
obscure.
(e) AhShi (TP) points often are present in myofascial syndromes, but the patient is unaware
of them until they are pressed.
7. One of the following statements is not correct. Indicate the incorrect statement:
(a) AhShi points usually show decreased electrical resistance and decreased local skin
temperature.
(b) Local vasomotor abnormalities and dermatographic changes occur in the AhShi area.
(c) Histology of the AhShi area shows local cell infiltration and non-specific inflammatory
changes. There is sometimes a fibrous infiltration of the AhShi area (ropy muscle sign).
(d) Pressure on the AhShi often refers pain to the "problem area". Needling the AhShi often
causes the "Jump Sign": local muscle contractions cause the needle to jump.
(e) Master acupuncturists always needle the area of referred pain (the area of subjective
pain).
8. One of the following statements is not correct. Indicate the incorrect statement:
(a) In myofascial syndromes, AhShi therapy very seldom gives dramatic or immediate relief
of pain.
(b) AhShi therapy in myofascial cases can give better results than traditional AP using local
and distant points.
(c) AhShi points may arise anywhere in the muscles, but they are often near the problem area.
(d) The most important muscles to search for upper body problems are: infraspinatus, neck
muscles and GB21 area. In upper limb pain (shoulder, elbow, arm, etc) the AhShi is often in
the infraspinatus of the affected limb. In shoulder pain, sometimes the GB21 area, or
scalenus muscle may hold the AhShi. In bilateral anterolateral shoulder pain, the AhShi is
often in the sternalis muscle. In such cases, one needle in the sternal AhShi can give
immediate pain relief. In middle finger pain, search muscles near TH08.
(e) In abdominal and intercostal pain, check the back and sides for AhShi. For lower body
problems search the gluteus, vastus medialis, soleus, gastrocnemius. In heel pain, the AhShi
is often in the soleus area, left or right of BL57. In plantar pain, the AhShi is often in the
gastrocnemius. In lowback/leg pain, search the gluteus muscle.
9. One of the following statements is not correct. Indicate the incorrect statement:

(a) About 33% of all cases of aching pain are myofascial in origin and respond fast and
reliably to AhShi therapy. Expect excellent results in 38% and good results in 60% of cases
(98% total cases).
(b) Chung's AhShi findings disagree in major respects from Western experiences of TP
therapy, as described by Ronald Melzack (Canada), Pekka Pontinen (Finland) and Alex
Macdonald (UK).
(c) Chung found the following points to be useful: Renal colic pain/spasm: GB34, LV03,
SP04,06; Gastric colic/pain/spasm: ST36, CV12; Biliary colic/pain/spasm: GB34
(d) Rogers did not see use of Earpoints in Taiwan, but was told that earpoints are sometimes
used alone or in combination with body points, with good success.
(e) The most commonly used points use were the Channel points, especially LU07;
LI04,10,11,15; ST25,36,37,38; SP04,06,09; HT07; SI03,06,09,11,19;
BL10,11,23,40,57,60,62, KI03, PC06, TH05,14,15, GB20,21,30,31,34,39, LV03, CV04,12.
10. One of the following statements is not correct. Indicate the incorrect statement:
(a) GV points were seldom seen used. GV15, needled 2" deep in one patient, appeared to
cause a very severe left-sided headache, needle shock and some loss of power in the legs. The
patient was being treated for facial paralysis and slurred speech following a minor CVA.
(b) Extra-Channel Points (points not on the main Channels) often were used for their local
or distant effects. The most commonly seen were Hand Points "Loin & Leg" between the
proximal heads of metacarpals 2-3 and 4-5 respectively. These Hand Points gave immediate
relief in some cases of lumbago and lowback/leg pain.
(c) Hand Point "Neck" (between the knuckles of fingers 2-3 with fist tightly closed, needled
1" deep towards the wrist. This point gave immediate relief of neck pain/restricted movement
in one patient.
(d) Other points used were: LanWei (Appendix point) in abdominal pain/ constipation, XiYan
(Knee Eyes) in knee pain, YinTang (between eyebrows) and TaiYang (temporal fossa) in
headache, sinusitis.
(e) As they seldom give good results, distant points were seldom used. For example, the
following points gave poor results: ST38, GB39 or GB34 in shoulder or neck problems;
LU07 in headaches; TH03, SI03 in neck/shoulder problems.
11. One of the following statements is not correct. Indicate the incorrect statement:
(a) Chung seldom used distant points in myofascial or arthrotic syndromes.
(b) If patient was not helped within 20 minutes, the needles were left in situ for up to 40
minutes and other points (AhShi, Local points) were tried also.

(c) In needle use, operators were very careful to cleanse the skin (alcohol swab), use sterile
and/or disposable needles and to touch only the handle (not the shaft) when inserting the
needle.
(d) Styles of inserting and manipulating the needle varied between operators but most
operators placed great importance on obtaining DeQi after needle insertion.
(e) Chung twirled and pecked the needle very strongly in AhShi/TP points for 15-60
seconds. The patient often had very strong reaction to this (grunts, slight groans, facial
grimaces etc). In many cases, the needle was removed within the 15-60 seconds.
12. One of the following statements is not correct. Indicate the incorrect statement:
(a) DeQi has subjective (patient and operator) and objective characteristics.
(b) The patient reports strong sensations ("sore, heavy, tingling, electric shock-like, running,
aching but not painful") running, proximally, or distally from the needle. Sometimes the
sensation is said to travel proximally and distally.
(c) The patient may grunt, groan, flinch the limb or part being needled. Other responses
include explosive intake or expulsion of breath, facial grimaces and occasionally (in strong
reactors) sudden jerks involving all or part of the body, and occasional expletives.
(d) The operator usually has the sensation that the needle is being gripped by the tissue, i.e.
especially on withdrawal of the needle, (when a definite "nipple" seems to form at the skin
surface) or on twirling of the needle (when the needle seems to "lock" at the end of each
twirl).
(e) A clear 1-3 cm diameter blanched zone (vasoconstriction) appears around the needle after
a few minutes in some patients.

1 = d 2 = a 3 = e 4 = d 5 = b 6 = c 7 = e 8 = a 9 = b 10 = e 11 = a 12 = e

CLINICAL ACUPUNCTURE IN HORSES

This paper is based on published material (textbooks, journals etc), as well as on written and
verbal material from colleagues in many countries, together with our own clinical experience
with horses. The paper is given in three main parts:
1. Indications and contraindications for AP in horses;
2. Points and methods used in common conditions in equine practice;
3. APPENDIX: Acupuncture point locations and Channel functions.

The Appendix discusses Traditional versus the Transposition systems and the location of the
traditional and transposed points in horses. It also contains 26 figures and 26 charts showing
the location of the points and the main points used in many common conditions in horses.
Those unfamiliar with AP should study the Appendix and the references listed in it.

Rogers wrote the first drafts for seminars in Tokyo and Melbourne in 1985. He sent the drafts
to Dr. Cain, who made major changes then. The texts were corrected further and updated for
the IVAS Congress (Antwerp 1987) and for courses in Arhus (1988), (Oslo 1988), Sydney
(1991) and Dublin (1996). Without Dr. Cain's input, these papers would have been less
valuable than excreta from the taurine rectum. Most of the detail on point location and
function is his work.

The International Veterinary Acupuncture Society (IVAS) has existed since 1974. Since then,
documentation of the effects of acupuncture (AP) in humans, small animals and laboratory
animals has been much more extensive than in horses. AP is used today by veterinarians in
more than 34 countries and, in most of these, horses are also treated by AP. In an attempt to
document the current methods used and to give specific examples of AP in "Western" clinical
equine practice, questionnaires were sent to veterinarians experienced in equine AP,
especially to colleagues in IVAS. They were asked to indicate conditions which they found
were responsive to AP and the points and methods which they use.

The following colleagues gave details of their approach to equine AP, either in formal or
informal meetings, discussions or correspondence: Grady-Young,H., (deceased) of
Thomasville, Georgia, USA; Jeffries,D., 2612 White Rd., Grove City, Ohio 43123, USA;
Johnson,R., 209 Lake Aires Rd., Fairmont, MN 56031, USA; and Kuussaari,J., 25460 Toija,
Finland.

Basic texts on large animal AP are scarce. The best include those by Hwang,Y.C., Dept.
Anatomy, Veterinary School, Tuskeegee, AL 36088, USA; Klide,A., Dept. Anaesthesia,
Veterinary School, Philadelphia, USA; Kothbauer,O., Windberg 2, Grieskirchen, OberOsterreich, Austria; Lin,J.H., Dept. Animal Husbandry, National Taiwan University, Taipei,
Taiwan, ROC; van den Bosch,E., G. van Heuvelstraat, Ramsel, Belgium; Westermayer,E.,
(deceased) Bellamont, Sud Wurttemberg, Germany; and White,S., Dept. Anatomy, Veterinary
School, Murdoch University, West Australia. The authors of those texts kindly presented us
with copies of their work and explained their methods to us.

To these friends, to many others unnamed, and to our patients who have taught us to listen to
the body we give our most sincere thanks.
1. INDICATIONS AND CONTRAINDICATIONS
ABSTRACT
Acupuncture (AP) has major effects on the autonomic, nervous and endocrine systems. It has
immunostimulant, immunosuppressive, analgesic and antiinflammatory effects. It can
influence the physiological processes of all major systems. It has therapeutic value when the
affected organ or function is capable of responding through the normal response mechanisms.
AP is physiotherapy at its most powerful.

The main indications for AP therapy are functional disorders of the musculoskeletal, nervous
(central or peripheral), gastrointestinal, reproductive, urinary and respiratory systems. Certain
conditions of the skin and eye can be helped. The most important indication is in muscular
lameness (neck, back, limb muscles) and in poor athletic performance due to soft tissue
involvement. Milder or more acute problems usually respond faster and better than chronic
problems. However, many chronic diseases, (including chronic laminitis and navicular
disease) and certain serious acute diseases (including severe non-obstructive colic) can
respond.

The main contraindications are severe organic disease in which irreversible change has
occurred already (calcification, fracture chips, cancer, necrosis, fibrosis, degeneration,
degenerative myelopathies). Although AP may help to control symptoms in toxic, infectious,
nutritional and neoplastic diseases, its use as a primary therapy in such cases is
contraindicated but it could be combined with chemotherapy, other therapies and dietary
supplementation.

The cost factor may be an important contraindication. A prolonged course of AP might not be
justified on economic grounds in horses of low cash value, whereas it might be justified in
horses of great cash- or sentimental- value.

INTRODUCTION
Specific areas (Trigger Points (TPs) and the AP points (APs), usually in muscle and skin)
often become tender in response to pathogenic irritation of organs or body parts. Segmental,
intersegmental, supraspinal and autonomic reflexes mediate this response. Tenderness or
increased sensitivity of the TPs and APs may be found by firm palpation or by the response to
constant thermal or electrical stimuli applied to the points. Alternatively, electrical resistance-,
impedance- or conductance- meters may be used to detect the increased permeability of the
skin points. As these points related via the nervous system to the affected parts, stimulation of
the points by , TENS, needling, point-injection and other methods can evoke a reflex
therapeutic response in the affected organ or part. The diagnostic and therapeutic efficacy of
the organ-point relationship is possible only if the nervous system is functional and if the
affected part is capable of the desired physiological response.

AP influences all physiological systems, including the nervous (central, autonomic and
peripheral), endocrine, musculoskeletal, gastrointestinal, urogenital, respiratory and skin. It
has analgesic, antiinflammatory, immunostimulant and immunosuppressive effects. It has
antispasmodic effects on striated and smooth muscle. It has marked effect on blood microcirculation, cell metabolism and glandular secretion in organs related to the APs being
stimulated.

AP is a most powerful physiotherapy. Its therapeutic effects are mediated by the reflex system
and by activation of spinal and central neuroendocrine and systemic responses. Its therapeutic
value lies in its ability to induce homoeostasis. For example, needling ST36 (TsuSanLi) can
control gastric spasm in one case and gastric atony in another. The same point can have
diametrically opposite physiological effects, depending on the homoeostatic needs of the body
at that time.

Therapeutic effects of AP are possible only when the normal physiological mechanisms of the
body are capable of response. For example, AP can have little or no effect on paralysis due to
spinal transection, motor neuron degeneration (German Shepherd syndrome) or severe
damage to motor centres in the brain. However, AP can accelerate recovery in paralysis due
to peripheral nerve trauma or radiculopathy due to soft tissue inflammation or in CVA cases
where paralysis is due mainly to vasospastic ischaemia of the motor centres. AP may be
useless in severe fibrosis of the liver or kidney but it can help in early hepatitis or nephritis,
before the pathological changes have become severe or irreversible. In humans and animals,
AP can be very helpful in bronchospasm but may be of little use in emphysema, in which
severe rupture of the alveolar sacs has occurred.

The prognosis for full recovery is very good in paralysis due to cervical radiculopathy, if the
symptoms are due to soft tissue swelling with very minor damage to the motor neurons or
tracts but the prognosis is very poor if neuronal degeneration is severe.

The contraindications include neoplasia and severe organic disease. Although some claims are
made for effectiveness of AP in tendinitis, many experts got poor results in these cases.
Tendinitis responds poorly to AP of Local points over the tendon but Laser or "Plum Blossom
Needling" may give a better response.

Although AP may help to control symptoms in neoplastic, toxic, infectious and nutritional
diseases, its use as a primary therapy in such cases is contraindicated but it could be combined
with chemotherapy, other therapies and dietary supplementation.

Table 1 summarises the more important indications for AP in horses but it is not a complete
list. For example, AP can help in splints (especially inside splints), curbs, tying-up (azoturia)
and skin problems (M.J.C).

CONCLUSIONS
AP has many applications in equine practice. The conditions covered in this paper are only
some of those which can be helped by AP. The success rate in many conditions is above 70%,
especially in many lamenesses, functional diseases and infertility. Success often can be
attained in 1-3 sessions at intervals of 1-3 days (acute cases) or in 1-10 sessions at intervals of
4-7 days (chronic cases).

The value of thoroughbred stock, stabling and training costs, the value of a foal in infertility
cases are considerable. The AP technique is very safe if it is used properly (Rogers 1981).
Therefore, AP must be deemed to be a valuable therapy for use on its own or in combination
with other methods in thoroughbred practice.

Part 2 of this paper deals with the points and methods used in many common disorders of the
horse. These are good indications for AP in horses but must not be interpreted as an
exhaustive list. AP is a very versatile technique and offers much to the busy practitioner, the
client and the patient.
Table 1. Some of the more important indications for AP in horses.
Condition

Author

% Success

Sessions days between

rate
MUSCULOSKELETAL
Soreback

20-100
1-12
Ca Jo Kl Ko Ku 75-85 (short
2-10
term)
Ro Wh Y

(thoracic, lumbar, sacral)

0.5-1

5-7

2-4

1-3

3-4

2-6

1-3

3-7

20-80 (long
term)

Saddle-sore

Ca Jo Ro Y

Shoulder lame

Ca Ku Ro Wh

80-100
80-90
(v. few
relapse)

(acute, chronic)

Elbow lame

sessions
Acute Chronic
0,5-4 3-7

Ca Ro We

70-80 (?)

1-3 recent 1-3

3-7

3-8
chron.

Hip, thigh lame

Stifle lame

Ca Ro
Ca Je

70-80 (?)
> 90

Laminitis

Ca Kl Ku

80-90

same
1-2
1-4 (3)

80-90

1-12 (6)
3-7

same
2-4
2-4

3-7

Navicular
Foot abscess
PERIPHERAL N.
PARALYSIS

Ca Jo
Jo

>80 (?)
>80 (?)

6
?

Radial n. paralysis

Ca Hw Wh Y

90 (recent)

1-4

50-70 (> 2
weeks)

Facial n. paralysis
Wobbler, cervical ataxia

Ca Wh
Ca Je Ro

same
3-7

3-4
?

3-7

1-10

?
1-10
50-80 recent 1-10

1
1-3

0-40 chronic 4-30

3-7
4-7
4-7

GASTROINTESTINAL
Colic (sand, gas, bloat)
Windsucking
Cribbing
Gastric ulcer
Chronic diarrhoea

Ca Ko Ku Wh
Ku
Ku
Ro
Ro

80-100
1-2
67
29
100 (2 cases) 2
33 (3 cases) 3-5

0.5
2-6 (3)
2-6 (3)
-

1-3
2-5 (4)
2-5 (4)
7
7

RESPIRATORY
Heaves (no emphysema)
Bleeders
Rhinitis

Ko Ku
We Y
Ca Je Ro
Y

Poor
50-85
75-90
> 90

1-6
4-8
1
3-5

1-3
1-3
-

3-7
3-7
3-4

REPRODUCTIVE

We Ca

60-70

2-4

Anoestrus
Cystic ovary (better in luteal
cysts)

Hw Jo Ku Wh Y 50-100

1-10(4)

1-5 (3)

Je Jo Ro Y

2-5 (3)

3-4

1-8 (3)

3-4

1
(implant)

75-90

Stallion problems

Ca Je Jo Ro Wh
70-95
Y
Jo
good

NERVOUS esp. female

Ca

Repeaters

good

Ca=Cain Hw=Hwang Je=Jeffries Jo=Johnson Kl=Klide Ko=Kothbauer Ku=Kuussaari

Ro=Rogers We=Westermayer Wh=White Y=Grady-Young
2. POINTS AND METHODS USED IN THERAPY
ABSTRACT
Acupuncture (AP) therapy is based on stimulation of relevant reflex points. These are the
AhShi points, paravertebral (Shu) points and other points with effects on specific organs,
areas or functions. The choice of points can be made from traditional horse texts or by
transposition of the human AP point system to the equine anatomy, or by combining both
systems. Classical AP gives better and more long lasting results than Cookbook AP,
especially in complicated cases.

There are other methods of point selection (earpoints, hoof points etc) and of point stimulation
(magnets, staples, implants, Dermojet, Laser etc) but these methods must be regarded as
experimental until adequate documentation and comparative clinical trials are available.
Points and techniques used by leading international experts are described for many common
conditions in horses. These include lameness, peripheral nerve paralysis, colic, windsucking,
heaves, bleeders, infertility and nervousness.

The points may be stimulated by simple needling, electroneedling, point-injection or other

methods. The classical method is simple needling for 20 minutes every 1-3 days in acute
cases or every 4-7 days in chronic cases. Point-injection is fast, popular and effective in busy
practice.

Most responsive cases show improvement after 1-4 sessions but 4-10 sessions or more may be
needed in long standing serious cases.

When AP is accompanied with Herbal Medicine, success rates are higher and longer-lasting,
especially in internal problems, such as gastrointestinal and respiratory disorders (bleeders
etc) (M.J.C)

The locations of the AP points (APs) mentioned in the text are in an Appendix, together with
26 charts and 26 figures.

INTRODUCTION
In classical AP, the practitioner seeks to identify any imbalances in the Jing-Luo (the
classical Channel and Collateral) system, now called the Channel-Organ System (COS).
These imbalances are corrected by stimulating specific AP points (APs). Unpublished
research with thermography in the horse (Cain 1984) suggests that activation of APs causes
immediate communication of energy with other points.

It is important to make a correct AP diagnosis before AP therapy is attempted. Cookbook AP

is useful for beginners and can give good or excellent results in simple cases but beginners are
advised to study AP in depth to get the best results. However, simply selecting tender points
(TPs, AhShi points, "sore points") and needling a few points from Cookbook recipes is
inferior therapy. Cookbook AP alone, without an adequate knowledge of traditional AP
principles (Channel paths, Yin-Yang pairs of Channels, Master Points, Five Phase
Theory, Shu-Mu relationships to Channel function etc) gives only mediocre results, at best.
For long-lasting results, especially in complicated cases, the practitioner needs to know the
classical principles, in order to correct the imbalances in body energies.

Part 2 discusses points and methods used by leading exponents of equine AP. Much of the
clinical material was gathered by personal contact with experts and is confirmed by extensive
clinical usage. The following areas are discussed:

1.0. Classical tonification and sedation points

1.0.1. Important Shu-Channel relationships
1.0.2. Ting Points in horses
1.1 Musculoskeletal problems
1.1.1. Soreback (thoracic, lumbar and sacral area)
1.1.2. Saddle-sore

1.1.3. Shoulder lameness

1.1.4. Elbow lameness
1.1.5. Hip and thigh lameness
1.1.6. Stifle and hock lameness
1.1.7. Laminitis, navicular disease, foot abscess
1.1.8. Tendinitis, splints, curbs
1.1.9. Azoturia, tying-up syndrome
1.2. Neurological problems
1.2.1. Peripheral nerve paralysis
1.2.2. Radial paralysis
1.2.3. Facial paralysis
1.2.4. Cervical ataxia (the Wobbler Syndrome)
1.3. Gastrointestinal problems
1.3.1. Colic
1.3.2. Windsucking, crib-biting
1.3.3. Gastric ulcer, diarrhoea
1.4. Respiratory problems
1.4.1. Bronchospasm, heaves, bronchitis
1.4.2. Bleeders, lung haemorrhage, epistaxis
1.4.3. Rhinitis, sinusitis
1.5. Reproductive problems
1.5.1. Anoestrus
1.5.2. Cystic ovary
1.5.3. Repeat breeders
1.5.4. Reproductive problems in stallions

1.6. Other clinical uses

1.6.1. Anxiety, nervousness, especially in filly
1.6.2. Skin problems
1.6.3. Cracked Heels

Charts 1-23 (Appendix) show the location of the main APs used in conditions 1.1-1.6.

1.0. CLASSICAL TONIFICATION AND SEDATION POINTS

In TCM/Classical AP, the symptom picture, clinical exam, Chinese Pulses, facial and lingual
colour etc may suggest energy (Qi) deficiency (hypoactive Qi = Xu) or excess (hyperactive
Qi = Shi) in one or more Channels. Deficiency or excess Qi in a Channel can be corrected
by many methods (herbal remedies, fasting, feeding, diuretics, bleeding, fluids, laxatives etc,
as appropriate) but AP can also be used according to the Mother and Son Law of the Five
Phase Cycle.

For Xu (deficiency) use Bu (tonification) needling: To stimulate (tonify) a weak Channel,

one can needle its "Mother Point", manipulating the needle in Bu-style ("Tonification Mode",
thrusting heavily and rapidly but lifting gently and slowly, while rotating the needle with
small amplitude and low frequency).

For Shi (excess) use Xie (sedation) needling: To pacify (sedate) a hyperactive Channel, one
can needle its "Son Point", manipulating the needle in Xie-style ("Sedation Mode", thrusting
gently and slowly but lifting forcefully and rapidly, while rotating the needle with large
amplitude and high frequency).

TONIFICATION AND SEDATION POINTS

PHASE METAL EARTH FIRE WATER FIRE WOOD
Mother Earth

Fire

Wood Metal

Wood Water

Son

Metal

Earth Wood

Earth Fire

Water

PHASE

METAL EARTH FIRE WATER FIRE WOOD

Channel

LU LI ST SP HT SI BL KI PC TH GB LV

To Tonify: 09

11 41

02 09 03 67

07 09 03 43 08

To Sedate: 05

02 45

05 07 08 65

01 07 10 38 02

For example, in acute bacterial enteritis, with excess Qi in LI and SI Channels (Metal and
Fire), one could sedate LI at the Son (Water) point of LI (LI02) and sedate SI at the Son
(Earth) point of SI (SI08), needling in Xie-style ("Sedation Mode"). One could also use
fluids, demulcents, intestinal sedatives, antibacterials etc, as needed. In chronic bronchitis,
with deficient Qi in the LU (Metal) Channel, one could tonify LU at its Mother (Earth)
point (LU09), needling in Xu-style ("Tonification Mode"). These principles are explained in
more detail in The Essentials of Chinese AP (Beijing 1993).

1.0.1. IMPORTANT SHU-CHANNEL RELATIONSHIPS

The AhShi points and sensitivity at the Shu points (BL points in the paravertebral area) are
most important in the selection of APs in horses. Shu point sensitivity often gives diagnostic
information on the location of Channel problems and helps in the choice of APs for therapy.

If the Shu of one Channel is tender, the Shu of its paired Channel may be used also. The
pairs are: Fire (HT-SI/PC-TH); Earth (SP-ST); Metal (LU-LI); Water (KI-BL); Wood
(LV-GB). Thus, in hindlimb lameness, if BL23 (kidney Shu) is tender, one can add BL28
(bladder Shu) to the prescription.

The Sheng (Mother-Son) relationship is:

FIRE -> EARTH -> METAL -> WATER -> WOOD

Yin Channels: HT, PC -> SP -> LU -> KI -> LV
(HT, PC nurtures SP; LV is nurtured by KI etc)

Yang Channels: SI, TH -> ST -> LI -> BL -> GB

(SI, TH nurtures ST; GB is nurtured by BL etc).

The Sheng (Mother-Son) relationship can be used clinically via the back Shu (Paravertebral
BL) points:

The Mother point of HT is BL18 (LV) and of SI is BL19 (GB).

The Son point of HT is BL20 (SP) and of SI is BL21 (ST).

The Mother point of SP is BL15,14 (HT, PC) and of ST is BL27,22 (SI, TH).
The Son point of SP is BL13 (LU) and of ST IS BL25 (LI).

The Mother point of LU is BL20 (SP) and of LI is BL21 (ST).

The Son point of LU is BL23 (KI) and of LI is BL28 (BL).

The Mother point of KI is BL13 (LU) and of BL is BL25 (LI).

The Son point of KI is BL18 (LV) and of BL is BL19 (GB).

The Mother point of LV is BL23 (KI) and of GB is BL28 (BL).

The Son point of LV is BL15 (HT) and of GB is BL27 (SI).

The Mother point of PC is BL18 (LV) and of TH is BL19 (GB).

The Son point of PC is BL20 (SP) and of TH is BL21 (ST).

If there is weakness (deficiency) in a Channel, the Shu of the Mother Channel can help. If
there is hyperactivity (excess energy) in a Channel, the Shu of the Son Channel can help.
Thus, in weakness of KI, one could use the LU Shu (BL13) with other points; in weakness of
LI, one could add the ST Shu (BL21). In excess of HT, one could add BL20 (SP Shu). In
excess of ST, one could add BL25 (LI Shu). (See section 1.0. (above) for the more classical
method).

Injury to Shu points, or to key APs, can have effects far more serious than "local injury" in a
western sense. It may induce signs and symptoms in the associated organ or Channel and in
related Channels. Injury to the paravertebral area from the withers to the tail, whether due to
incompetent riding, badly fitting saddle etc must be identified and treated as quickly as
possible.

Those who have not used AP in horses should study the references and, if possible, attend
professional veterinary AP teaching seminars before trying to use the method. The
information which follows is aimed at colleagues who know the basics of AP rather than at
complete novices of the technique.

APs seem to have properties like magnetic vortices: they can receive and transmit
electromagnetic signals. A point which is too deep to reach by the needle (such as KI24,25,26
on the chest wall medial to the shoulder muscles, or ST29,30 and SP12 in the abdominal
muscles medial to the thigh muscles) can be acted upon by inserting a needle pointed towards
the point, although the needle may not reach the point (M.J.C). The vortex theory is supported
by the powerful effect of superficial implants in lameness of deep tissues or joints in horses
and dogs. The implants (gold beads, orthopaedic suture wire etc) are dropped at whatever
depth DeQi arrives (usually less than 1.5 inches (M.J.C). (See hip lameness, 1.1.5 below).

See Appendix 1 for details of the points and Channels (figures 1 to 26).

1.0.2. TING POINTS IN HORSES

The Ting Zones, located 1-2 cm above the hoof-hair junction, are the most distal points on
each Channel. Are Thoresen (Norway) pioneered their diagnostic and therapeutic use in
horses. He found that stimulation of a distant reactive body AP point on the affected Channel
caused complete disappearance of the pitting in the reactive Ting Zone, within seconds. This
effect was visible from several metres away. The speed of this reaction indicates that the
reactivity at the Ting Zone is functional and it confirms the connection between the Ting
Zone and the Channel concept of TCM.

Stimulation of the correct Ting Zones causes a biological response in the microcirculation
and in the affected organ(s), part(s) or function(s) and can influence all other reactive Zones
on the affected Channel, especially the Shu points, as well as the parts traversed by the
Channel. Thoresen found (and we have confirmed) that needling the appropriate (usually

reactive) Ting Zones can sedate ("satisfy", "cool" or obliterate reactivity from) reactive Shu
points, or AhShi points elsewhere on the body within 2-15 minutes (and sometimes within 10
seconds).

Where more than 1 reactive Ting Zone is present, needling of the primary one (according to
Five Phase Theory) is often followed by disappearance of the secondary Ting Zones within
seconds.

Location of Ting Zones in horses

Zones 1 and 7 medial side of the fore and hind hoof respectively, 1-2 cm anterior to a line
with the posterior edge of the coronet.

Zones 2 and 8 medial side of the fore and hind hoof respectively, about 1/2 of the distance
between Zones 1 and 3 or 7 and 9 respectively.

Zones 3 and 9 anterior midline of the fore and hind hoof respectively.

Zones 4 and 10 lateral side of the fore and hind hoof respectively, about 1/2 of the distance
between Zones 3 and 5 or 9 and 11 respectively.

Zones 5 and 11 lateral side of the fore and hind hoof respectively, 1-2 cm anterior to a line
with the posterior edge of the coronet.

Zones 6 and 12 in the hollow of the heel of the fore and hind foot respectively, on a line
joining the highest point of the horn on the medial and lateral side of the hoof.

Zone 1 (HT09) (forelimb, posterolateral zone) relates to the Heart Channel. The horse often
pulls up towards the end of the race for no apparent reason, especially in very hot or very cold
weather. There can be lameness in different joints, which may alternate from time to time.
Although the HT Channel relates to the forelimb, the lameness may also affect a hindlimb.
Zone 1 is often reactive in overexertion. (See Zone 5). It may be reactive in bruised sole/soft
horn, laminitis and flexor tendon strain.

Zone 2 (SI01) (forelimb, mid lateral zone) relates to the Small Intestine Channel and arteries,
especially the larger vessels. The symptoms may be similar to those of Zone 1 but are less
obvious or less severe. There are often intestinal problems, especially jejunal (colic, pain) and
these often arise with change in feeding or a new supply of hay. This Zone often reacts in
forelimb deep flexor tendon problems. It is often reactive together with Zones 10 and 11 (see
below).

Zone 3 (TH01) (forelimb, anterior zone) relates to the Triple Heater Channel, skin
microcirculation and especially to mucosae and joint cavities. There tends to be a recurrent
sinusitis and the serous fluid in the joints is often too thin. The history often mentions frequent
injections of hyaluronic acid. Zone 3 is often reactive in sore heels/heel haemorrhage, cracked
heels and hoof-bend bleeders. The lesion in these cases is near Zones 6 and 12.

Zone 4 (LI01) (forelimb, mid medial zone) relates to the Large Intestine (Colon) Channel
and to muscles of the forelimb and shoulder area. Faeces may smell sour and their consistency
may vary widely. The case often shows purulent nasal discharges. Very often the horse pulls
to one side in training or racing and does not want to lead, but prefers to run with a follower
group. Trotters (which should not gallop) tend to gallop in the bends and may show signs of
pain in the shoulder. Its therapeutic uses include neck problems, (reactive LI16-18, BL25),
sinusitis, ankle (forelimb fetlock) problems and inside forelimb splint problems (M.J.C).

Zone 5 (LU11) (forelimb, posteromedial zone) relates to the Lung Channel. This Zone reacts
often when the horse is forced to breathe dusty, stale or polluted air, or has been raced in cold
weather. Zone 5 indicates whether left or right lung is affected. (The ipsilateral Zone is
reactive). Zone 5 is nearly always reactive in overexertion (see Zone 1), in lung disorders and
in poor quality horn (soft, easily cracked or too thin), bruised sole. Its therapeutic uses include
respiratory problems, respiratory bleeders (reactive BL13, 13a, 41-47), inside forelimb splint
problems, infection (M.J.C).

Zone 6 (PC09) (forelimb, between and above heel bulbs) relates to the Pericardium
(Circulation-Sex) Channel, which influences the psyche and sexual hormones. The symptoms
include changes in sexual behaviour, sweating, nervousness, forelimb superficial flexor
tendon problems. Zone 6 is not a diagnostic Zone for beginners, as outlined below. It does not
react in ways that can be detected manually by novices. It is included here to complete the
systematic AP schema and because it is a valuable therapeutic Zone. Its choice is dictated by
the history and symptoms.

Zone 7 (BL67) (hindlimb, posterolateral zone) relates to the Bladder Channel and the
paravertebral muscles from neck to tail, in the area from the midline to 20-30 cm laterally. It
relates to the hindlimb flexor tendons, especially the superficial flexors. In humans, the BL
Channel is often related to headaches. Horses which are seen nodding, headpressing or
headbanging often respond immediately to one treatment at Zone 7 and the response is
longlasting.

Zone 8 (GB44) (hindlimb, mid lateral zone). The horse has no gallbladder but functions of
the Gallbladder Channel in man are similar in the horse. Zone 8 relates to the GB Channel
which relates to the back and head lateral to Zone 7, i.e. paravertebral in an area 30-60 cm
lateral to the midline. It is strongly related to the hip joint and to the area of insertion of the
Longissimus dorsi muscle to the tuber coxae. Marked pain sensitivity in the hip or tuber coxae
area is usually associated with reactivity of Zone 8. The horse does not race well and pulls to
one side. Trotters may gallop in the straight as well as on bends (see Zone 4). There may be
recurrent colic (see Zone 2), especially at night. (Midnight is the hour of the GB energy in
TCM).

Zone 9 (ST45) (hindlimb, anterior zone) relates to the Stomach Channel. This Channel
relates to appetite, stomach function, mastitis and stamina in humans. Zone 9 is very
important in cattle (mastitis) but horses rarely show reactivity at this Zone. It may be reactive
in thoracic stiffness and in bone spavin. Its therapeutic uses include stifle problems, (reactive
BL21, ST10, 25a, stifle points in the muscle groove below the tuber ischii), colic, toothache
(M.J.C).

Zone 10 (LV01) (hindlimb, mid medial zone) relates to the Liver Channel, digestion, food
allergies, detoxification, eye diseases, problems of the medial hindleg muscles, also to general
musculature and fitness. It is one of the most common to be found reactive in the horse. Its
value in therapy is enormous. It is reactive in hindlimb lameness, generalised muscle cramp
(azoturia, tying-up syndrome, Monday morning disease, Easter disease, muscular dystrophy
etc). Because of the importance of optimum muscle fitness in the horse, the importance of
Zone 10 in diagnosis and therapy is obvious. It is also reactive in allergies (urticaria, food
allergy etc) but not in dust allergy (see Zone 5). Zone 10 is often reactive together with Zones
2 and 11 (see).

Zone 11 (SP01) (hindlimb, posterolateral zone) relates to the Spleen-Pancreas Channel. In

humans, this relates to digestion, reproduction, the muscles and the psyche. In horses, is
diffuse. It is often reactive with Zones 2 and 10 (see). It may be used in prognosis with Zone
10 in muscle problems. If both Zones 10 and 11 are reactive together, the prognosis is bad and
recovery may take several months. Even in cases where is reactive on its own, the prognosis
is bad. The signs often are confined to the hindquarter, especially during racing. A change of
diet (especially hay) can shorten the recovery time when is reactive. Homoeopathic

Arsenicum album D12 and Plumbum metallicum D30 (3 pillules each/day) also help to
shorten recovery time by about 1 month in these cases.

Zone 12 (KI01) (hindlimb, between and above heel bulbs) relates to the Kidney Channel.
The symptoms include stiffness or weakness of the lumbar area, stifle problems, bone
problems (tendency to weakening, fracture, bone spavin etc), tendency to abortion and a very
unreliable (dangerous) psyche. Nearly all horses with those symptoms benefit from treatment
at Zone 12 and most horses between 1 to 2 years of age can also benefit from it. Zone 12 is
not a diagnostic Zone for novices, as outlined below, as it does not react in ways that can
easily be detected manually. It is included here to complete the systematic AP schema and
because it is a valuable therapeutic Zone. Its choice is dictated by the history and symptoms.

Most details on the use of Ting Zones are from Thoresen's paper on the subject. We (Cain &
Rogers), Peggy Fleming, Dominique Giniaux, Emiel van den Bosch and others, have
confirmed the value of Ting Zone therapy in horses.

Clinical uses of Ting Points in horses

Ting points can be used in organic syndromes as well as in functional disorders. Thoreson has
treated more than 10 cases of bone spavin. Zones 9 and 12 (ST and KI) were usually reactive.
Treatment at these Zones, plus 2 Dermojet treatments of the reactive (pain) point on the ear,
gave improvement in all cases and about 90% were clinically cured and remained sound for
more than 1 year.

Abortion: Add the relevant Ting point, especially KI

Bone spavin: Add the relevant Ting point, especially ST, KI

Bronchitis/cough/lung disorders: Add the relevant Ting point, especially LU

Colic, acute: Add the relevant Ting point, especially LI, SI, KI, GB

Cracked heels arise when Channel blockage is present over a period. Use of Ting Points
predictably cures cracked heels in 5-7 days, even in severe long-lasting cases, especially if
LU or LI are involved (M.J.C).

Diarrhoea: Add the relevant Ting point, especially LI, SI, LV, SP, ST

Dust allergy: Add the relevant Ting point, especially LU, LI, TH

Flexor tendon strain: reactive Ting Zones especially from LI, PC, TH, KI, BL, HT, SI.
The usual interval to clinical success was 1-35 days, (mean of 2 weeks) and most could
resume full training in 3-6 weeks. In acute cases of tendovaginitis, training may be resumed in
1-2 weeks. Tendovaginitis: Add the relevant Ting point, especially TH, LI, SI

Food allergy: Add the relevant Ting point, especially LV

Headache (headpressing, headbanging, nodders): Add the relevant Ting point, especially
GB, BL

Joint pain, arthritis, uncomplicated strains: all reactive Ting Zones

Lung bleeders: Add the relevant Ting point, especially LU

Male viciousness, hitter, biter: Add the relevant Ting point, especially SP, PC, KI

Overexertion: Add the relevant Ting point, especially HT, SI, LU

Polyarthritic shifting lameness: Add the relevant Ting point, especially HT, SI, TH

Pulls to one side (check atlas !): Add the relevant Ting point, especially LV, GB

Sexual/reproductive/Female infertility/Nymphomania: Add the relevant Ting point,

especially HT, TH, KI, LV, PC

Skin: Add the relevant Ting point, especially LU, TH, SP, LV

Sole haemorrhage/trauma, soft horn: Add the relevant Ting point, especially LU, HT, SI

Tracheitis: Add the relevant Ting point, especially LI, LU

Tying-up syndrome: Add the relevant Ting point, especially LV, SP

Urticaria: Add the relevant Ting point, especially LV, LU

1.1 MUSCULOSKELETAL PROBLEMS
(Kothbauer; Westermayer; Jeffries; Hwang; Grady-Young; Kuussaari; White)

The paravertebral Shu are helpful diagnostic points to isolate Channel lameness. Once the
Channel(s) are identified, all anatomical structures under or nearest to that Channel path are
considered (and palpated). For example, the LI Channel passes through or near the
intermediate and 3rd carpal bone, the inside shin, the osselet under the medial digital flexor
tendon, the inside splint, anterior branch of suspensory ligament, shoulder bursa etc. In
tenderness of BL25 (lumbar 4-5, large intestine Shu), the lameness may lie in those
structures, if it is not due to primary strain of the lumbar area, or referred from the organ.
Thus BL25 may relate to anterolateral forelimb lameness above the carpus or the
anteromedial forelimb below the carpus. In such cases, apart from needling the affected Shu
and other key points, one should balance the paired Channel of LI (LU) by needling BL13
(LU Shu).

Check for diagonal relationships. Forelimb lameness is often accompanied by AhShi

(tenderness) at contralateral lumbosacral or hindlimb points (M.J.C). Also, hindlimb lameness
is sometimes associated with AhShi points on the contralateral side of the neck.

Forelimb lameness: Add the relevant Ting point, especially LI, LU.
Hindlimb lameness: Add the relevant Ting point, especially SP, KI, LV.

Search for tender points in all local problems (neck, shoulder, elbow, back, thoracolumbar,
lumbosacral, hip, stifle, laminitis etc). These are the Trigger Points (TPs), Pain Points, or
AhShi Points. Check especially the paraspinal area (neck and interscapular area in forelimb
problems; thoracolumbar and lumbosacral area in hindlimb problems).

Ovarian or uterine irritation in mares and fillies, may cause severe sporadic lameness due
to referred pain (hindquarter, hunched or rigid back and, occasionally, forelimb lameness).
This may occur in cystic ovary or at the time of ovulation if there is a lot of local
haemorrhage. It is essential in such cases to check for AhShi points related to the ovary and
uterus (see section 1.5 below).

Experts locate the Channel imbalances and choose points according to Five Phase Theory
(Sheng and Ko Cycles) and the relevant Ting and/or Shu points. If the Command Points are
dangerous to needle (too distal on the limbs or in other sensitive areas), they can be treated by
painless methods (Laser, LACER etc). This minimises the number of needles and sessions
needed. It also gives longer lasting results than the Cookbook method.

Use AhShi points, Local points, Region points. Consider points with potent actions: BL11
(bones & joints); BL40 (hindlimb & back); LI04 (forelimb & general effects); ST36
(hindlimb & general effects); ST44 (hindlimb); TH05 (forelimb); GB34 (hindlimb, muscles,
tendons, neck, shoulder & elbow); GV03 (BaiHui) (hindlimb, lumbosacral area, general
effects); BL23 (lumbosacral and hindlimb, adrenal point (all stress conditions),
ovary/kidney/Vitamin D/parathyroid/bone point & general effects).

Problems of the back, sacral- and gluteal- area respond better and longer and need fewer
sessions if AP is combined with spinal manipulative therapy (M.J.C).

Treat for 20 minutes, 2-4 times at intervals of 1-2 days (acute) or 3-7 days (chronic). White
suggests electro-AP for 20 minutes, repeated every 12-24 hours in acute cases with severe
pain or paralysis. Before using electro- AP, ensure that the horse has not had adverse
electrical experience in the past (electric goad etc).

1.1.1. Soreback (thoracic, lumbar and sacral area) (Fig. 1)

(Cain; Kothbauer; Kuussaari; Klide; Grady-Young; Johnson; Rogers; White)

Search the back and paravertebral muscles for AhShi (tender) points. If the tail twitches
during riding, this indicates AhShi at BL23 (kidney Shu). Use all AhShi points. Add BaiHui
and points from BL18 (ICS 15) to BL26 (L5-L6) and BL28,30 (foramina S2,4) or points
from BL17 (ICS 14) to BL25 (L4-L5) and BL27,29 (foramina S1,3). Use the more anterior
points if the pain is more anterior. Consider also GV12; BL31,34,54 and the point at the
meeting of the scapula and the anterior edge of the scapular cartilage (TH15 = TCVM
PoChien).

Spinal and paravertebral muscle pain (cervical, thoracic, lumbar, sacral): Add the relevant
Ting point, especially KI, GB, BL.

Lumbar weakness: Add the relevant Ting point, especially BL, KI, SI.

Treatment: injection, simple needling, electro-AP (20 seconds/needle) or Laser. Treat 1-2
times/week (usually every 5 days) for 2-10 times. In acute cases, with severe pain or
paralysis, treat every 12-24 hours. Relapse within 6 months after successful treatment may be
5-50%.

1.1.2. Saddle-sore (Fig. 2)

(Cain; Grady-Young; Johnson; Rogers)

In all cases of "saddle-sore", check the design and fit of the saddle and the habits, skill,
balance and of the usual rider. Advise on necessary correction of detected faults. Advise the
use of high-quality saddle-pads (especially cellular, gel-filled saddle pads, for the first few
weeks after treatment.

Pain, stiffness, rigidity in the area of the saddle, is treated as in 1.1.1, above. Tenderness near
BL18 (liver Shu) may be associated with a muddy colour of the mucosa of the eye. (The liver
controls the eye in TCVM).

Use AhShi points plus BL points, especially BL21,23,25. Add the relevant Ting point,
especially ST, SP, GB, LV, HT, LU, as may be indicated by the findings of the AP
examination.

Treatment: Inject procaine-B12 (9 ml 1% procaine + 1 ml B12; 3000 units/ml at each point),

using 19g needle, depth 3-4 cm (or)
needle or electro-AP 20 minutes; 2/week; 2-4 times.

1.1.3. Shoulder lameness (Fig. 3)

(Cain; Kuussaari; Rogers; White)

Check for cervical subluxation, especially in the area C6 to T1. See the LI, SI and TH
Channels (Appendix). Check TH16 (endocrine), BL22 (TH Shu, endocrine), BL27 (SI
Shu), BL25 (LI Shu).

SI10, if still tender after proper Channel balancing, is diagnostic for LOCAL shoulder
lameness (OCD). TH14 may be tender in shoulder lameness but true joint lameness (OCD) is
rare. More often, the lameness is muscular, referred from subluxation of vertebrae C6-T1, via
the brachiocephalicus m., attached to the humeroscapular joint. Painful shoulder or neck can
cause spasm of that and other muscles and a choppy forward stride on the ipsilateral forelimb.
If the problem is ovarian, treat BL22 (TH Shu) and the sensitivity at TH16 usually
disappears. If the problem is shoulder lameness, treat TH14 and SI10, with BL22 and 27
(Shu of TH and SI). If the shoulder pain is referred from the neck, treat the neck, with
vertebral adjustments, if needed (see 1.2.4).

The main points are: AhShi points located in the muscles of the neck, scapular, shoulder and
paravertebral area, with points from BL11,22,27; GB21; TH05,14,15,16; LI15,17;
SI09,10,13,17; LU01,01a; ST10.

Treatment: Electro-AP (10-20 seconds/point) or simple needling (20-30 minutes), 2-6 times
(mean 3) at intervals of 3-7 days (mean 4). White suggests 20 minutes electro-AP every day
in acute cases.

If the lameness is due to irreversible OCD, gold bead implants at ST10, LI17, SI09,10,13,17,
BL22,27 can halt the progress of the condition. If done at 1-2 years of age, the result is very
good: most can go on to full training and racing (M.J.C). Few cases relapse after successful
treatment.

1.1.4. Elbow lameness (Fig. 4)

Lameness associated with AhShi points in the muscles behind the elbow is a good indication
for AP. The points used are:
AhShi points in the area (check also the scapular and neck muscles)
Local points LI10,11,12; TH10; HT03; PC03; SI08
Region points (BL11; LI15; TH14; SI09 etc)
additional points from TH05; LI05

Treat by simple AP, electro-AP or point injection every 3-7 days for 1-3 times in recent cases
and 3-8 times in chronic cases.

1.1.5. Hip and thigh lameness (Fig. 5)

(Cain; Rogers)

Hip and thigh lameness may be due to local muscle strain, hip arthritis, hip dysplasia or pain
referred from the thoracolumbar area. Dysplasia is very common in horses. It is often
misdiagnosed as stifle or hock lameness. In severe dysplasia, BL19,48 (GB Shu),
GB29,30,31 are usually tender, making it possible to diagnose dysplasia pre-purchase (as in
yearlings). Tenderness at all those points indicates a poor prognosis, even if the points are
implanted. In mild cases, or in other cases of hip and thigh pain, needling those points gives
very good results (M.J.C). In coxofemoral lameness of horses and dogs, insertion of gold

beads towards the rim of the acetabulum (using a 16 g 30 mm needle) has powerful clinical
effects, even though the beads are inches away from the acetabulum in horses.

Injection of irritant substances (such as copper compounds) over the sciatic nerve may cause
sciatica with hip and thigh lameness (Rogers). BL25 may be tender in sciatica.

The points most effective on the hip and thigh are:

AhShi points in the thoracolumbar, sacral, hip-thigh and posterior thigh muscles.
Local points (GB29,30,31,32; BL30,36,37,38,54; ST31,32,33,34)
Region points (BaiHui; BL23,54)
Additional points from BL18,19,25,27,47,48, GB21,25a,34,39
Add the relevant Ting point, especially GB.

Treatment: as for elbow lameness.

1.1.6. Stifle and hock lameness (Fig. 6)

(Cain; Jeffries; Rogers)

Points BL36,36a,37 are diagnostic/therapeutic for the stifle. ST25a, at the lower, posterior
edge of the tuber coxae (origin of tensor fascia lata) is also important. Add BL20,21, SP10,
ST10 and point anterior to the origin of the biceps femoris (near BL35).
Tenderness at BL18,20,23 (LV, SP, KI) suggests inside stifle.
Tenderness at BL19,21,28 (GB, ST, BL) suggests outside stifle.

In stifle wear, Cain injects 10 ml Hypodermin (18g needle, 3 cm) towards BL40 in the
intercondyloid fossa and adds SP09, ST36, GB34. Jeffries uses Sarapin (containing Vitamin
B12 and C), 3 ml injected below the patella, medial and lateral to the patellar tendon at XiYan

(Knee Eyes = ST35) and the point posteromedial to the patellar tendon; ST36 (12 ml); KI10
(5 ml); BL40 (4 ml, 5 cm deep).

In stifle lameness, point injection is excellent in 1-2 sessions. Walk the horse for 2 days before
return to the track.

In hock lameness, tenderness at BL18,20 (LV, SP) can help to diagnose cunean tendon
problems (inside hock). Tenderness at BL19,28 (GB, BL), and BL27 (SI Shu, Son of GB)
can arise in curbs. Reactive GB can cause spasm of the biceps femoris muscle, resulting in
hindlimb lameness.

In hock lameness, Local points (BL60, KI03) and BL30,35,53,38,39,40, ST36 (hock-related
points) are used with reactive BL points (M.J.C). In bone spavin, add the relevant Ting point,
especially ST, KI.

1.1.7. Laminitis, navicular disease, foot abscess (Fig. 7)

AP is successful in 80-90% of cases of laminitis in the short and longterm (Klide; Kuussaari).
Acute cases respond faster than chronic cases. The most important points are FL21 and 22
(Klide and Kung's system). They are at the back of the hoof, at the medial and lateral
cartilages (FL21) and in the centre of the hollow above the hoof (FL22).

Additional Local points are FL19 (two points on medial and lateral digital veins, dorsocaudal
to fetlock) and FL20 (4-8 fen lateral to anterior of the coronet at the hoof-hair junction)
(Klide).

Kuussaari also adds a point for the forelimb (behind the humerus in fossa between long and
lateral heads of the triceps m. and the posterior edge of the deltoid m.).

Johnson also searches the paravertebral area. In laminitis and navicular disease, BL18 (liver
Shu) and BL23 (kidney Shu) are often tender. Johnson adds these AhShi points and SI08
(forelimb) or BL40 (hindlimb). The veins (FL19) are bled only if there is heat in the coronary
band. He may add BL11,12,13 as Region points in forelimb cases.

Cain punctures PC09 several times with a 16 gauge needle until the blood changes from tarry
and dark to cherry red and normal viscosity. He adds puncture of medial and lateral digital
veins or other terminal points (LU11, LI01, ST45, SP01, HT09, SI01, BL67, KI01, PC09,
TH01, GB44, LV01) with 18 or 20g needles. These points are at the coronary band. It is
helpful to puncture the medial and lateral digital veins with 18 or 20g needle also.

Add the relevant Ting point, especially HT, SI.

Treatment: simple AP or electro-AP, 1-4 times (mean of 3 times) every 2-4 days (mean of 3
days) in recent cases (Kuussaari) or 1-12 times (mean of 6 times) every 3-7 days in chronic
cases (Klide, Johnson). Use corrective shoeing, silicone pads and foot care to put pressure on
the frog supplements the AP effect.

Laser on LI04; LU07 (10 seconds/session) may help AP treatment (Johnson).

Navicular disease is treated with similar points but success in navicular is not as well
documented as in laminitis. One theory of navicular disease is that of poor blood supply to the
area. Vasodilators and anticoagulants have been used in attempts to alleviate this. Vasodilation
can follow AP at Local points but Region points, can help also:

Forelimb: LI11,15; TH05,14; SI09; BL11 etc

Hindlimb: GB30,34; ST36; BL40; BL23; BaiHui

Johnson claims excellent results in navicular disease. Treatment is to a maximum of 6 times in

3 weeks (some need less than this). He uses electro- AP, with 7-8 cm 26g needles. No twitch
is necessary in most cases. Laser at LI04 and LU07 helps.

Foot abscess is treated as for laminitis or navicular disease (Johnson).

Hoof-bend bleeders, heelcracks, heel haemorrhage/sores: Add the relevant Ting point,
especially TH (Thoresen).

1.1.8. Tendinitis, splints, curbs

(Cain)

Tendinitis and sheath inflammation may be helped by application of local Laser. Many
veterinarians find that Laser is better than standard AP. Plum Blossom Needling has helped in
problems of the superficial flexor tendons. Many cases of injury to the tendon sheath are
misdiagnosed as tendon tears. Sheath injuries respond well to stimulation of Local and
Channel points. Local circulation is enhanced. Intradermal or dermal needle implants, left in
place for several days, help.

Magnets (500 gauss) with gold bead centres (CORIMAGS) may be glued on with Superglue.
They are remarkably beneficial if used with Laser or AP.

Splints (especially inside) respond very well when the affected Channels are balanced. Inside
splints are usually related to the ipsilateral stifle. The Channels LU, SP are those primarily
involved, with LI and ST as secondary.

Curbs respond well to local therapy when the affected Channels (GB, LV) are balanced.

1.1.9. Azoturia, tying-up syndrome

(Cain)

Azoturia often accompanies the tying-up syndrome. CPK, SGOT levels usually are elevated
in blood. The syndrome occurs especially in spring (season of Wood, GB-LV). It is a
common racetrack problem and responds very well if GB-LV, SP-ST, KI-BL can be
balanced. These are Wood, Earth, Water in the Five Phase Cycle. See the Sheng and Ko
Cycles in classical AP. See section 1.0 and the Appendix.

1.2. NEUROLOGICAL PROBLEMS

1.2.1. Peripheral nerve paralysis (Fig. 8)

AP is of no real use in paralysis due to spinal transection, motor neuron
degeneration (German Shepherd syndrome) or severe damage to motor centres in the brain. It
can accelerate recovery in paralysis with radiculopathy due to soft tissue inflammation or in
CVA cases where paralysis is due mainly to vasospastic ischaemia of the motor centres. It
helps to establish a cross-spinal reflex arc, which can be important in the salvage of a horse
with traumatic "Wobbler Syndrome".

Peripheral nerve paralysis, especially that following trauma, also can be

helped by AP. The points are usually along the course of the affected nerve but points are
often stimulated on the normal side also.

In brain or spinal paralysis in humans (such as arm paralysis after cerebrovascular accident or
leg paralysis after polio), a chain of points along the nerve is used. For example, sciatic
nerve:BL31,35,36,36a,37,38,40,57,60; GB30,31,34,39. Add BL19 (GB) and BL28 (BL) to
balance Channels if GB and BL points are used. Add ST10 and BL21 if ST points are used.

In paralysis, electro-AP is better than simple needling but great care is needed to avoid
electrical burns or electrolytic lesions in areas with sensory paralysis. Alternatively, inject the
points with homoeopathic acid substances (ascorbic acid or HCl 9c). If definite improvement
is not seen by 10 sessions, further AP is unlikely to be helpful.

1.2.2. Radial paralysis (Fig. 8)

(Cain; Hwang; Grady-Young; White)

Expect 90% success if recent case; 50-70% if paralysis is more than 2 weeks old. Use local
AhShi points. Add points from LI04,10,11,15; LU01,01a, SI08,10; TH10,14 bilateral. Add

BL27,22,13,25 respectively to balance the Channels if SI, TH, LU, LI points are used
(M.J.C).

White suggests electro-AP for 30 minutes every day in acute cases. Others would treat every
3-7 days in chronic cases.

1.2.3. Facial paralysis (Fig. 8)

Points such as ST02-06; CV24; GV26; LI20 are used, depending on the nerve affected. In
TCVM, the classic points are: SouKou; KaiGuan; BaoSai; FuTu. HouMen and HouYu on
the neck (see White 1985) may be added to these. Add BL21 and BL25 to balance ST and LI
points, if these are used (M.J.C).

1.2.4. Cervical ataxia (the Wobbler Syndrome) (Fig. 9)

(Cain; Jeffries; Rogers)

Early cases of ataxia in young horses can be helped or cured completely by AP. It is one of
the most rewarding applications of AP therapy. Wobblers respond better and longer and need
fewer sessions if AP is combined with spinal manipulative therapy (M.J.C). Adjustment of the
neck vertebrae must accompany AP therapy for good success. Using adjustment and AP, Cain
has restored to normal competitive ability many horses which had been sanctioned by
insurance companies to be destroyed. In some cases, especially congenital and OCD cases,
the ataxia was not fully cured but 90% of these were suitable for breeding, provided there was
no history of genetic transmission. Jeffries has had similar success. Longstanding cases, with
severe articular damage, have a poor prognosis.

Clinical experience in hundreds of cases suggests that 80% of cases are due to mechanical
causes. A further 10-15% are genetically programmed. Gradual onset may be due to
nutritional disorders, but these are rare.

The condition usually arises suddenly (overnight), due to trauma (a fall; being pulled up
roughly by the training-rope; tie chains; being cast in the box). The earlier the case is treated,
the better the success rate. Cure is impossible if the motor neurons are degenerated.

The signs include ataxia (especially of the hindlimbs), inability to turn sharply or to back-up
properly (the horse may fall over if forced to do these movements). Some cases show obvious
restriction of neck movement. The limbs (especially hind) may be placed heavily, as if the
horse does not know when they should make contact with the ground. In milder cases or in
cases of spontaneous improvement (rare !), the only signs may be slight awkwardness or
restricted ability to turn sharply, (excessive abduction of the hindlimb on turning), toeing of
the ground at the walk or turn and heavy placement of the hindlimbs.

There is usually, if not always, vertebral misalignment with consequent pressure on cervical
nerves or compression of the spinal cord. The primary sites are at C5, C6, C7, T1, atlas, C2,
C3. Rear ataxia relates to an autonomic reflex arc from the C6 sympathetic ganglion. This
affects the whole sympathetic chain to the lumbar plexus. Vertebral adjustments must be made
to ensure integrity of the cord and nerves. A successful adjustment is confirmed when the
horse gives a good "wet dog shake". If this does not occur, the adjustment is not successful. In
long-lasting cases, AP must be done first to release the spasticity of the intervertebral muscles
and ligaments.

Wobblers are treated similarly to cases of cervical syndrome in humans, with symptomatic
treatment for hindlimb problems in the later stages. The initial results can be very dramatic,
with marked improvement after 1-3 sessions. However, full cure (full coordination and total
elimination of all signs) may take up to 30 sessions. Thus, treatment of wobblers may be
impractical on economic grounds except for valuable bloodstock or loved pets.

GB20 and 21 are essential in treating wobblers and neck pain. GB20 can be injured easily by
bad riders and by tie-chains in stalls. This can cause subluxation of the atlas, requiring
chiropractic adjustment. AP alone, in such cases, gives poor or only temporary relief.

Cervical problems involve one or more of the Yang Channels of the forelimb (LI, TH, SI) or
hindlimb (ST, GB, BL) or the GV Channel (see the Appendix below). Check the Shu points
of all the Yang Channels and check for AhShi on the GV line. As most of the Yang
Channels are involved, careful Five Phase balancing is necessary for full athletic recovery
(see section 1.0 above and the Appendix).

A careful search is made for AhShi points (neck, paravertebral, especially thoracolumbar and
sacral area). All AhShi points are used. They are often absent in Wobblers.

Points for Neck and Forelimb weakness:

JiuWei; GB20,21; TH14,16; BL11; LI16,17; ST10; GV10,11,12 (withers)
emergence points of dorsal cervical nerves;
emergence of 2nd cervical nerve (SI17);
emergence of spinal accessory nerve;
Additional points: BL13,19,21,22,23,25,27,28; GV00 (tip of the tail), GV03 (BaiHui),04,

Points for Hindlimb weakness: BL29 (or 30); GB30,31,32,34,39; BL40

These points relate to the deep musculature of the neck, nuchal ligament, supraspinous
ligament, lumbosacral plexus and sacral plexus.

In horses under 3 years old, AP and adjustment is combined with Adequan i/m (2 vials
initially, 2 at 5 days and 2 at 2 weeks later). If used before 3 years of age, this helps to
promote healing of any cartilaginous damage.

Treatment: Simple AP (20 minutes) or electro-AP (20 minutes) every 3-7 days for 4-30 times,
as needed. Advise exercise on short and long rope (left and right turning), backing exercise,
neck exercise (using carrot to persuade horse to do lateral and vertical movements).

If improvement is noted, allow 3-4 weeks between courses of 3-5 sessions of AP. Full cure
may take up to 12 months.

Cain and Jeffries use point injection of the AhShi points plus points on the BL, GB, LV, ST,
SP Channels (the hindlimb Channels), as indicated by tenderness at the Shu points for these
Channels. Once improvement occurs, point stapling can be used for longterm stimulation (up
to 12 months) and to reduce the number of visits needed (Jeffries). Cain usually injects the
points with homoeopathic NaOH 10c and uses LACER (light stimulation) in horses over 3
years old.

Rogers' experience with wobblers (4 cases, AP but no adjustment) was that two were
destroyed within 18 months. AP did not help sufficiently to ensure the jockey's safety in
competitive racing, although it did improve the coordination markedly (Case 1) and
completely but with relapse in Case 2. Case 3 was a foal which responded very well. Case 4
was a yearling which responded well to two sessions but was not presented for further
treatment, owing to the death of the owner. One year later, the horse was OK.
1.3. GASTROINTESTINAL PROBLEMS (Fig. 10)
AP can help in many g/i/t problems, including diarrhoea, constipation, indigestion, colic,
windsucking, gastritis, enteritis etc. When AP is accompanied with Herbal Medicine, success
rates are higher and last longer (M.J.C).

The most important points for g/i/t problems in the horse are on the BL and GV Channels
(area T11-S4). The more anterior points are mainly for LV, SP, ST problems. Intestinal
problems are treated mainly by points in the area T18-S4. Rectal problems relate to the sacral
points, such as BL29,30,33,34.

In TCVM, GuanYuanShu is placed about 2 hands from the GV line, just behind the last rib.
This point is most important in gastric and intestinal problems, including colic and
windsucking. It is in the position of BL50 in the transposition system, lateral to BL21 (the
Shu point of the stomach). Human GuanYuanShu (BL26) is between the transverse
processes of L5-L6. It (with BL25) relates to uterus and large intestine in humans.

1.3.1. Colic (Fig. 11)

(Cain; Kuussaari; Kothbauer; White)

AP can give 100% success to a single treatment in acute cases of sand colic and gas colic (but
not in surgical cases). It is useful in intestinal distension also.

AP can be by simple needling (20 minutes) or by electro-AP (20 minutes). Cain gives strong,
repeated stimulation to all points except GV26. That point should not be overstimulated in
conscious animals, as it may cause shock.

The important points are: BL50 (2 hands from GV line, behind last rib); CV12 (midway
navel to xiphoid, on ventral midline). To these may be added three points behind BL50, level
with vertebrae L3,4,5 (Kothbauer's BL51-1,51-2,51-3 (old 46-1,46-2 and 46-3)), SP21,21a,
LI17, BL20,21,25,27, GV01, ST36, GB25a, GV26, ST02.

1.3.2. Windsucking, crib-biting (Fig. 12)

Horses which suck wind and are cribbers usually have chronic digestive problems, especially
chronic or mild gastritis (Kuussaari). They may show colic, tympany and flatulence.
Successful treatment of the digestive disorder is associated with disappearance of
windsucking in 67% of cases but longterm success in crib-biters is much less (29%)
(Kuussaari). Workers at Tuft's University have shown that windsucking and cribbing causes
endorphin release, similar to "runners' high". They have been able to control cribbing by
injecting naloxone.

The important points are BL50; PiShu; WeiShu; AnHua; SanChuan; ChiChia (GV12).

Treatment: simple AP (20-30 minutes) or electro-AP (20 seconds/point) for 2-6 times (mean
of 3), at intervals of 2-5 days (mean of 4 days) (Kuussaari). White (1985) gives two new
points on the upper and lower ends of the brachiocephalic muscle (YINQI 1 and 2) for this
condition.

Treatment by strong electro-AP every 12-24 hours for 0.5-4 hours/time, on 9-29 occasions
was said to be successful. Relapse was predicted unless a muzzle was used and the feed-pot
lowered to the ground.

Thus, at present, Kuussaari's points seem to be a better combination.

1.3.3. Gastric ulcer, diarrhoea

P.A.M.R. treated 2 suckling foals with gastric ulcer and 3 adult horses with chronic idiopathic
diarrhoea. The important points are BL20,21,25,27; GV03; ST36; PC06; AhShi points in the
paravertebral area.

Treatment: electro-AP (20 minutes) for 2-5 times (mean of 3), at intervals of 7 days. Success:
2/2 foals recovered within days (2 sessions) but only 1/3 adults recovered within 2 weeks (3-5
sessions).

1.4. RESPIRATORY PROBLEMS (Fig. 13)

See the LU and SP Channels in the Appendix. Despite textbook claims and reports from
some clinicians, Kothbauer and Kuussaari had poor success with AP in equine respiratory
conditions. When AP is accompanied with Herbal Medicine, success rates are higher and last
longer in respiratory disorders (bleeders etc)- (M.J.C)

Important points for upper respiratory problems are in the area of the trachea (CV22,23;
ST09,10; GV14,15 etc) or nose (LI20; YinTang; GV26 etc).

Important points for lower respiratory conditions are the BL and GV points in the area T3T10 (BL13-17,42-46; GV09-12 ) and points in the intercostal spaces (ICSs) over the lung
area.

1.4.1. Bronchospasm, heaves, bronchitis (Fig. 14)

The late Drs. Grady-Young and Westermayer reported good success (50-85%) in early cases
of heaves (before alveolar rupture occurs). AhShi points in the lung area were used. BL13
and 43 were usually tender. Points were selected from: BL13,14,15,42,43,44;
LU01,01a,07,09; PC06; KI10,27; ST19; GV14,17,19,20; HT01; LI04,20; ST36,45; TH01
(depending on other signs).

Treatment: simple AP, 15-20 minutes at intervals of 3-7 days for 4-8 times. Success depends
on the seriousness of the pathology.

Grady-Young used Laser on the Shu points for the lung and on other points in the lung reflex
area (behind the scapula) in Pasteurella pneumonia in cattle. He reported good success. He
also suggested its use in respiratory conditions in horses but gave no statistics of its success.

1.4.2. Bleeders, lung haemorrhage, epistaxis (Fig. 15)

The diagnostic and therapeutic success of AP in bleeders is excellent (Cain; Jeffries). A
history of sudden fading in a race, together with tenderness at the Shu and other reflex points
for lung (below the posterior edge of the scapula and behind the scapular cartilage in the area
of BL17, BL42-46 and GV09) indicates lung or nose bleeder in 95% of cases. The SP
Channel points (BL20 (SP Shu), SP21,21a) are always tender in bleeders.

If vertebrae C1-T8 are intact (normal neck movement and no AhShi in the neck and anterior
withers area), sensitivity along the outer BL line (BL42-46 (old BL37-41) from T8 through
T14, together with sensitivity at BL13 and 20 suggests a lung bleeder. Bleeding usually
occurs in the right lung, thus the right side is usually sensitive, especially on BL42-46,
although left BL13 and 20 (Mother of LU) are also tender. These points are diagnostic for
lung bleeders, even when endoscopic examination may be negative. There is evidence that
Bleeding may be transmitted genetically. One of Cain's mares had 5 bleeders. Such mares
should not be bred. However, 80-85% of non-genetically determined bleeders in Cain's
practice do so because of abuse of drugs (banamine, phenylbutazone, aspirin, androgenic
anabolics etc) or due to stress (pain from any source causing hypertension).

Identify and balance all affected Channels; stimulate the lung (BL13) and its Mother (BL20,
SP Shu). This is the best treatment. The points used are the AhShi points and TianPing;
BaiHui and two other GV points between these points. AhShi points may be injected with 2
ml of Vitamin B12 + C solution and 1 ml in the GV points. BL17 (diaphragm and
haemorrhage point) is especially good in haemorrhage, anaemia and blood diseases. BL17
and 18 (liver Shu) influence liver function also and may improve prothrombin formation and
blood clot formation. Herbs to strengthen the Qi of LU and SP help also. These methods are
not effective in genetically affected cases.

The therapeutic success can reach 90% if AP is given 4-24 hours before the race (Jeffries).

1.4.3. Rhinitis, sinusitis (Fig. 16)

Grady-Young claimed c. 95% success with simple AP or Laser. Treatment was 20 minutes, 35 times, every 3-4 days. The points are chosen from CV23; GV25; SP21; LV13; BL18;
GB25; ST09; SI16 and AhShi points over the lung and chest area. Other Local points
(YinTang; TaiYang, LI20; GV26; ST02,03 etc) can be used also.

1.5. REPRODUCTIVE PROBLEMS (Fig. 17)

The Channels most often involved in reproductive problems are SP, KI, TH. Their Shu
points are BL20,23,22 respectively. Their Mu points are LV13, GB24, CV05. There is also
an ovary point in the paralumbar fossa and point TH16 (endocrine) is a useful distant point.
Local points include WeiKen (GV02), BaiHui (GV03), MingMen (GV04), BL51,28,35.
Occasionally BL14 (PC Shu) and the GV point in between may be tender in breeding
problems. Sensitivity at TH16 usually disappears when BL22 (TH Shu, endocrine) is treated
(M.J.C).

The most important points for reproductive disorders and for the genital organs are in the
lumbosacral area. A simple guide is to imagine the female organs (ovary to vulva) as a straight
tube. The ovaries relate to APs in the area T18-L3 (points such as BL21,22,23,50,51,52;
TianPing; GV05,04). The vulva/anus/perinaeum relate to the area from S3 to the tailhead
(points such as BL29,30,33,34,35,54; GV01,02). The other organs (tubes, uterine horn,
uterine body, cervix, vagina) relate to intermediate points.

Kothbauer recommends BL22,23,52; GV04 for the ovary and BL27,28,31; BaiHui; CV06
for the uterus. Johnson reports excellent results with these points in cases of uterine atony,
metritis, embryonic reabsorption etc.

If one had to remember 4 points for reproductive/genital disorders, they should be: BL23
(between transverse wings of L2-L3) for the ovary; BL26 (between transverse wings of L5L6) for the uterus; BaiHui (lumbosacral space) for the cervix and BL28 (lateral to sacral
foramen 2) for the vagina/bladder.

There are other points (Fig. 18). The abdominal Channels include ST, SP, BL, KI, GB, LV,
CV, GV. Local points (points nearest the target organs) on ANY of these Channels influence
the organs. Although most importance is attached to the GV and BL points (lumbosacral
area), GB26-28 (paralumbar fossa and under the external angle of the ilium) are sometimes
tender in mares with ovarian problems, especially cysts. Points over the iliac wing (between
the tuber coxae and the iliac crest) may also be tender in uterine disorders.

In disorders of the reproductive system and genitalia, (as in all other clinical uses of AP !)
Treat the AhShi (tender) points. A few points (whether tender or not) for the affected organ
may be added and CV02,03,04; BL54; LV02 may be considered as additional points. SP06 is

regarded as a point with special action on the inguinal area, genitalia and reproductive
function of males and females.

Westermayer suggested treatment for 20-30 minutes for 2-4 times (mean of 3), at intervals of
5 days.

1.5.1. Anoestrus (Fig. 9)

(Cain; Kuussaari; Hwang; Grady-Young; Johnson; White)

See section 1.5.

In anoestrus mares, points in the area L3-S4 (BL23-34; BL52-54), points along the KI
Channel and SP06 are palpated for tenderness. AhShi (tender) points are treated. Other
points in anoestrus include: BL22,23; SP6; YanChi; YungChi; BaiHui; XieQi; CV01,05,08;
GV01.

Treatment: 20-30 minutes simple AP (deep needling to reach the broad ligament in the
posterior lumbar points), or electro-AP (20 seconds/point or 20-30 minutes/time). Moxa may
be combined with simple AP (Hwang; Johnson). Moxa should not be used where there are
inflammable materials (straw bedding etc in stalls, barns etc). Always consider fire hazard
before moxa is used. Laser was also good (Grady-Young).

Kuussaari: Treat 1-5 times (mean 2 times) at intervals of 2-5 days (mean 3 days).
Hwang: Treat with needle + moxa for 10 minutes for 5-10 times at intervals of 1-2 days and
expect oestrus within 2 weeks.
Grady-Young: Laser (20 minutes total to do all points) 3-8 times at intervals of 3-4 days.
Mares cycled after session 6 (after 3 weeks).
Johnson: Needle + moxa (20 minutes) on 10 cm, 20 gauge needles. Inject BL40 and Laser
SP06; ST36 and (sometimes) BL11.
White: BaiHui (8-10 cm deep); YanChi (18-23 cm deep); GV01 (20-25 cm deep; needle
directed forwards and up to lie under the sacrum). Electro-AP, 20-30 minutes, 1-3 times at
intervals of 2 days.

1.5.2. Cystic ovary (Fig. 20)

(Cain; Jeffries; Grady-Young; Johnson)

See section 1.5.

Luteal cysts often are associated with metritis or pyometra. They may be expressed manually
(per rectum) in many cases (Grady-Young). Follicular cysts are usually associated with
nymphomania. Cystic ovaries often cause neck and shoulder lameness and thoracolumbar
lameness on the same side (M.J.C). See the TH, GB and LV Channels (Appendix). If BL22
is tender, check TH16.

Points in area L2-S1 (BL22-27,51,52; GV04) and in the para-lumbar fossa and under the
tuber coxae (GB26,27,28) are examined for tenderness. Check BL18,19 (LV Shu and GB
Shu) also and TH16 (endocrine point). All AhShi (tender) points are used. Other points are
chosen from: BL22-29; SP06,15; LV14; GB25,25a; ST36; BaiHui; YanChi.

Jeffries and Johnson also inject 10 ml of 2% procaine solution into the broad ligament on each
side of the cervix, using a special 50-60 cm needle. This method was successfully used in
cows by Kothbauer and Greiff for many years. It is called paracervical injection or neural
therapy.

Treatment: Simple AP; injection of homoeopathic NaOH 9d solution + Vit B12 and Ascorbic
acid; Laser. The choice is individual preference.

Jeffries: Injection method plus paracervical injection, 2 times. Success is 5-15% better in
luteal cysts than in follicular cysts.
Grady-Young: Laser (20 minutes total to do all points) 3-5 times at interval of 3-4 days. Skip
3 oestrus periods before breeding.
Johnson: Needle + moxa (20 minutes) on 10 cm, 20 gauge needles. Inject BL40 and Laser
SP06; ST36 and (sometimes) BL11.

1.5.3. Repeat breeders (Fig. 21)

(Cain; Jeffries; Grady-Young; Johnson; Rogers; White)

See section 1.5.

In the investigation and treatment of repeaters, it is assumed that the stallion has been
examined and been found to be fertile, potent and that ejaculation is normal.

Repeating may be due to ovarian disease, failure of the ovum to reach the uterus (salpingitis
etc), failure to implant (metritis etc) or early death of the embryo.

The lumbosacral area and the paralumbar fossa area are examined for AhShi points, as above.
All AhShi points are used. It is not possible to give just one prescription for repeaters, as the
cause and the organs involved differ as described. The general principle is: AhShi points +
points for the affected organ(s) or function(s).

Thus a selection must be made from points such as: BaiHui; YanChi; BL22-34,51-54,58;
GB25,25a,26-28; GV01,02,04; SP06; KI06; LV03; CV02-06 etc.

Treatment: Simple AP; injection of homoeopathic NaOH 9d solution + Vit B12 and Ascorbic
acid; Laser. The choice is individual preference.

Jeffries: Treat as for ovarian cysts.

Grady-Young: Laser (20 minutes total to do all points) 3-8 times at intervals of 3-4 days.
Johnson: needle + moxa (20 minutes) on 10 cm, 20 gauge needles. Inject BL40 and Laser
SP06; ST36 and (sometimes) BL11
White: Electro-AP, 20-30 minutes, 1-3 times at GV01,04; BaiHui; YanChi; BL24

1.5.4. Reproductive problems in stallions (Fig. 22)

(Cain; Johnson)
See section 1.5.

Male disorders (oligospermia, libido loss, reluctance to mount or pain on mounting) can be
treated successfully by AP in the stallion and the bull (Kothbauer).

Testicle points correspond with ovary points (see embryology of kidney, testis, ovary). The
main points are BL21,22,23,50,51,52; TianPing; GV04,05 and SP06.

Penis points correspond with vagina points (see embryology of these organs). The main penis
points are BL29,30,33,34,35,54; GV01,02 and SP06.

The principles of selecting points in male disorders are the same as in the female:
: AhShi points in area L2-S4 and in the paralumbar fossa, iliac area
: points for the affected organ(s) and functions.

1.6. OTHER CLINICAL USES

1.6.1. Anxiety, nervousness, especially in filly (Fig. 23)

Cain found that extremely nervous, "freaked-out" horses may become somnambulistic and
impossible to needle because all points become sensitive (flight of fight syndrome). These
horses quieten down when injected with 3 ml naloxone solution. They can be needled
successfully then (see section 1.3.2).

The main Channels for nervousness are the HT and PC (Fire) Channels. Key points are
BL15,14,22; PC06 (M.J.C). SI18 and TH17 are tranquillizer points.

Gold bead implants (using a 16 gauge, 3.5 cm needle) in BL14,15,43,44; LI17; SP21 and
CV17 give good results (M.J.C). He used 2 beads/point. The beads were inserted under local
anaesthesia or sedation and are left in situ permanently.

Sweating, nervousness: Add the relevant Ting point, especially PC.

1.6.2. Skin problems

(Cain)

The skin is Metal (LU, LI). Skin problems are more common in late autumn (Metal) and late
winter (Water, KI-BL). Excess activity in TH (Fire) can weaken LU (Metal) (via the Ko
Cycle). This manifests as poor hair coat (LU controls skin). Balancing LU, TH and KI
enhances local treatment remarkably.

CONCLUSIONS
The main methods of stimulating the AP response in horses are point injection (very fast), or
simple needling or electroneedling for 20 minutes.

Classical AP gives better and more longlasting results than Cookbook AP, especially in
complicated cases. Cookbook AP is useful for beginners and can give good or excellent
results in simple cases but beginners are advised to study AP in depth to get the best results.
This is not as difficult as it might seem. The classical concepts can be learned from AP
courses, such as those given by IVAS.

Point selection for local problems includes the relevant Ting Point(s), plus AhShi (tender)
points which remain after that. Other points include: Local points, Region points, points with
special or generalised action and (most of all) the paravertebral Shu point(s) for affected
organ(s) or function(s). This includes the use of Shu points in superficial problems which may
not have direct organic involvement. For example, BL13 and 25 (Shu points for the LU and

LI Channels) are indicated as part of a prescription to help resolve pain of an inside forelimb
splint (in the Channel area of LU and LI). Similarly, BL23,28 (Shu of KI and BL) are
indicated in capped hock (Channel area of KI and BL). One or two distant points on a
Channel passing through the problem area, or a chain of points along an affected nerve also
help.

Some key points are:

BL11,23 bones, joints;
BL13,43 lung;
BL18, GV09 liver;
BL23, BaiHui adrenal, urogenital, hindquarter;
BL25, BaiHui hindgut;
GB20,21 neck;
GB34, TH15 muscles;
LI11, GV14, ST36 immunostimulation.
ST36, BL21 stomach and appetite;
TH15, GB21 forequarter;

A high clinical success rate can be attained in 1-3 sessions at 1-3 day intervals (recent or acute
cases) or in 1-10 sessions at 4-7 day intervals in longstanding or chronic cases. However,
beginners should study the principles of AP before attempting to use the system.

Treatment effects last longer when Ting points are used. This has been found to be essential
in therapy of long-lasting or chronic cases.

There are other methods of point selection (earpoints, hoof points etc) and of point stimulation
(magnets, staples, implants, Dermojet, Laser etc) but these methods must be regarded as
experimental until adequate documentation and comparative clinical trials are available.

See the Appendix for point locations and references.

APPENDIX: ACUPUNCTURE POINT LOCATIONS AND CHANNEL FUNCTIONS

TRADITIONAL VERSUS TRANSPOSITION SYSTEM OF AP IN HORSES

Traditional Chinese Veterinary Medicine (TCVM) includes herbal medicine and acupuncture
(AP). The TCVM system of AP concentrates on the location and uses (diagnostic and
therapeutic) of isolated AP points (APs). TCVM does not show a Channel system in
animals. Its concepts of diagnosis and therapy are very difficult for westerners to master.

Texts on the TCVM system in horses are scarce. They include those by Hwang, Klide &
Kung, Kothbauer, Lin, White and the late Erwin Westermayer. Readers are referred to those
texts for details.

The human AP system is based on Channel concepts. It is much better integrated than the
TCVM system. Therefore, it is much easier to learn. Once the human system is mastered, its
principles can be applied in animals by transposing the anatomical location and functions of
the human AP point system to animals. This transposition system is very useful in the horse,
especially in painful local conditions. The greatest difficulty is in locating points below the
carpus or tarsus. It may be better to use TCVM points in these areas. The TCVM system
differs from the transposition system in some respects but the two systems are basically very
similar and either may be used alone or they may be combined.

Cookbook prescriptions for common conditions, body organs and parts in humans are listed
in Appendices 1-3 of the paper on "Choice of points for particular conditions" (Rogers
1996). Those prescriptions may be applied in the horse although they are extracted from texts
on humans.

The horse has no gallbladder but some GB points have important local uses. These codes are
the same as those used in the Cookbook prescriptions, as mentioned above.

In this paper, the transposition system is used mainly, except for some TCVM points, which
are described below.

1. TCVM POINTS IN THE HORSE

See the texts, listed at the end of the Appendix, for a complete list of names, locations and
uses of TCVM points.

The following are a few of the TCVM points mentioned in the paper:

AnHua between spines of T8-T9

BaoSai in jaw muscles behind last molar
ChiChia between spines of T3-T4 (= GV12)
ZhongFu LU01 in some texts: behind shoulder joint in 2nd intercostal space (ICS 2). AP
analgesia point with TH08.
FuTu behind occipital protuberance
XieQi 2 cun lateral to root of tail, in bicipital groove
JiuWei 9 points on the upper lateral neck. Point 1 is 6.5 cm behind the base of the ear, 4 cm
from the mane (Fig. 7). Point 9 is 4 cm anterior to scapula, 6 cm from the mane. The other
points are at equal intervals between these points
KaiGuan in jaw muscles behind molar 3
BaiHui lumbosacral space (GV03)
PiShu 1 hand from GV line in 3rd last ICS
SanChuan between spines of T4-T5
SouKou behind oral canthus
TianPing thoracolumbar space
WeiShu 3 spaces in front of PiShu
YanChi one third distance from tuber coxae to dorsal midline
YinTang midline of forehead, between the eyes
YungChi between the free ends of the transverse processes of L5-L6
FL 2 PoChien at anterior junction of scapula and its cartilage (TH15)

FL 4 PoLan one third distance down anterior edge of scapula

FL 7 ChangFeng 5 cun post. inf. to shoulder joint point in fossa between long and lateral
heads of triceps m., behind humerus, at anterior edge of deltoid m. (LI13)
FL12 JianYu hole below upper head of humerus at its anterior edge
FL13 JianWaiShu Just behind and below shoulder joint
FL19 ChanWan on lat. and med. digital veins dorsoposterior to fetlocks
FL20 TiMen midpoint of med. and lat. cartilages at back of hoof. Needle from behind.
FL21 TiMen midpoint of lat. and med. cartilages at back of hoof. Needle from behind.
FL22 ChienChiu centre of pit in hollow above back of hoof

2. TRANSPOSITION SYSTEM
At this time there is no International Standard Chart to show the location of the Channel
points (LU, LI, ST, SP, HT, SI, BL, KI, PC, TH, GB, LV, CV, GV) in horses. To locate the
Channel points in horses, one can transpose the locations of human points to similar
anatomical locations in the horse.

Figures 1-26 respectively show the approximate locations of the equine Channel points.
These charts must be taken as provisional. They are for teaching purposes only, as they may
help the beginner to locate the more important areas for treatment, especially if using
Cookbook Prescriptions (Appendix 1-3 in Rogers 1996) or the points recommended for the
conditions discussed in the clinical part of this paper.

From extensive clinical experience in equine AP, MJC made many corrections to earlier
charts prepared by PAMR. MJC's locations are often (but not always) similar to those of other
experts (Giniaux, Kothbauer; Westermayer etc). Emiel van den Bosch DVM, G. van
Heuvelstraat, Ramsel, Belgium (Fax: 32-1656-1374) published very fine charts
(Acupuncture Points and Meridians in the Horse, 1995). We recommend those charts to
equine acupuncturists.

Location of GV and BL points in the thoracic area must take 18 pairs of ribs into account.
Apart from the rib area, transposition of other GV points (GV01-04, 14-28) and BL points
(BL01-12, 36-40 (old BL50-54) and 55-60) are similar to human positions:

GV01 Midline between anus and coccyx (as in human)

GV02 Dorsal midline in sacrococcygeal space (as in human)
GV03 (BaiHui) in midline in lumbosacral space (L4-L5 space in human)
GV04 (MingMen) in midline in L2-L3 space, between left and right BL23 (KI Shu) (as in
human). Some equine vets put it between left and right BL23a, in L3-L4 space.
GV05 Dorsal midline in L1-L2 space (as in human), between left and right BL22 (TH Shu)
GV06-10 are located by counting 2 spaces for each point forward from GV05 (below spine of
L1), with GV10 below spine T10
GV06 (TianPing): Dorsal midline behind the dorsal spine of T18 (thoracolumbar) space,
between left and right BL21 (ST Shu)
GV07 Dorsal midline, 2 spaces before GV06 (behind spine of T16), between left and right
BL19 (GB Shu)
GV08 Dorsal midline, 2 spaces before GV07 (behind spine of T14)
GV09 Dorsal midline, 2 spaces before GV08 (behind spine of T12), between left and right
BL17 (Diaphragm, Haemorrhage, Blood point)
GV10 Dorsal midline, 2 spaces before GV09 (behind spine of T10), between left and right
BL15
GV11-12 are found by counting 3 spaces/point forward from GV10 or backward fromGV13.
GV11 Dorsal midline, 3 spaces behind GV12 (behind spine of T7)
GV12 Dorsal midline, 3 spaces behind GV13 (behind spine of T4), between left and right
BL12
GV13 Dorsal midline in T1-T2 space (as in human)
GV14 Dorsal midline in C7-T1 space (as in human)
GV15-28 as in human

The Shu points (Organ-associated points or paravertebral reflex points) run parallel to the GV
line, in humans about 1.5 inches and in horses about 1 hand from the GV line. They are
covered under the BL Channel (see below).

The Mu (Abdominal Alarm) points are used in diagnosis and therapy in humans and small
animals. The Mu points are: Lung = LU01,01a; Colon, large intestine = ST25; Stomach =
CV12; Spleen-Pancreas = LV13; Heart = CV14; Small Intestine = CV04; Bladder = CV03;
Kidney = GB25,25a; Pericardium, Heart Constrictor = CV17; Triple Heater = CV05;
Gallbladder = GB24; Liver = LV14. Because of the danger to the operator, CV03,04,05 and
ST25 are seldom needled in horses but CV12,14,17, GB24,25, LV13,14, LU01,01a are
relatively easy to needle. Horses tolerate Shiatsu (deep massage) of awkward points and this
can be very useful.

LV13,14 (Mu points of SP, LV) are very powerful points for balancing the Yin Channels,
especially when coupled with SP21,21a (linking point for all Yin Channels, the Luo point for
all Luo points).

T8 and L4: LU & LI Channels (Metal) (FIGURES 1 & 2)

LU (Lung) and LI (Large Intestine, Colon) are related in Metal. When Shu point tenderness
or clinical signs indicate Channel imbalance, treat the Shu point and the Shu of the paired
Channel. LU Shu is BL13,42 and LI Shu is BL25. LU Mu is LU01,01a and LI Mu is
ST25.

When treating LU problems, the Mother (SP) Channel must be balanced and stimulated
(BL20) and the Son (KI) Channel must be assessed (BL23) and treated, if needed.

When treating LI problems, the Mother (ST) Channel must be balanced and stimulated
(BL21) and the Son (BL) Channel must be assessed (BL28) and treated, if needed.

Metal may be used to support weakness of Water. Thus, BL13 (LU) may help weak KI and
BL25 (LI) may help weak BL.

The LU Channel runs from the lung to the anterior edge of the lower third of the scapula
(LU01a), level with the base of T1 (M.J.C), to just lateral to the biceps tendon (05). It then
runs down the anteromedial edge of the radius (06,07,08) and carpus (09), down the inner
splint to the medial sesamoid (10) and medial heel (LU11). Internal branches go to the colon.

Traditional texts place LU01 in ICS 2, just behind the shoulder joint.

BL13,42 (LU Shu) may show acute tenderness with inside forelimb splints, check ligament,
inside carpal, inside suspensory and sesamoid problems. They (and BL42-46) are usually
tender in acute respiratory problems (see 1.4.2).

LU01,01a relates to the inside forelimb and carpus.

The LI Channel runs from the centre of the medial aspect of the pedal joint (LI01), up the
medial side of the pastern, fetlock, to the top of the inner splint (04) and carpus (05). It
ascends the forearm, curving anterolaterally, to the front of the elbow joint (11), to the point
of the shoulder (15), to the nerve plexus at the base of C6-C7 (17), to the lateral side of the
larynx (18), teeth and nostrils (LI20). Internal branches go to the colon and lung.

LI04 is near the upper head of the inner splint.

BL25 (LI Shu) may be tender in problems of the sacroiliac joint/ligament, the iliolumbar
ligament, the inside splint, the 3rd and intermediate carpal bones, the elbow and shoulder,
misalignment of vertebrae C6-T1, larynx, teeth, sinuses etc. It may be tender also in colic and
impaction and in gluteal problems.

LI16 relates to the shoulder and inside carpus, fetlock and pastern.

LI17 has powerful effects, similar to LI04 in humans. It affects the sympathetic ganglion,
producing endorphin-like effects and blocking the sympathetic nervous system. It is very
tender in subluxation of C6, C7 or T1. Tenderness at LI17 may arise in shoulder, outside arm,
inside carpus and fetlock. It may also arise ipsilateral to lumbar pain (BL25, LI Shu) or in
contralateral hindlimb lameness.

LI18 relates to the forelimb shins.

T9 and L1: PC & TH Channels (Fire) (FIGURES 9 & 10)

PC (Pericardium, Circulation-Sex, Heart Constrictor) and TH (Triple Heater) are related in
Fire. When Shu point tenderness or clinical signs indicate Channel imbalance, treat the Shu
point and the Shu of the paired Channel. PC Shu is BL14,43 and TH Shu is BL22. PC Mu
is CV17 and TH Mu is CV05.

When treating PC problems, the Mother (LV) Channel must be balanced and stimulated
(BL18) and the Son (SP) Channel must be assessed (BL20) and treated, if needed.

When treating TH problems, the Mother (GB) Channel must be balanced and stimulated
(BL19) and the Son (ST) Channel must be assessed (BL21) and treated, if needed.

Fire may be used to support weakness of Earth. Thus, BL14 (PC) may help weak SP and
BL22 (TH) may help weak ST.

The PC Channel arises in the pericardium, runs to the medial side of the olecranon (PC01),
to the medial side of the biceps tendon (03), down the medial side of the leg in the ulnar-radial
groove (04,05,06,07), down by the inner splint (08), to the coronary band (over the medial
plantar digital vein) (PC09). Internal branches go to the Triple Heater.

BL14,43 (PC Shu, pericardium) may show tenderness in cases similar to BL15,44 (see) and
in anxiety and psychological problems.

PC points (BL14,43, PC06) are used in nervousness/psychological disorders and PC09 is a

useful point to bleed in laminitis (M.J.C). Some females with breeding problems show
sensitivity of BL14 (PC Shu) and GV10 (beside BL14). (See TH Channel also).

The TH Channel arises at the lateral side of the coronary band (over the lateral plantar digital
vein) (TH01). It ascends the anterolateral side of the metacarpus (3) and carpus (04) and then
follows the lateral ulnar-radial groove (05-08) and anterior edge of the olecranon (09,10). It
runs behind and parallel to the humerus (10-13) to the lateral side of the shoulder joint
(between the joint and the scapular spine, TH14). Then it runs to the anterior edge of the
scapula at the junction with the scapular cartilage (15), to the dorsal side of the C3-C4 joint on
the brachiocephalicus m. (16), to the posterior side of the ear (17). It runs over the root of the

ear (18-22) and ends behind the lateral canthus of the eye (TH23). Internal branches go to the
PC and the endocrine centres.

The TH Channel is important in endocrine disorders, especially in female infertility (M.J.C).

TH14,16 are often sensitive in ovarian problems, cyst, oestrus). TH14 may be tender in
shoulder lameness, but true joint lameness (OCD) is rare. More often, shoulder lameness is
muscular, referred from subluxation of vertebrae C6-T1, via the brachiocephalicus m.,
attached to the humeroscapular joint. Painful ovary or neck can cause spasm of that and other
muscles and a choppy forward stride on the ipsilateral forelimb. If the problem is ovarian,
treat BL22 (TH Shu) and the sensitivity at TH16 usually disappears. If the problem is
shoulder lameness, treat TH14 and SI10, with BL22 and 27 (SI Shu). If the shoulder pain is
referred from the neck, treat the neck (see 1.2.4).

TH16 may be tender in problems of the ovary/testis and in pain of the outside forelimb.

Excess activity in TH (Fire) can weaken LU (Metal) (via the Ko Cycle). This manifests as
poor hair coat (LU controls skin) (M.J.C).

BL22 (TH Shu) may be tender in endocrine imbalance (thyroid, gonads, adrenal), in
disorders of thermoregulation (non-sweaters), psychological problems, neck problems of the
spinal accessory nerve (mid-cervical) and in neck vertebral misalignments. It may be tender in
thoracolumbar problems, post-castration pain, cryptorchidism, inguinal ring problems (see
BL23) and pain of the outside forelimb.

TH05 is used in shoulder problems and in navicular disease.

TH17 is a tranquillizer point.

T10 and S1: HT and SI Channels (Fire) (FIGURES 5 and 6)

HT (Heart) and SI (Small Intestine) are related in Fire. When Shu point tenderness or clinical
signs indicate Channel imbalance, treat the Shu point and the Shu of the paired Channel.
HT Shu is BL15,44 and SI Shu is BL27. HT Mu is CV14 and SI Mu is CV04.

When treating HT problems, the Mother (LV) Channel must be balanced and stimulated
(BL18) and the Son (SP) Channel must be assessed (BL20) and treated, if needed.

When treating SI problems, the Mother (GB) Channel must be balanced and stimulated
(BL19) and the Son (ST) Channel must be assessed (BL21) and treated, if needed.

Fire may be used to support weakness of Earth. Thus, BL15 (HT) may help weak SP and
BL27 (SI) may help weak ST.

The HT Channel arises in the heart, runs to the posteromedial side of the shoulder joint
(HT01), to the anteromedial side of the elbow (medial to the biceps tendon (03) and down the
posteromedial side of the arm (04-06) and carpus (07), to the medial sesamoid (08) and the
medial bulb of the fore heel (HT09). Internal branches go to the small intestine.

BL15,44 (HT Shu) may be tender in problems of the posterior side of the forelimb, tendons,
sesamoids, heel bulb bruises, elbow (rare), circulatory function. BL14,15 (PC, HT) may be
tender in anxiety and nervousness.

The SI Channel arises at the back of the outside bulb of the foreleg coronary band (SI01),
ascends to the sesamoid (02,03), along the outer splint (04), along the posterolateral edge of
the carpus (05), to the lateral side of the ulnar-humeral notch (06,07), to the olecranon (08), to
the first muscular groove behind the shoulder joint (09), to a deep hole just below and behind
the lower limit of the scapular spine (10). Then it zig-zags up the scapular spine (11,12) to the
edge of the scapular cartilage (13) at T4-T5. Then it runs down and forwards to the side of C7
at the centre of the C6-C7 joint (15), to the centre of the C4-C5 joint (16), to the lower edge of
the C2-C3 joint (17), to the malar bone (18) and the anterolateral root of the ear (SI19).
Internal branches go to the small intestine and heart.

The SI Channel is very important. It is involved in many race-track injuries. It is used to treat
bowed tendons, inferior check ligament injury, posterior branch of suspensory at outside
sesamoid, "windgalls", and annular ligament damage. Subluxation of the lower neck (C6-T1),
or of the atlas, or sacrococcygeal injury (in the starting gate, or in transport, due to backingup), sacral plexus (parasympathetic) damage may involve the SI Channel (BL27, SI15,16).
Reflex lameness in the superficial gluteal muscles at GB30 may arise in GB imbalance (GB is
the Mother of SI). The SI is often involved in shoulder lameness. SI09,10,13 and the SI Shu

(BL27), its Mother Shu (Wood-GB Shu, BL19) and its Son Shu (Earth-ST Shu, BL21) are
indicated in such cases (see 1.1.3).

BL27 (SI Shu) may be tender in problems of the posterior side of the forelimb, tendons,
sesamoids, heel bulb bruises, elbow (rare), sacral nerve plexus, biceps femoris, intestinal
function.

SI10, if still tender after proper Channel balancing, is diagnostic for LOCAL shoulder
lameness (OCD) - see 1.1.3.

SI13, at the edge of the scapular cartilage at the highest point of the
withers (see GV11,12 below) is very important in neck and thoracic muscle pain. The bursa
between the nuchal and the supraspinous ligaments is very easy to injure. Needling SI13,
GV11,12 in such cases is useful but proper Channel balancing, using BL19 (GB, Mother of
SI) and BL21 (ST, Son of GB) is important.

SI17 is related to the outside sesamoid, suspensory ligament and lameness at the posterior
side of the forelimb. It also relates to ipsi- and contra- lateral lower sacral injury, hindlimb
lameness and all neck problems.

SI18 is a tranquillizer point.

BL16 (GV Shu) and BL17 (Diaphragm/blood/haemorrhage Shu)

BL16 and 17 are used for local problems as well as special effects. Their helper (outer) points
are BL45 and 46 respectively.

BL16 (GV Shu) is used to increase or reduce GV activity. It assists the supraspinous
ligament. Problems of the ligament are common in racehorses because they seldom have the
opportunity to fully stretch their neck and paraspinal muscles (grazing, drinking from streams,
rolling etc are seldom allowed !). Weakness of the supraspinal and nuchal ligaments
predispose to neck and back problems and to tender bursae on top of the withers.

BL17 (Diaphragm Shu) is used for diaphragm/blood/haemorrhage problems. It helps in

anaemia (increased PCV and Hb), bleeders (prothrombin and reduced blood pressure in lung
vessels), other respiratory problems (to stimulate breathing in neonatal foals) (with GV26). It
is an immunostimulant point (with GV14, ST36, LI11), useful in viral diseases.

BL19 (GB Shu) is associated with whirlbone, outside stifle, outside hock, outside hind splint,
curb.
T14 and 15: LV and GB Channels (Wood) (FIGURES 12 and 11)
LV (Liver) and GB (Gallbladder) are related in Wood. When Shu point tenderness or clinical
signs indicate Channel imbalance, treat the Shu point and the Shu of the paired Channel. LV
Shu is BL18,47 and GB Shu is BL19,48. LV Mu is LV14 and GB Mu is GB24.

When treating LV problems, the Mother (KI) Channel must be balanced and stimulated
(BL23) and the Son (HT, PC) Channels must be assessed (BL15,14) and treated, if needed.

When treating GB problems, the Mother (BL) Channel must be balanced and stimulated
(BL28) and the Son (SI, TH) Channels must be assessed (BL27,22) and treated, if needed.

Wood may be used to support weakness of Fire. Thus, BL18 (LV) may help weak HT or PC
and BL19 (GB) may help weak SI or TH. Weakness or excess activity in Wood (LV, GB)
can have profound effect on the ovarian/endocrine system (via TH - Fire-, Son of Wood).
Such cases often have thoracolumbar pain (near BL18,19,22 - Shu of LV, GB, TH) and may
also have spasm and a choppy stride in the ipsilateral shoulder/ forelimb, via TH16 (see TH
Channel).

The LV Channel runs from the medial bulb of the hind heel (LV01), up the posteromedial
edge of the pastern, medial sesamoid (02), along the inner splint (03), to the anteromedial side
of the hock (04), up the inner side of the leg (05-07), to the posterior edge of the medial
epicondyle of the femur (08). It runs along the inner thigh behind the femur to the inside of
the hip joint. Then it runs to the tip of rib 17 (LV13, SP Mu) and ends behind rib 9, one hand
above the level of the olecranon (LV14, LV Mu). Internal branches to the liver, eye and
"gallbladder" function.

Deficiencies are more common than excesses in the LV Channel. Therefore, adding more
energy (by correct feeding, HERBAL medicine (fresh dandelions in spring) and lipotropic
agents) are needed to obtain the optimal response.

The LV Channel is used with GB points in disorders of Wood. BL18,47 (LV Shu), LV13
(SP Mu) and LV14 (LV Mu) helps in myositis, azoturia, tying-up syndrome; to regulate
SGOT, CPK, serum albumin and globulin; as immunoregulators; in allergies and eye
problems (especially in spring (Wood); to regulate hoof-horn growth (Wood controls the
nails) and in breeding problems (Wood is Mother of Fire (TH, PC)).

BL18 (LV Shu) may be tender in allergy (elevated globulin levels), muddy colour of the eye
mucosa, lacrimation and conjunctivitis, problems of muscles, tendons, ligaments, azoturia,
myositis, (tying-up syndrome), elevated CPK, SGOT in blood. The LV controls the eye in
TCVM.

LV13,14 (Mu points of SP, LV) are very powerful points for balancing the Yin Channels,
especially when coupled with SP21,21a (linking point for all Yin Channels, the Luo point for
all Luo points).

The GB Channel begins at the lateral canthus of the eye (GB01). It runs to the ear (02), loops
to the temporal (03-09) and post-auricular area (10-12) to above the eye (14), to the wing of
the atlas (GB20). Then it follows the wings of the cervical vertebrae to the upper edge of the
body of T1 half- way down the front edge of the scapula (GB21). It follows the lateral thorax
to ICS 10 (GB24, SP Mu), then to the tip of rib 18 (GB25, KI Mu), forms a triangle of points
(GB26-28) under the external iliac angle, curves around the hip joint (GB29,30), then down
the lateral thigh behind the femur (31,32) to the posterior edge of the lateral epicondyle of the
femur (GB33), the upper anterior notch between the fibula and tibia (GB34). It follows the
lateral side of the leg to the lateral side of the hock (35-40), over the outer splint (41), the
outer side of the fetlock (43), to end on the lateral side of the coronary band (GB44). Internal
branches go to the liver and "gallbladder" function. A branch joins 25 to 25b just above the
tuber coxae and rejoins 30. The tuber coxae point 25b is useful with BL19 in GB Channel
problems, when BL19 (GB) is tender. Cain puts GB25a (another KI Mu) half way between
the costochondral junction of rib 18 (GB25) and the lumbar muscles.

The GB is one of the most frequently used Channels (after the BL) in the horse. The GB and
LV Channels are important in myositis and azoturia (tying- up syndrome), especially in
spring (season of Wood). Wood relates to muscle, tendon, ligament and the Krebs cycle (LV).
Imbalance of Wood relates to build-up of lactic acid, impaired blood buffering, elevated
SGOT, CPK and arginase in blood. Balancing the Wood (GB, LV) is essential for muscle
health and liver metabolism. Water (KI, BL), Fire (HT, SI, PC, TH), Earth (SP, ST) and
Metal (LU, LI) can all interact with Wood. All must be in balance for full health.

In hindlimb lameness due to reflex spasm of the superficial gluteal muscle (may arise in
damage to the sacral plexus, or due to backing up against fixed objects), the local point
(GB30) must be balanced by BL19 (GB Shu) and BL27 (SI Shu; Fire is Son of Wood).

BL19 (GB Shu) may be tender in problems of muscles, tendons, ligaments, azoturia,
myositis, (tying-up syndrome), elevated CPK, SGOT in blood. In curbs, tenderness can arise
at BL19 (GB), BL28 (BL Shu, the Mother of GB) and BL27 (SI Shu, Son of GB). Reactive
GB can cause spasm of the biceps femoris muscle, resulting in hindlimb lameness.

GB20 and 21 are essential in treating wobblers and neck pain. GB20 can be injured easily by
bad riders and by tie-chains in stalls. This can cause subluxation of the atlas, requiring
chiropractic adjustment. AP alone, in such cases, gives poor or only temporary relief.

T17 and T18: SP and ST Channels (Earth) (FIGURES 4 and 3)

SP (Spleen-Pancreas) and ST (Stomach) are related in Earth. When Shu point tenderness or
clinical signs indicate Channel imbalance, treat the Shu point and the Shu of the paired
Channel. SP Shu is BL20,49 and ST Shu is BL21,50. SP Mu is LV13 and ST Mu is CV12.

When treating SP problems, the Mother (HT, PC) Channels must be balanced and
stimulated (BL15,14) and the Son (LU) Channel must be assessed (BL13) and treated, if
needed.

When treating ST problems, the Mother (SI, TH) Channels must be balanced and stimulated
(BL27,22) and the Son (LI) Channel must be assessed (BL25) and treated, if needed.

Earth may be used to support weakness of Metal. Thus, BL20 (SP) may help weak LU and
BL21 (ST) may help weak LI.

The SP Channel runs from the medial side of the coronary band of the hind heel (SP01), up
the inner side of the pastern (03), by the inner splint (04), along the anteromedial hock (05),
up the inside leg behind the tibia (06-08), to the inner stifle behind the tibial head (09). It runs
up the inner thigh to the lateral abdomen to the tip if rib 15 (15). It curves along the thorax to

the ICS 4 (SP20) and ends in ICS 10 (SP21, controller of all Yin Channels, the Luo of all
Luo points). Internal branches go to the spleen-pancreas, stomach and the muscles.

BL20 (SP Shu) may be tender in disorders of blood, circulation, spleen, pancreas; in digestive
disorders, impaction, colic; in lameness of the inside hindlimb/stifle/hock (cunean tendon) and
in thoracolumbar injury. The SP points (BL20 (SP Shu), SP21,21a) are always tender in
bleeders.

Cain locates a point (SP21a) about 1 hand above the olecranon, in ICS 5. This point has
similar diagnostic and therapeutic functions to SP21. It is located on the large plexus of the
posterior thoracic nerves at the posterior border of the latissimus dorsi muscle. SP21,21a
show extreme sensitivity with imbalance of ANY Channel, especially a Yin Channel (LU,
SP, HT, KI, PC, LV). These points can be used with LV13,14 (Mu of SP, LV) to balance all
Yin energies. SP21,21a are very powerful points. Be careful that the horse does not fall on
you! This has happened to Cain. Check these points after ANY treatment. If the Channels
are balanced, SP21,21a should not be tender. If they are, additional therapy is needed.

The ST Channel begins below the eye (ST01), runs to the oral canthus (04), masseter (06),
the temporomandibular joint (07). It runs down the neck (09), along the ventral edge of the
sternocephalicus to ST10 (about one hand cranial to the point of the shoulder). It runs along
the ventrolateral thorax to ST25 (LI Mu, level with navel), into the groin and towards the
anterior of the hip joint. It runs down the lateral thigh, parallel with the cranial edge of the
femur (31-34), to the hole lateral to the patellar tendon (ST35), to 1 hand below the tibial
tuberosity, lateral to the tibia, between the long and lateral digital extensor muscles (36). It
continues down the anterolateral leg (37-40), to the anterolateral side of the hock (41), down
the anterior side of the shin and pastern (43,44). It ends at the coronary band on the
anterolateral side of the hind foot (ST45). Internal branches go to the stomach and spleenpancreas. A branch goes from ST25 to the origin of the tensor fascia lata (25a) (at the lowest,
posterior edge of the tuber coxae), to return to ST31. The tensor fascia lata point (25a) is used
with BL21 (ST) in stifle lameness when BL21 (ST) is sensitive.

BL21 (ST Shu) may be tender in digestive disorders, impaction, colic, in anterolateral
hindlimb lameness, stifle lameness, sacrosciatic ligament, sacral pain at the origin of the
biceps femoris, thoracolumbar injury. ST10 (on sternocephalicus m.) relates to BL21. BL21
may be tender in shoulder pain when sternocephalicus is involved. This is common.

ST10 relates to the ipsilateral stifle, especially if BL21 is tender.

ST36 is used as a Local point for the stifle.

L2 and S2: KI and BL Channels (Water) (FIGURES 8 and 7)

KI (Kidney) and BL (Bladder) are related in Water. When Shu point tenderness or clinical
signs indicate Channel imbalance, treat the Shu point and the Shu of the paired Channel. KI
Shu is BL23,52 and BL Shu is BL28,53. KI Mu is GB25,25a and BL Mu is CV03.

When treating KI problems, the Mother (LU) Channel must be balanced and stimulated
(BL13) and the Son (LV) Channel must be assessed (BL18) and treated, if needed.

When treating BL problems, the Mother (LI) Channel must be balanced and stimulated
(BL25) and the Son (GB) Channel must be assessed (BL19) and treated, if needed.

Water may be used to support weakness of Wood. Thus, BL23 (KI) may help weak LV and
BL28 (BL) may help weak GB.

The KI Channel runs from the hollow between the bulbs of the hind heels (KI01), up the
back of the metatarsals to the posteromedial side of the hock (02-06). It ascends the inner leg
(07-09) to the medial stifle, one hand behind the medial epicondyle of the femur (10). It runs
up the inner thigh to the groin (11), and along the ventral abdomen, 3 fingers lateral to the
midline, to reach KI16 (lateral to navel) and KI22 (on the rib-cartilage of the 6th rib). From
here, it runs inside the forelimb muscles, along the thorax, to end at KI27, in the ICS 1, at the
sternum. KI27 can be reached by a 10 cm needle through the anterior superficial pectoral m.
Internal branches go to the kidney, bones, ear, spinal cord, adrenal, ovary, bladder.

BL23 (KI Shu) is between the wings of L2-L3. It relates to the inside of the hindlimb. BL23
and 47 may be tender in urogenital (renal, gonadal), adrenal and fertility disorders and in
thoracolumbar problems. It may be tender with BL22 (TH) in lameness related to psoas
muscles, post-castration pain, cryptorchidism, inguinal ring problems, inside hindlimb
problems. In those cases, BL23 is helped by KI03,07,10 and BL28 (BL Shu). If the tail
twitches during riding, this indicates AhShi at BL23.

The BL Channel is the most important. Its clinical uses include diagnosis and treatment (via
the Shu points). BL points are used in almost every AP prescription. BL points from C1-S4
correspond with superficial branches of spinal nerves in the sympathetic (neck-lumbar) and
para-sympathetic (sacral) areas.

The BL Channel runs from the medial canthus of the eye (BL01), up the forehead (02,03),
and head medial to the ears (04-09), to the wing of the atlas (10), to the notch at the anterior
upper edge of the scapula, just behind the tip of the spine of T2 (BL11) and T3 (BL12) beside
the high point of the withers. The inner and outer BL lines run paravertebrally from T3-S4.
Key landmarks are BL13,42 below spine of T8, at posterior edge of the scapular cartilage;
BL21,50 just behind last rib; BL23,52 between wings of L2-L3; BL32,28,53 (medial to
lateral) at 2nd sacral hole. The Channel continues down the posterolateral thigh in the muscle
groove from just above the tuber ischii (BL54a) to below the tuber ischii (BL36,36a,37) to the
popliteal area (BL38,39,40), down the posterolateral leg (BL55-59), to the notch between the
Achilles tendon and the lower head of the tibia (BL60), over the lateral hock (BL61,62),
down the outer splint (BL63-65) and sesamoid (BL66), to end at the coronary band at the
lateral bulb of the hind heel (BL67). Internal branches go to the kidney, bladder and pelvic
functions.

In humans, the sequence of Shu points (BL13-30) is:

Below level of spine of T3-T7 (BL13-17): LU, PC, HT, GV, Diaphragm-BloodHaemorrhage
Below level of spine of T9-T12 (BL18-21): LV, GB, SP, ST
Below level of spine of L1-L5 (BL22-26): TH, KI-ovary, QiHaiShu, LI, GuanYuanShu
Below level of spine of S1-S4 (BL27-30): SI, BL, ZhongLuShu, BaiHuanShu

In the horse, pending careful provocation tests, one can transpose BL21 as in humans (just
behind the last rib). The area just behind the posterior edge of the junction between the
scapula and the scapular cartilage is consistently tender in lung disease (bleeders etc)- M.J.C.
This point is below the spine of T8. It is taken to be BL13 (lung Shu). Another BL13 point is
directly dorsal to this, at the edge of the scapular cartilage. Thus, it is easy to locate BL13 and
BL21. The simplest way to locate BL12-20 is as follows:

There are 9 points between (and including) BL13-21. BL17 can be taken as mid-way between
them. The remaining points (BL14-16 and BL18-20) can be located easily by counting
forward or backward from BL17.

However, more accurate locations of equine Shu points BL13-21 (LU, PC, HT, GV,
Diaphragm-Blood-Haemorrhage, LV, GB, SP and ST respectively) are as follows:

HORSE THORACIC SHU POINTS

BL13 FeiShu = LU Shu: Below the dorsal spine of T8, at caudal edge of scapular cartilage in
8th intercostal space (ICS 8) (M.J.C). It relates to the inside of the forelimb. Its partner is
BL42
BL14 JueYinShu = PC Shu: Below the dorsal spine of T9 (ICS 9). It relates to the inside of
the forelimb. Its partner is BL43.
BL15 XinShu = HT Shu: Below the dorsal spine of T10 (ICS 10), lateral to GV10. It relates
to the inside of the forelimb. Its partner is BL44.
BL16 DuShu = GV Shu: Below the dorsal spine of T11 (ICS 11). It relates to the dorsal
surface of the back and local (nearby) organs and their functions. Its partner is BL45.
BL17 GeShu = Diaphragm-Blood-Haemorrhage Shu: Below the dorsal spine of T12 (ICS
12). It relates to diaphragm, blood diseases, and immunity. Its partner is BL46.
BL18 GanShu = LV Shu: Below the dorsal spine of T14 (14th ICS, or 4th last). It relates to
the inside of the hindlimb. Its partner is BL47.
BL19 DanShu = GB Shu: Below the dorsal spine of T16 (16th ICS, or 2nd last). It relates to
the outside of the hindlimb. Its partner is BL48.
BL20 PiShu = SP Shu: Below the dorsal spine of T18 (last ICS). It relates to the inside of the
hindlimb. Its partner is BL49.

HORSE LUMBAR SHU POINTS

BL21 WeiShu = ST Shu: Below the dorsal spine of L1, just behind last rib. It relates to the
anterolateral side of the hindlimb. Its partner is BL50.
BL22 SanJiaoShu = TH Shu: A key Endocrine point, behind the wings of L1. It relates to
the lateral neck and the outside of the forelimb and to endocrine problems, especially
reproductive. Its partner is BL51.
BL23 ShenShu = KI Shu: Between the wings of L2-L3. (Cain and Glardon find the latter
place the more important. It relates to the inside of the hind limb and to KI-gonad-adrenal and
bone function. Its partner is BL52.
BL24 QiHaiShu = Qi Sea Shu: Behind the wings of L4.

BL25 DaChangShu = LI Shu: Behind the wings of L5, behind a line between the most
anterior point of the left and right external angle of the ilium. It relates to the outside of the
forelimb. It may be tender in colic and sciatica.
BL26 GuanYuanShu = Gate Origin Shu, Uterus Shu: Behind the wings of L6, before a line
between the highest points of the left and right tuber coxae.

HORSE SACRAL SHU POINTS

BL27 XiaoChangShu = SI Shu: Lateral to sacral foramen 1; it relates to the back of the
forelimb. BL31 is medial to it.
BL27a Unnamed = another SI Shu: lateral to GV02 (sacrococcygeal space). This point is
more reactive than the classical BL27 in SI problems. It is very close to, if not the same as
Cain's sacral hip-stifle point. It has the same functions as BL27.
BL28 PangGuanShu = BL Shu: lateral to sacral foramen 2, at the top of the muscle crease.
It relates to the posterior side of the hindlimb. BL32 is medial to it. Its lateral partner in
humans is BL53.
BL28a Unnamed = another BL Shu: lateral to coccygeal 2, in the groove just posterior to the
origin of the biceps femoris, about 2 inches behind BL27a. This point is more reactive than
the classical BL28 in BL problems (M.J.C). It has the same functions as BL28, as have BL32.
BL28,28a (BL) may be tender in urogenital (renal, gonadal) disorders, in sacral problems, in
all problems of the spinal column (from the atlas to the sacrum). BL28 is important in cervical
misalignment, in sacrococcygeal injury (in transport etc), in stress-related pain of the
semimembranosus and semitendinosus muscles. It is used also in GB-related (see BL19)
lameness; Water (BL) is the Mother of Wood (GB) in the Sheng cycle.
BL29 ZhongLuShu = Middle of Back Shu: lateral to sacral foramen 3. BL33 is medial to it.
BL30 BaiHuanShu = White Circle Shu, Anus: lateral to sacral foramen 4. BL34 is medial to
it. Its lateral partner in humans is BL54.

In humans, the Outer paravertebral BL line (O = points BL41-52, between vertebrae T2 and
L2) has a relationship to the Inner (I) line:
O (41 to 52) = I (12 to 23) + 29, i.e. points BL12,41 / 13,42 / ... / 23,52 / are functional pairs.

The outer (O) point is in the SAME ICS, lateral to the inner (I) point. The same
relationship applies in the horse. The outer BL line relates to the parasympathetic nervous
system. In particular, BL42 (ICS 8 in the horse; partner of BL13) is sensitive in lung bleeders,
especially on the right side.

Human points BL53 and 54 are lateral to BL28 and 30 (lateral to sacral foramina 2 and 4
respectively). In horses, BL53 is just behind the anterior edge of the external angle of the
ilium, lateral to BL26; BL54 is level with coccygeal 1-2 space, below and in front of BL28a.
BL54a is below BL53, in the muscle crease just at the tuber ischii. BL54 and 54a are used in
hip and thigh problems.

BL24 (QiHaiShu) and BL26 (GuanYuanShu)

These points are used mainly for local effects, as in lumbar and sacral disorders. There is a
traditional horse point GuanYuanShu behind last rib. It is active on gastrointestinal problems
and should not be confused with BL26, which has effects on the uterus. BL24,26 may be
active in disorders of the lumbosacral ligaments, sciatica, pain at the insertion of the
longissimus dorsi, iliosacral ligament, middle gluteal muscle, sacrosciatic ligament, sacral
nerve plexus.

The lumbar Shu (BL21,22,23,24,25,26: ST, TH, KI, QiHaiShu, LI, GuanYuanShu) reflect
the sympathetic nervous (cervicolumbar) and endocrine systems.

The sacral Shu (BL27,28,29,30: SI, BL, ZhongLuShu, BaiHuanShu) reflect the
parasympathetic nervous system (craniosacral).

CV Channel (FIGURE 13)

The CV (Conception Vessel) Channel runs in the ventral midline, from CV01 (between the
anus and the vulva/root of the penis, along the perinaeum above the penis or mammary gland,
to the navel (CV08), to the tip of the xiphoid (CV14), to the manubrium sterni (CV22), to the
hollow above the larynx (CV23), to the centre of the lower lip (CV24). This Channel is
important in humans as Mu points for BL, SI, TH, ST, HT, PC (CV03,04,05,12,14,17
respectively) are on it. In the horse, points CV03-08 can be dangerous to needle but
CV12,14,17 are relatively easy to needle. Horses, however, often tolerate Shiatsu (deep
massage) of awkward points. CV12 is located midway between the navel and the xiphoid.
CV17 is located about 1 hand anterior to the caudal border of the olecranon, on the sternum.

Shiatsu at CV05 can be used with AP at other points in endocrine/autonomic disorders (lack
of sweating, breeding problems, thyroid problems). CV08,12 are useful in colic (Shiatsu or
massage with heat-producing liniment).

CV01 + GV01 are useful to stimulate initial defecation in neonatal foals.

Stimulation of the clitoris (YinTi) produces a strong extensor reflex of the hindlimbs. This is
of clinical use in dogs with posterior paresis: if marked extensor reflex is not produced, the
prognosis is poor (M.J.C). In cows, warm Laser stimulation of the clitoris can help in the
treatment of infertility.

CV23 (needling or Laser) is useful in pharyngitis (M.J.C).

GV Channel (FIGURE 14)

The GV (Governing Vessel) Channel runs in the dorsal midline from GV01, (between the
anus and the root of the tail), to the sacrococcygeal space (WeiKen, GV02), to the
lumbosacral space (BaiHui, GV03), to the L2-L3 space (GV04), to the T5-T6 space (GV11),
to the T3-T4 space (GV12), to the top of the head (GV20), to the midpoint between the
nostrils, at their lower limit (GV26). It ends at GV28, between the upper lip and the upper
gum.

The GV is a very important Channel in humans. Its points have similar functions to their
nearest BL points. In the horse, because it can be difficult to penetrate the dorsal midline
between L1 and T8, points GV05-10 are not used often. However, GV01,02,03,04,11,12,14
and 26 are very important points. GV01-04 are used in problems of the hindquarter,
genitourinary system and hindgut.

When a Shu point is injured (from trauma, external or internal causes), the GV point or the
dorsal spinal process nearest it is usually tender and should be treated. Very superficial picks
(just slightly subdermal) are all that is needed.

GV01 + CV01 are useful to stimulate initial defecation in neonatal foals. The tip of the tail
(GV00) is a special action point, used in shock and recumbency.

GV11 and 12, at the highest point of the withers, are related clinically to GV14 in humans
(antifebrile point, antiasthmatic point, problems of the neck, thoracic limb and upper thoracic
spine). GV11,12 often are tender in cervical problems in horses. They are as important to the
forequarter as BaiHui (GV03) to the hindquarter. After adjustment of subluxated neck
vertebrae (see 1.2.4), balance at GV11,12 can be obtained by pricking superficially with a 22g
needle. The points can be injected with 0.1 ml homeopathic NaOH 9d. This releases spasm at
the origin of the trapezius, latissimus, rhomboideus, serratus and other deep muscles attached
to the withers. Occasionally, BL14 (PC Shu) and the GV point in between may be tender in
breeding problems (M.J.C). The withers area is very prone to pressure injury from the
pommel of the saddle or from bad riders, who ride too far forward. This is the site of fistulous
withers and a point easy to injure the bursae of the supraspinous ligaments/neck muscle
attachments.

GV26, the Shock Point, is useful in emergencies in all species. It is effective in stimulating
respiration and circulation in the newborn foal. GV01 + CV01 are useful to stimulate initial
defecation in neonatal foals.

REFERENCES
1. Hwang,Y.C. (1990) Handbook on Chinese veterinary acupuncture and moxibustion.
FAO Regional Office for Asia and the Pacific, Bangkok. 193pp.
2. Klide,A. & Kung,S. (1977) Veterinary AP. University of Pennsylvania Press,
Philadelphia, PA, USA. 297pp.
3. Kothbauer,O. & Meng,A. (1983) Veterinary AP: cattle, pigs and horses (in German)
Verlag Welsermuhl, Wels, Austria. 334pp.
4. Lin,J.H. & Rogers,P.A.M. (1980) AP effects on the body's defence systems. A
veterinary review. Vet. Bulletin 50, 633-640.
5. Lin,J.H. (1985) AP in the ox, pig, horse, goat & dog. (in Chinese). Write c/o Dept.
Animal Husbandry, National Taiwan University, TAIPEI, TAIWAN, R.O.C.
6. Rogers,P.A.M. & Ottaway,C.W. (1974) Success claimed for acupuncture in domestic
animals. A veterinary news item. Irish Vet. J., 28, 182-191.
7. Rogers,P.A.M., White,S.S. & Ottaway,C.W. (1977) Stimulation of the acupoints in
relation to analgesia and therapy of clinical disorders in animals. Vet. Annual (Wright
Scitechnica, Bristol) 17, 258-279.
8. Rogers,P.A.M. (1979) Acupuncture in equine practice: a brief review. Irish Vet. J., 33,
19-25.
9. Rogers,P.A.M. (1981) Serious complications of acupuncture... or acupuncture abuses ?
Amer. J. Acup., 9, 347-350.
10. Rogers,P.A.M. & Bossy,J. (1981) Activation of the defence systems of the body in
animals and man by acupuncture and moxibustion. Acup. Res. Quarterly (Taiwan) 5,
47-54.
11. Rogers,P.A.M. (1996) Choice of points for particular conditions. In: An Introduction
to Veterinary AP. Proceedings of a training Course for Irish Veterinaians, Part 1,
Dublin.
12. van den Bosch,E. (1995) Acupuncture Points and Meridians in the Horse. Contact
the author at G. van Heuvelstraat, Ramsel, Belgium (Fax: 32-1656-1374).

13. Westermayer,E. (1980) Treatment of horses by AP. Health Science Press, Holsworthy,
Devon, UK. 90pp.
14. White,S.S., Herbert,P.A. & Hwang,T. (1985) Electro-AP in veterinary medicine.
Chinese Materials Centre Publications, San Francisco. 122pp.
QUESTIONS
Channel codes used in these questions are: LU, LI, ST, SP, HT, SI, BL, KI, PC, TH, GB,
LV, CV, GV.

1. One of the following statements is not correct. Indicate the incorrect statement:
(a) AP point sensitivity may be found by palpation or by response to thermal or electrical
stimuli applied to the points.
(b) Electrical resistance-, impedance- or conductance- meters may be used to detect reactive
AP points.
(c) The therapeutic aspects of AP are mediated by the reflex system and by activation of
spinal and central neuroendocrine and systemic responses.
(d) AP has analgesic, antiinflammatory, immunostimulant and immunosuppressive effects;
antispasmodic effects on striated and smooth muscle; marked effect on blood microcirculation, cell metabolism and glandular secretion in organs related to the stimulated AP
points.
(e) AP has therapeutic effects on the nervous, endocrine, urogenital, gastrointestinal,
musculoskeletal and respiratory systems but has no effect on the skin.

2. One of the following statements is not correct. Indicate the incorrect statement:
(a) AP at the same point can have opposite effects, i.e. needling ST36 (TsuSanLi) can control
gastric spasm in one case and gastric atony in another.
(b) AP can help in early hepatitis or nephritis but may be of little use in severe fibrosis of the
liver or kidney. AP can help in bronchospasm but may be of little use in emphysema with
rupture of the alveoli.
(c) AP is effective in less than 40% of cases of equine lameness.
(d) AP is effective in treating paralysis in more than 70% of disc-disease cases and in less
than 40% of myelopathy cases.
(e) Although claims are made for effectiveness of AP in tendinitis, many experts got poor
results in these cases. Tendinitis responds better to local Laser or to Plum Blossom Needling
than to AP.

3. One of the following statements is not correct. Indicate the incorrect statement:
Acupuncture has powerful therapeutic effects as the sole (only) or main therapy in the
horse in:
(a) muscle pain
(b) radiculopathy due to soft tissue inflammation
(c) windsucking (aerophagia) with no other digestive signs
(d) early hepatitis
(e) bronchospasm
(f) early case of foal ataxia (wobbler), if used with neck manipulation

4. One of the following statements is correct. Indicate the correct statement:

Acupuncture has excellent therapeutic effects as the sole (only) or main therapy in the
horse in:
(a) azotaemia/rhabdomyolysis
(b) spinal transection
(c) motor neuron degeneration
(d) colic with intussusception
(e) gastric ulcer in foals

5. One of the following statements is not correct. Indicate the incorrect statement:
Acupuncture has poor or no therapeutic effects as the sole (only) or main therapy in the
horse in:
(a) acute laminitis
(b) severe damage to brain motor centres
(c) severe fibrosis of the kidney
(d) alveolar emphysema

(e) female infertility with uterine cysts/fibrosis

(f) chronic tendinitis, especially where owner will not rest horse

6. One of the following statements is not correct. Indicate the incorrect statement:
(a) If the Shu of one Channel is tender, the Shu of its paired Channel may be used also.
Thus, in hindlimb lameness, if BL23 (kidney Shu) is tender, one can add BL28 (bladder Shu)
to the prescription.
(b) Injury to the paravertebral area from the withers to the tail, whether due to incompetent
riding, badly fitting saddle etc has little effect on racing performance.
(c) If there is weakness (deficiency) in a Channel, the Shu of the Mother Channel can help.
Thus, in weakness of KI, one could use the LU Shu (BL13)
(d) If there is hyperactivity (excess energy) in a Channel, the Shu of the Son Channel can
help. Thus, in excess of ST, one could add BL25 (LI Shu).
(e) Injury to a Shu point, or to any key AP point, can have effects far more serious than "local
injury" in a western sense. It may induce signs and symptoms in the associated organ or
Channel and in related Channels.

7. Shu point sensitivity may give diagnostic information on the location of Channel
problems and helps greatly in the choice of AP points for therapy. One of the following
statements is not correct. Indicate the incorrect statement:
(a) In mares and fillies, sporadic lameness can arise due to referred pain from ovarian or
uterine irritation. It is essential in such cases to check for AhShi points related to the ovary
and uterus. The most likely point to be tender in these cases is BL17.
(b) Tenderness at BL25 (lumbar 4-5, LI Shu) may relate to lameness of the anterolateral
forelimb above the carpus or to anteromedial forelimb below the carpus.
(c) Horses with pain of the outside forelimb splint bone are more likely to show tenderness
at BL15,22 or 27 (Shu of HT, TH or SI) than at BL13,14 or 25 (Shu of LU, PC or LI)
(d) BL23 (between the wings of L2-L3) may be tender in urogenital (renal, gonadal), adrenal
and fertility disorders and in thoracolumbar problems, lameness related to psoas muscles.
(e) BL23 may be tender in post-castration pain, cryptorchidism, inguinal ring problems, inside
hindlimb problems. If the tail twitches during riding, this indicates AhShi at BL23.
8. Shu point sensitivity may give diagnostic information on the location of Channel
problems and helps greatly in the choice of AP points for therapy. One of the following
statements is not correct. Indicate the incorrect statement:

(a) BL27 (SI Shu) may be tender in problems of the posterior side of the forelimb, tendons,
sesamoids, heel bulb bruises, elbow (rare), sacral nerve plexus, biceps femoris, intestinal
function.
(b) SI10, if still tender after proper Channel balancing, is diagnostic for LOCAL shoulder
lameness (OCD)
(c) SI17 is related to the outside sesamoid, suspensory ligament and lameness at the
posterior side of the forelimb. It also relates to ipsi- and contra- lateral lower sacral injury,
hindlimb lameness and all neck problems.
(d) BL19 (GB Shu) is associated mainly with spain, periostitis, splints or lameness of the
inside forelimb.
(e) TH17 and SI18 are tranquillizer points.

9. Shu point sensitivity may give diagnostic information on the location of Channel
problems and helps greatly in the choice of AP points for therapy. One of the following
statements is not correct. Indicate the incorrect statement:
(a) BL20 (SP Shu) may be tender in disorders of the spleen, pancreas; in digestive disorders,
impaction, colic; in lameness of the inside hindlimb/stifle/hock (cunean tendon) and in
thoracolumbar injury.
(b) Spleen points (BL20 (SP Shu), SP21,21a) are seldom if ever tender in bleeders or horses
with blood disorders.
(c) BL18 (LV Shu) may be tender in allergy (elevated globulin levels), muddy colour of the
eye mucosa, lacrimation and conjunctivitis, problems of muscles, tendons, ligaments,
azoturia, myositis, (tying-up syndrome), elevated CPK, SGOT in blood.
(d) BL19 (GB Shu) may be tender in problems of muscles, tendons, ligaments, azoturia,
myositis, (tying-up syndrome), elevated CPK, SGOT in blood. Tenderness at BL19 can arise
in curbs. Reactive GB can cause spasm of the biceps femoris muscle, resulting in hindlimb
lameness.
(e) BL21 (ST Shu) may be tender in digestive disorders, impaction, colic, in anterolateral
hindlimb lameness, stifle lameness, sacrosciatic ligament, sacral pain at the origin of the
biceps femoris, thoracolumbar injury. BL21 may be tender in shoulder pain when
sternocephalicus is involved. This is common. ST10 (on sternocephalicus m.) relates to BL21
and to the ipsilateral stifle, especially if BL21 is tender.

10. Shu point sensitivity may give diagnostic information on the location of Channel
problems and helps greatly in the choice of AP points for therapy. One of the following
statements is not correct. Indicate the incorrect statement:

(a) The BL Channel is the most important. Its clinical uses include diagnosis and treatment
(via the Shu points). BL points are used in almost every AP prescription.
(b) BL28,28a (BL Shu) may be tender in urogenital (renal, gonadal) disorders, in sacral
problems, in all problems of the spinal column (from the atlas to the sacrum). BL28 is
important in cervical misalignment, in sacrococcygeal injury (in transport etc), in stressrelated pain of the semimembranosus and semitendinosus muscles.
(c) When a Shu point is injured (from trauma, external or internal causes), the GV point or
the dorsal spinal process nearest it is usually tender and should be treated. Very superficial
picks (just slightly subdermal) are all that is needed.
(d) CV01 + GV01 are useful to stimulate initial defecation in neonatal foals.
(e) GV14 (antifebrile point, anti-asthmatic point, problems of the neck, thoracic limb and
upper thoracic spine) is located in the midline between the skull and the atlas bone.

11. A horse with poor appetite has a tender point on the left side, 10 cm lateral to the GV
Channel, just behind the last rib. Which number (1 to 5) corresponds with:
(1) (2) (3) (4) (5)
a. the tender point :
BL19 BL20 BL21 BL22 BL23
b. the Mother Point of ST: BL23 BL24 BL25 BL26 BL27
c. the Son Point of ST:
BL23 BL24 BL25 BL26 BL27

12. A horse with poor stamina, dirty congested eyes, poor quality flaky hooves and
tendency to azoturia/rhabdomyolysis is tender on right side on BL18. Which number (1
to 5) corresponds with:

a. the affected organ:

b. the Mother Point of LV :
c. the Son Point of LV :

(1)

(2)

(3)

(4)

(5)

HT

LV

GB

SP

ST

BL21 BL22 BL23 BL24 BL25

BL12 BL13 BL17 BL15 BL16

13. Two weeks after recovery from rotavirus infection, a 6-week-old foal develops mild
colic, poor appetite, pasty dung, grinding of the teeth and dry harsh coat. Three tender
points are located on the inner BL line. Which number (1 to 9) corresponds with the
affected Channel linked to each tender point:

(1) (2) (3) (4) (5) (6) (7) (8) (9)

a. behind last rib :
LU LI ST SP HT SI BL TH GB
b. at anterior edge of lumbar 6: LU LI ST SP HT SI BL TH GB
c. over sacral foramen 1 :
LU LI ST SP HT SI BL TH GB

14. The points in 13 above are BL21, BL25, BL27. Which pair of points (a to d) is best
for use with those three points in gastrointestinal disorders:
a. GB34 + LU07
b. ST36 + PC06
c. ST44 + ST06
d. SP10 + LI11
e. GB20 + GB21

15. A mare with a history of repeat breeding at 20-day intervals is tender bilaterally half
way between lumbosacral space and external angle of the ilium. Which number (1 to 5)
corresponds with:
(1) (2) (3) (4)
(5)
a. the organ related to the point :
KI LV ovary uterus cervix
b. the AP point at the tender point: BL23 BL24 BL25 BL26 BL27
c. the TH Shu point:
BL20 BL21 BL22 BL23 BL24
d. the KI Shu point:
BL20 BL21 BL22 BL23 BL24
e. the SP Shu point:
BL20 BL21 BL22 BL23 BL24

16. Which letter (a to e) corresponds with the correct location of GV01:

a. between anus and vulva
b. between anus and tail
c. between tail vertebra 1-2
d. between tail vertebra 2-3
e. sacrococcygeal space
1=e; 2=c; 3=c; 4=e; 5=a; 6=b; 7=a; 8=d; 9=b; 10=e;

11: a=3; b=5; c=3;

12: a=2; b=3; c=4;
13: a=3; b=2; c=6;
14=b;
15: a=4; b=4; c=3; d=4; e=1;
16=b

ACUPUNCTURE IN SMALL ANIMAL PRACTICE

INTRODUCTION
Acupuncture (AP) literally means needle (acus) puncture. In the past it referred to needling
specific points of the body to assist the healing (homoeostatic) power of the human or animal
patient. The word AP has a much wider meaning today. It infers diagnostic and prognostic
value as well as therapeutic effects.

Many methods can be used to activate the defensive systems of the body via the AP points.
These include: simple needling, injection of the AP points (with orthodox or unorthodox
medicaments, non-isotonic saline, B12 or local anaesthetic solutions), insertion of surgical
staples or other implants at the points, electro-needling, transcutaneous electrical stimulation,
ultrasound, low level laser therapy (LLLT), application of heat (microwave; infrared; moxa;
thermostatically controlled heat probes) or cold (ice massage; ethyl-chloride or other
vapocoolant sprays), massage etc. As long as it is adequate, the method of stimulation is less
important than the correct choice of AP points.

This paper, discusses AP in small animal (SA) practice under 6 headings:

1. AP concepts and mechanisms
2. Methods of choosing AP points for therapy
3. Diagnostic prognostic and therapeutic aspects of AP with examples in emergencies,
musculoskeletal problems, disc disease and reproductive disorders
4. AP analgesia for surgery
5. Practical methods of AP stimulation, especially in Trigger Point (TP) therapy
6. Further training

1. AP CONCEPTS AND MECHANISMS

Traditional Chinese Medicine (TCM) is based on oriental philosophies of Qi, Yin-Yang, Five
Phases, Perverse Causes of Disease, the Concept of Change and other concepts which
western-style professionals find difficult to understand. These concepts are discussed in detail
elsewhere. Those interested may read the basic human texts, listed below.

Briefly, Qi is the vital energy which comes from heaven (air), earth (food) and ancestors
(genetic vitality). The Channel-Organ System (COS) is a vast network of superficial
Channels (Jing), superficial and deep Collaterals (Luo, pathways connecting one Channel
with a specific Phase-Mate Channel) and deep pathways which connect the exterior with the
interior, the superficial Channels with their named Organs. The COS comprises an extensive
3-dimensional system of the Channels (Jing), Collaterals (Luo), superficial and deep
pathways of Qi and the organs and their TCM Functions. The COS is the anatomical and
functional system which controls all body organs, parts and functions and interfaces the
interior to the exterior and the exterior to the external world beyond. The Jing-Luo
(Channels and Collaterals) used to be called the Meridians and Qi Pathways of TCM.

Yin-Yang is the principle of opposite, yet complementary forces (female/male; hypo-/hyper-;

cool/warm; chronic/acute; parasympathetic/sympathetic; diastole/systole etc).

Five Phases (Fire, Earth, Metal, Water, Wood) represented the five basic types, once called
the Five Elements. Everything in existence can be categorised by analogy to Yin-Yang and
Five Phases. The Sheng Cycle (anabolic, creative) and the Ko Cycle (catabolic, restraining)
keeps the Five Phases in perfect harmony and balance. Each body organ and function relates
to a specific Phase and disease patterns reflect the Phases. For example, in Winter (Phase =
Water), the diseases to expect would be diseases of bladder and kidneys (Water), bones
(Water), nervous system (Water).

In TCM, the classical Exogenous Causes of Disease (the Perverse Causes, or External Evils
in TCM) are Wind, Damp, Heat, Summer Heat, Dryness and Cold. If the Wei (Defensive) Qi
in the skin is weak, the External Evils can penetrate the body via the AP points and
Channels. If the Qi in the Jing-Luo is not strong enough to throw off the attack, the Evil Qi
can reach the viscera via the Jing-Luo and lead to fatality. Trauma, diet and internal causes
are recognised also as causes of disease, as are phycological factors. In modern China, much
of this philosophy is replaced by "scientific concepts" of medicine and pathology. However,
many aspects of TCM still retain their full value in today's world, especially the holistic
concepts of TCM and the validity (objective reality) of the AP points and their diagnostic,
prognostic and therapeutic functions.

Two basic types of points are used in AP: Classical AP points and Tender Points which may
or may not correspond with documented AP points

Classical AP Points: More than 2500 years ago, TCM described the functions and
anatomical positions of hundreds of points on the classical human Jing-Luo System. These
points have diagnostic and therapeutic properties. They occur on the head, neck, trunk and

limbs. Specific sets of points relate to and/or have functional connections with each other and
with the COS, its TCM Functions and Qi-COS network.

The 12 Main Jing (Channels): In TCM, there are 12 Jing (Qi pathways) which run in the
long axis of the body and are bilaterally symmetrical. Each Jing has a superficial path, along
which lie its Channel points (close to the skin) and a deep path through the interior of the
body, to connect with its organ and other related body parts and functions. Each Jing connects
also with one "upstream" and one "downstream" in the daily energy (Qi) circuit. The 12 main
Jing are LU (Lung); LI (Large Intestine or Colon); ST (Stomach); SP (Spleen); HT (Heart);
SI (Small Intestine); BL (Bladder); KI (Kidney); PC (Pericardium; Circulation-Sex, Heart
Constrictor); TH (Triple Heater: respiratory, digestive, reproductive functions); GB
(Gallbladder); LV (Liver). Each of these Jing controls both superficial and deep functions.

The Qi in three Channels flows from thorax to fingers (LU, PC, HT); in three from fingers
to face (LI, TH, SI); in three from face to foot (ST, BL, GB) and in three from foot to chest
(SP, KI, LV).

Diurnal Qi circulation: Qi circulates in the Jing Luo to reach every cell in the body. The Qi
tide flows through the Jing-Luo in a definite direction and time sequence: LU -> LI -> ST ->
SP -> HT -> SI -> BL -> KI -> PC -> TH -> GB -> LV (and back to LU). The Qi peaks in
LU between 0300-0500h and peaks in the other Jing in sequence at 2-hour intervals, to begin
a new energy circuit in LU at 0300h next morning. Thus the Qi of each COS has its high- and
low- tide.

In TCM, blockage or imbalance in the flow and distribution of Qi is the cause of ill-health.
When there is disease, the Channel Qi is disturbed and certain points along the Channel
become sensitive to palpation, heat and electric current. Stimuli applied to the sensitive points
can normalise the energy flow, helping the adaptive responses to remove the disease (restore
ease).

Example of a Channel path: The BL Jing begins at the inner canthus of the eye, goes across
the skull, then paravertebral to the sacrum, then down the posterior midline of the buttock,
thigh and calf to pass between the lateral malleolus of the tibia and the Achilles tendon and
thence to the lateral aspect of the little toe.

Along the course of each Channel, a specific number of points is recognised. Each of these
points is said to influence the parts and functions "controlled" by the Channel. For example,
there are 67 BL points and BL67 (on the little toe) could influence the eye (BL01) and BL01

could influence the little toe. Each Jing also has a deep course and is "connected" to the organ
bearing its name. Thus any BL point could influence BL function.

Each Channel point has local functions also. For example, BL40 (old BL54, in the popliteal
crease) is used in knee (stifle) pain, arthritis etc; BL23 (between transverse processes of L2L3) in nephritis; BL01 in acute opthalmitis etc.

Channel points also influence the organs lying close to them. For example, BL13,14,15
(beside vertebrae T3, T4, T5) influence the lungs, pericardium and heart; CV03,4,12,17
influence the bladder, small intestine, stomach and heart respectively because of their
proximity to these organs.

The Eight Mo (or Mai): These are called the Eight Extra Vessels. As well as the 12 main
(bilaterally symmetrical) Jing, there are 8 special Qi reservoirs. Two of these are in the
midline: the Ren Mo (Conception Vessel, CV, in the ventral midline, from perinaeum to
lower lip) and the Du Mo (Governing Vessel, GV, in the dorsal midline, from the
anococcygeal area to the upper lip). The CV and GV are said to be reservoirs of energy and
contain many important AP points for cranial, thoracic and abdominal problems. The six
other Mo (Vessels, Qi reservoirs) are the Chong Mo; Dai Mo; Yangqiao Mo; Yinqiao Mo;
Yangwei Mo and Yinwei Mo. The Eight Extra Vessels link with some of the main COSs,
thereby allowing one COS to influence many other COSs and other body parts.

AP diagnosis: So far, we have discussed the relationship between points and organs mainly as
a one-way system (the points influencing the organs). In fact, AP has diagnostic aspects as
well as therapeutic aspects. The organs influence the points and the points influence the
organs. When an organ or its function is upset, reflex changes occur on the surface of the
body and can be detected by careful examination of the points. The best examples of the
diagnostic reflex points are the Shu (Back Association, paravertebral) and the Mu (Front
Alarm, abdominal/thoracic) points. In disease of the heart, BL15 (Shu) and CV14 (Mu) are
frequently tender to palpation, as are HT Channel points. In appendicitis (large intestine, LI),
ST25 (Mu, McBurney's point) and BL25 (Shu, paravertebral point between L4-L5) may be
tender in addition to LI Channel points.

Thus, via the Jing-Luo of TCM (or via neuroendocrine reflex/hormonal mechanisms in
western physiology) AP points have a two-way relationship with the COSs. Channel or
Organ pathology alters point sensitivity (diagnostic) and stimulation of the sensitive point
helps to normalise the affected organ. Point sensitivity also returns to baseline as the organ
or its function is normalised.

The relationships between point sensitivity and diagnostic/therapeutic aspects led to the
search (in recent years) for other sensitive points in specific pathologies. This uncovered
another 300 or so points not mentioned in the ancient texts. They are described in recent texts
as "Extra-Channel, New or Strange Points" and their human positions are described.

In modern physiology, segmental reflexes explain many of the therapeutic and diagnostic
relationships between internal organs and their related AP points; the same spinal nerves
service both the area of the point and the area of the pathology. However, not all the
therapeutic/diagnostic relationships can be explained by segmental reflex. For example, in
acute appendicitis, a new point (LanWei: literally gut tail or appendix) on the tibialis anterior
muscle (right side) is usually very tender to palpation. This point is very powerful in relieving
the pain and spasm of acute appendicitis. Its effect may be explained by short intersegmental reflexes. Other effects, for example between Earpoints and abdominal organs can
be explained by supraspinal reflexes.

As well as the documented AP points, Trigger Points (TPs) are another point category of
diagnostic and therapeutic value in AP. TPs often occur in pain syndromes, especially in
myofascial syndromes. They have no fixed location but may appear in the musculature,
where they may be palpated as "nodules" or areas of localised spasm. Heavy pressure on (or
needling of) the TP causes severe pain which radiates back to the area of complaint (i.e.) it
"triggers" the complaint. Other points can act as triggers, for example scar tissue is frequently
a trigger for muscle or organ pain elsewhere. TPs occasionally arise near the Golgi apparatus
of tendons and at motor points (where the motor nerve enters the muscle). International
experts, such as Melzack (Canada), Pontinen (Finland), MacDonald (UK) and Chung
(Taiwan), have done intensive research on TPs in relation to human pain syndromes and a
Belgian colleague has recently described TPs in myofascial problems in dogs (Janssens
1987).

In AP, location of tender points (including TPs) is extremely important in diagnosis and
stimulation of these points can give pain relief in 50-70% of cases. The quickest and easiest
way to convince sceptics of the benefits of AP therapy is to persuade them to experiment with
TP therapy. It needs no knowledge of AP points or of the very detailed laws of AP. The
clinical success of TP therapy is usually met with disbelief at first. Later the sceptic comes to
accept it. It is then be easier to persuade him/her to undertake serious study of the complete
AP system. The weakness of TP therapy is that many clinical cases (including some
myofascial cases) do not develop triggers. Therefore many of these cases can not be treated
successfully by needling unless the practitioner knows classical AP.

AP POINT STIMULATION
AP stimulation means the application of a sufficient stimulus to the AP points to activate a
desired response. There is not time in this talk to discuss mechanisms in detail. Briefly, AP

effects are mediated by the peripheral and CNS, autonomic, neuroendocrine and endocrine
systems.
(a)

(b)

(c)

Point ---> sensory nerve ---> spinal cord ---> CNS --->

Neuroendocrine

| |

ENDOCRINE.<---| |--> AUTONOMIC

(+) |
|

(-)

DISORDER <----

CENTRE

CENTRE

RESPONSE <-------<----v-------<-----------v---<------v

Local anaesthetic block or experimental section of the neural input at (a), (b), or (c) abolishes
the effect. Certain drugs active at central and peripheral sites can act as agonists or antagonists
to AP effects. Therefore, correct choice of points and adequate stimulation of the points are
critical to success.

For >2500 years, the points were stimulated by insertion of "needles" into them. Over the
millennia the "needles" were refined from crude instruments made of bamboo, flint or
porcelain, to lancets of metal and (finally) to extremely fine, solid, stainless steel needles.
Today, human AP needles are made of the finest quality steel and are 28-34 gauge. Vet AP
needles are usually 22-26 gauge (large animals) or 26-30 gauge (small animals).

Apart from needling, many other types of stimuli can activate the points. Modern methods of
stimulation include point injection; implantation of absorbable or non-absorbable materials;
TENS; faradism; magnetotherapy; ultrasound; low level laser therapy (LLLT); application of
heat or cold; massage; blisters etc. Thus the term AP therapy, though originally meaning
therapy by needle puncture, is now used to mean therapy using the AP points. The choice of
correct reflex points is more important than the method of stimulation used. For more details,
see "Techniques of stimulation of the AP points".

Up to now, we have discussed concepts of human AP. This was necessary because there are
no texts on small-animal AP other than those based on the human system. Since 1974, smallanimal vets around the world have been successful with transposition of the human principles
to dogs and cats etc, (In, fact, even large-animal vets must learn the human system before they
can hope to progress to the classical texts on large-animal AP).

We can summarise the talk so far by four points:

a. AP has diagnostic and therapeutic aspects.

b. Point sensitivity (to palpation and other stimuli) is a critical guide to the location of the
diagnostic points.
c. When present, the diagnostic points are also therapeutic points.
d. Successful AP therapy depends on a knowledge of classical points and concepts when
tender points are absent.

2. METHODS OF CHOOSING AP POINTS FOR THERAPY

In TCM, choice of AP points depends on the diagnosis in terms of: which Channel(s) are
involved; whether the Qi is deficient or excessive in the Channel(s) and whether or not AP is
appropriate. (TCM makes extensive use of herbal medicine, dietary advice, exercises
(physical and mental) fasting, sweating, purgation etc as needed. AP was only a small part of
TCM).

TCM has many Laws of Choosing Points. These include:

1. AhShi points (tender points, TPs; see later).
2. Local points (points near the problem area or near the affected organs).
3. Distant points, especially on Channels passing through the affected part or organ.
4. Points on the affected Channel.
5. A chain of points on an affected Channel, for example GB30,32,34,39 along the GB
Channel, from the hip to the lower lateral leg in leg paralysis.
6. Points on related Channels (on the "Husband or Wife" Phase-Mate, or on Channels near
the affected one.
7. Encircling the affected area.
8. "Fore and Aft" combination (points anterior and posterior to the problem organ or area).
9. Mu-Shu combination (combination of thoracoabdominal alarm points with paravertebral
reflex points for the affected organ or function).
10. Yuan-Luo combination (combination of Yuan-Source point of the affected Channel
with the Luo-Passage (Qi transfer) point of its Phase-Mate Channel).

11. Symptomatic Points: Certain symptoms were long known to respond to certain points,
for example, GV26 (in the philtrum) in shock; PC06 (over median nerve) in nausea and
vomiting etc.
12. Xi (Cleft, Accumulation) points (special points for acute diseases)
13. The use of the 5 Phase points (special points for energy transfer between Channels).

To these laws, modern medicine adds the following:

14. Needling along the affected nerve trunks relating to the affected parts or organs.
Needling near the affected dorsal nerve roots. Needling the affected dermatomes.
15. Needling "Extra-Channel" points (new points discovered in recent decades), such as
"Scalp", "Ear", "Face", "Nose", "Hand" or "Foot" zone points related to the affected function
or area. Examples are: Scalp Zone "Lower Motor Area" in paralysis of the legs; "Hand" point
"Loin and Leg" in sciatica; NX04 (TingChuan = Soothing Asthma) in asthma or bronchitis
etc.

The most common prescription is a combination of AhShi points + local points + distant
points on the affected Channel. This may seem to be a simple matter to resolve but a look at
any standard charts shows the difficulties. (It is advisable to limit the number of needles to 612 in most sessions, therefore one must discriminate which local and distant points are most
relevant). The textbooks (as individual texts) do not help much either. A careful study of the
texts shows that there is major variation between them in their choice of points for specific
conditions.

One solution to the problem is to construct a database from many textbooks and to use the
computer to do a frequency ranking on the points for specific conditions. In this way, the most
commonly recommended points for any specific condition can be output in seconds.

COOKBOOK AP: Cookbooks usually provide instant details of the ingredients needed to
prepare the required dish. They are used mainly by cooks, who have bad memories, or have
not tried to prepare the dish before. Either way, they are very useful and many an enjoyable
meal was prepared in this way. Master Chefs, however, are in a class apart from cooks. They,
through experience, good memory and intuition, seldom need to refer to cookbooks.

Cookbook AP is basically "prescription AP". It is suitable for statistical medicine

(standardised approach to all "similar" cases). It is quite unsuitable for difficult, complicated
or atypical cases, especially in humans. To treat such cases successfully by AP would require
a deep study of the classical concepts. Having said that, Cookbook AP is ideal for routine and
simple cases. It is the quickest, least painful way of introducing busy professionals to the AP
techniques. Whether right or wrong, many busy professionals are not prepared to devote the
effort and time to a deep study of AP. Without the cookbook approach, most of these would
never be able to attempt AP therapy (except for the simplest type, TP therapy or AhShi
therapy).

There are dozens of AP textbooks available. The main problem with the cookbook method is
to decide which text to use. The best include: Anon 1974; O'Connor & Bensky 1983; Cheng et
al 1987; Ellis et al 1989; Anon 1993. However, no one text lists all the conditions which can
be helped by AP, and there are many differences within and between texts. Thus, the serious
student is forced to either construct a personal database (as already discussed) or to purchase a
commercial AP point database (such as Shenberger's card-index system). The latter, based on
only a few textbooks, is good but is very incomplete. Tables 1 to 3 are examples of Cookbook
AP, as compiled by computer analysis. For more details on point selection, see "Choice of AP
points for particular conditions".

3. DIAGNOSTIC, PROGNOSTIC AND THERAPEUTIC ASPECTS OF AP

Diagnostic aspects of AP are based on the tenderness/sensitivity which occurs in certain
points when their related organs are affected. Five types of AP points may have diagnostic
value in humans: (a) Mu-Shu points; (b) Earpoints; (c) general tenderness along the
Channel (d) Voll-Akabane-Ryodoraku points; (e) Trigger Points (TPs).

a. MU-FRONT ALARM AND SHU-BACK ASSOCIATION POINTS

There are 12 main COSs: LU-LI, ST-SP, HT-SI, BL-KI, PC-TH, GB-LV. Each COS has a
specific point on the anterior abdomen-thorax called the Mu (Front Alarm) point and on the
paravertebral area between T3 to S2, called the Shu (Back Association, or Reflex) point,
corresponding with BL13-30. For example, the Mu-Shu points for stomach in humans are
halfway between the navel and the xiphoid (CV12, Mu point) and 1.5 cun paravertebral to the
lower edge of the spine of T12, or just caudal to the last rib (BL21, Shu point).

In disease, if there is tenderness to palpation at the Mu and Shu point of an organ, disease of
that organ must be considered. However, the spinal innervation of the internal organs comes
from several neighbouring spinal nerves and each spinal nerve can innervate more than one
internal organ. Thus, because of this overlap of spinal innervation, the Mu-Shu points are not
as specifically valuable as TCM would claim. They are, however, quite useful guides to the
affected organs.

b. EAR POINTS
A French worker (Nogier) discovered that the human ear contained a somatotopic
representation of the body and its organs. This has been developed by the European and
Oriental schools of Auriculotherapy. Certain zones on the ear become tender to probe-pressure
or to electrical current when the related organ or body part is diseased. These points have
diagnostic value and therapeutic value. Blind studies at University College of Los Angeles
(Oleson et al 1989), confirmed the diagnostic value of the human Ear zones. The therapeutic
value of the human Earpoint system is well documented also. Workers in Europe, USA,
Czechoslovakia and elsewhere have evidence to support the diagnostic and therapeutic value
of Earpoints in animals also but more work is needed before strong claims can be made for
the diagnostic and therapeutic value of ear points in the dog.

c. CHANNEL TENDERNESS
General tenderness along the course of a specific human Channel is diagnostic of a problem in
that COS.

d. CHANGES IN POINT SENSITIVITY

Changes in sensitivity to heat or electrical current at special measurement points on the
human hands and feet have diagnostic value in the Voll, Akabane and Ryodoraku systems of
AP. It is claimed that diseases can be diagnosed in the very early stages (such as pre-clinical
cancer) with these methods but, unfortunately, there is little written in orthodox scientific
refereed journals on these claims. Little research seems to have been done with these methods
in animals.

e. TRIGGER POINTS
Travell and Simons (1984) published the definitive textbooks on TPs. Part 1 deals with TPs
in every muscle from the hips up. Part 2 (1985) deals with the pelvic limb. TPs arise in most
cases of myofascial and musculoskeletal pain, whether of soft-tissue, arthritic or disc origin.
These TPs maintain pain and dysfunction long after the original causes have disappeared.

Janssens (1984) described TP therapy for myofascial lameness in 21 dogs. Mean duration of
lameness before therapy was 24 weeks. TP therapy was successful in 70% of cases in a mean
time of 17 days (2.5 treatments). The relapse rate was 33% but relapse cases also responded
well to therapy.

It is most important to identify TPs and eliminate them. TPs may occur in cases of disease of
internal organs and they may trigger autonomic effects (vasospasm, cardiovascular effects,
altered peristalsis etc), as well as effects on proprioception, muscle coordination, eye sight,
hearing and taste (when muscles relating to the cranial nerves are involved).

Prognostic aspects of AP: the tenderness in the Mu-Shu, Earpoints, the course of a Channel
or at the special measurement points returns to normal as the case improves. Disappearance of
tenderness at these points and at TPs during the course of therapy is taken as a sign that the
case is resolving satisfactorily.
EXAMPLES OF AP THERAPY IN SA PRACTICE
AP is effective in a very wide range of human and animal conditions. For example, a database
from >55 textbooks and clinical articles lists frequency-ranked prescriptions for >1100 human
clinical conditions. Only a very small number of prime indications are discussed here. The
text books listed in the references give more details on points for other areas.

Tables 1, 2 and 3 show examples of AP point selection for specific body regions, specific
organs and some common conditions. These tables are based on the human system; the point
coding used is similar to that used by IVAS, where BL41-54-40 for the outer line of the BL
Channel between T2 to S4 to the popliteal crease; older texts put BL36 at T2-3, BL49 at S4
and BL54 at the popliteal crease.

In all the examples below, the depth of needling is given a minimum and maximum range
depending on the size of the patient.

1. EMERGENCIES
Common emergencies include respiratory and/or cardiac arrest under general anaesthesia,
haemorrhagic or traumatic shock. Resuscitation points include:

GV26 (in the midline of the nasal philtrum, level with the lower canthi of the nostrils; depth
0.5-1.5 cm towards the nasal septum)
KI01 (between metatarsal bones 3-4, approached from the anterior or posterior edge of the
plantar pad; depth 0.5-1.5 cm)
Tip of the tail (needle the last coccygeal vertebra from the free end of the tail; depth 0.3-1.0
cm)

Ting (Terminal) points on the digits, beside or behind each nailbed.

GV26 is the most important of these points for its effect on the respiratory centre. It has a
marked effect as a sympathicomimetic and in improving cerebral circulation. In respiratory
arrest without cardiac arrest, needling for 10-30 seconds is usually sufficient (Rogers, 1977;
Janssens et al 1979).

In other forms of shock (trauma, haemorrhage) the needles are left in situ for 10-40
minutes, twirling strongly every 5 minutes. Emergencies with cardiac arrest require strong
needling for 5-15 minutes and points with cardiac effects should be added, such as:
PC06 (on the medial aspect of the forearm between radius and ulna, about 1/5 distance from
carpus to elbow; depth 1-3 cm)
BL15 (1.5-3.0 cm paramedian to the dorsal midline behind the spine of 5th thoracic vertebra;
depth 1-4 cm)
CV14 (midline, behind the tip of the xiphoid cartilage; depth 1-3 cm at 45 degree angle
anteriorly)

PC06 is the most important of these three points for cardiac conditions. PC06 is also effective
in conditions of the lung, diaphragm and stomach.

2. PAIN SYNDROMES
AP is excellent in treating myofascial pain; pain and stiffness in arthropathy; hip dysplasia;
spinal pain (root "disc" syndromes); acute traumatic pain (Chan et al 1996). It also helps to
relieve pain from smooth muscle spasm (various types of colic and bronchospasm etc).

MYOFASCIAL SYNDROMES: Muscle lameness (strain, rheumatism, claudication

"myositis" etc) is very common in greyhounds and is a major cause of poor racing
performance. The dog may not be visibly lame (although in many cases is lame). The
common feature of myofascial syndromes is the presence of exquisitely tender areas
("nodules", TPs, AhShi points) in the muscles or fascia. They can be found in any muscles
but are more common in the neck and shoulder muscles, paravertebral area and thigh
muscles. There is often a history of good racing performance coming to an abrupt end. There
need not be a history of known injury. Undoubtedly, most of these begin as minor muscle
tears, but chilling or draughts may also precipitate "muscle rheumatism" or myositis. (In
horses, there is often a history of virus infection in the stable in the previous 2-18 months). It
is possible that there may be nutritional causes also but I have no experience of this. AP is a

highly effective therapy. Recent cases usually respond in 1-4 sessions at 1-3 day intervals.
Chronic cases need 1-8 sessions at intervals of 3-7 days.

The most important part of the examination is to determine the location of the affected parts
of the muscles and the TPs in nearby (and occasionally distant) muscles. This is done by
careful palpation using the thumb or index finger. Where possible the muscles should be
palpated with a pincer grip (between thumb and index finger), for example, the triceps,
forearm, leg and thigh muscles, TPs are often found in the paravertebral areas from neck to
tail. They may be uni- or bi-lateral.

Diagonal relationships often exist in musculoskeletal problems; muscle pain in the left neck is
often associated with some tenderness in the right lumbosacral area and vice-versa.

Having carefully recorded the affected area(s) and the TPs, a few classical AP points known
to influence the affected area are chosen (see Table 1). All TPs are treated also. In searching
for these areas, one should check the major joints systematically.

a. Neck mobility: The neck is turned to the left, gently but firmly, in an attempt to make the
nose touch the left flank. This is repeated to the right side. Normal dogs do not whine or resist
this test. Vertical and rotation movement is also checked. If the dog resists or whines, the
tender points usually are found on careful (inch by inch) palpation.

b. Shoulder and elbow joints and muscles are checked by full extension, flexion and
abduction of the limb. This is followed by careful deep palpation of the muscles and joints.

c. The spine and paravertebral area is checked by running the thumbs down the spinal
processes and also along the muscles on 2 or 3 lines (1, 2 and 3" from the mid-line), applying
firm pressure, first left, then right, from the first thoracic to the base of the tail.

d. The hip and stifle are also checked by full extension, flexion and abduction, followed by
joint and muscle palpation.

If tender points are found, they are noted and rechecked later (some nervous or fidgety dogs
may give occasional "false positive" reactions to finger pressure but the recheck differentiates

the true from the false reaction). The true TP usually elicits a strong yelp and the dog usually
turns the head towards the pain and may try to bite.

The response to treatment of muscle lameness can be dramatic. If the case is not well
improved by 4-6 sessions (with marked loss of TP sensitivity) the prognosis for AP therapy is
poor. In general, if AP is to be successful, effective results should be seen by 3-6 sessions.
Improvement may occur within 20 minutes and is usual by session 2 or 3. Full improvement
however may require more sessions. Racing dogs should be given mild to moderate exercise
during the course of therapy but racing should be postponed until they are fully sound and all
TPs are absent.

ARTHROPATHY: AP is very effective as a therapy in trauma (sprain), arthritis and

rheumatism of joints (especially in older dogs). Much of the pain and stiffness in arthropathy
comes from the muscles and soft tissues around the joint rather than from the joint itself. The
original pain signals may have come from the joint but they usually set up reflex "guarding"
of the joint, with secondary triggers in the muscles and soft tissues above or below the joint.
The secondary triggers may become the main foci of pain signals long after the irritation in
the joint has eased.

AP can not alter the bone lesions in an arthritic joint but it can have antiinflammatory effects
and can be very effective in treating the soft tissue foci of irritation. The net result after
successful AP is greatly improved locomotion (less stiffness, less pain on movement). The
approach to arthropathy is to tackle the causes if known. AP can be of value, even if little can
be done to treat or alleviate the causes. It is important to locate AhShi points if present, as in
myofascial syndromes. AhShi points are needled for about 20 minutes, together with local
and distant points for the specific joint (see Table 1). Arthropathy usually is treated every 3-7
days. If results are poor by 6 sessions, AP is unlikely to be of value.

Janssens (1984) described AP therapy in 61 dogs with arthrosis. The mean duration before
treatment was 36 weeks. AP was most successful in shoulder and stifle (80 and 72%), less so
in hips (55%) and lease successful in elbow, carpus and tarsus (33%). Recovery averaged 24
days (3.5 sessions/case); 48% relapsed but with original success rates on re-treatment. Schoen
(1984) reported good or excellent results in 63% of dogs with arthrosis. There were 24 dogs in
the series. Patients treated successfully for arthrosis/arthritis may relapse in 6-12 months.
They usually respond well and rapidly to further courses of AP, as required (Janssens 1984;
Schoen 1984).

Purulent arthritis is unsuitable for AP as a sole therapy. If specific pathogens are involved,
specific anti-microbial drugs are indicated but AP may be added for its immunostimulant
effect.

HIP DYSPLASIA often manifests with muscle pain and lameness. Much of the pain and
stiffness is due to excess joint mobility, with consequent strain on ligaments and soft tissues.
Hip dysplasia is a very good indication for AP. Although AP does not alter the X-ray lesion,
abnormal joint mobility can be curtailed if the muscle tonus around the joint can be improved.

The main points for hip dysplasia are AhShi points (if present) plus local points (in the
vicinity of GB30) together with GB34 (between the upper head of the fibula and the tibia,
from the lateral side). Three needles may be placed near the hip joint, one in GB30 and the
other 2 about 2.5-3.5 cm on either side of it, angled towards the acetabulum. The needles are
placed deep enough so that they almost touch the acetabulum. Sessions are about 7 days apart.
Usually 3-4 sessions give excellent results. Relapses may occur and require further AP
treatment. AP can be combined with homoeopathic remedies such as Arnica (soft tissue
bruising), Hypericum (deep pain), Ruta (joint pain) or Rhus toxicodendron ("rheumatism").

An alternative approach is to implant 5-7 gold beads (1 mm diameter) around the rim of the
acetabulum in one single session. The technique is inexpensive, safe, simple and fast. If gold
beads are difficult to obtain, orthopaedic suture wire or 18 gauge, 18 carat gold wire, tied in
tiny knots (with the ends clipped off) may be used instead. The implants are inserted using
aseptic techniques under general anaesthesia, using a wide-bore (14-16 gauge) needle and a
stilet to deposit each implant. The first implant is deposited at the uppermost edge of the
acetabulum ("12 o'clock"). The remaining 4-6 implants are deposited between "9-12" and "123 o'clock".

It is not uncommon for the dog to jump up on its hindlimbs within 2 days after implantation.
Although it is not essential, antibiotic cover is advisable in the post-operative period. Longterm success rates of more than 80% are claimed by some workers (Grady-Young, 1979).

DISC DISEASE, VERTEBRAL ARTHROSIS: As mentioned in relation to arthritis and hip

dysplasia, the presence of lesions on X-ray need not cause pain or lameness and successful
outcome to AP therapy often occurs in spite of persistence of the lesion. The pain and
lameness in vertebral problems usually are due to muscle spasm and irritation of nerve roots
and meninges. Vertebral arthrosis is treated similarly to disc disease.

Prognosis in disc disease: Before attempting to treat spinal disc syndromes, it is important to
assess the degree of neurological damage. The prognosis is excellent in Grade 1 and 2 disc
disease (mild to moderate damage, i.e. (pain only to pain + some paresis)). The prognosis is
still very good in Grade 3 disc disease (severe, i.e. motor paralysis but with deep pain
sensation intact), but additional nursing and care is always needed. In Grade 4 disc disease

(where damage is very severe, with paralysis and total loss of superficial and deep pain
reflexes), the prognosis in cases presented more than 48 hours after onset is about 33%. Grade
4 cases require a lot of care, work and nursing. Time to recovery in Grade 4 is >> Grade 3 >>
Grade 2 >> Grade 1.

The approach to AP treatment of disc cases is to localise the affected area by finger palpation
and other methods. One to two points are used (bilaterally) above and below the problem disc,
together with Tender and Distant points as indicated in Table 1. Treat acute cases every 1-2
days, chronic cases every 3-7 days. If there are other symptoms (faecal/urinary retention etc),
these must be treated also, usually by western methods.

In a series of 75 dogs with thoracolumbar disc disease, AP gave success rates of 97,95,85
and 33% in Grades 1, 2, 3 and 4 respectively. Mean time to complete recovery was 13, 24, 32,
76 days respectively, requiring a mean of 2, 3.4, 4.8 and 9 sessions respectively (Janssens
1983, 1984). In a series of 32 dogs with cervical disc disease, 70% had full recovery after 2.5
sessions (mean recovery time 14 days). 37% relapsed with similar results on re-treatment
(Janssens 1984).

To ensure the best outcome, Janssens recommends good nursing (catheterisation of the
bladder; treatment of cystitis; enemas or digital rectal evacuation; frequent turning to avoid
pressure-sores etc, if required). He also advises confinement in a playpen to prevent any
exaggeration of clinical Grade from further trauma to, or bleeding into, the nerve roots or
spinal cord etc. However, Chan et al (1996) found that controlled mild exercise (supervised
walking on a lead) shortened the recovery time and improved the success rate of AP in disk
disease.

ACUTE TRAUMATIC PAIN: The human pain-point par excellence is GB34 (between the
upper head of fibula and the tibia, needled from the lateral side). One or two local points are
added (ipsilateral). However, if the tissues are badly mangled or are covered by a cast, points
on the contralateral limb may help. Treat daily for 2-3 days. If the animal is in shock, GV26 +
KI01 help to control shock (+ western therapy).

SMOOTH MUSCLE SPASM: Human colic can arise from spasm of smooth muscle in the
coronary arteries, bileduct, gastrointestinal tract, urinary and female reproductive systems.
These types of colic can be relieved (often in minutes) by AP. The main points for disorders
of the internal organs are given in Table 2. In small animal practice, gastrointestinal colic is
very rare, but is a good indication for AP, once surgical emergencies have been eliminated
from the diagnosis. In acute cases treatment is given every 8-24 hours; in chronic cases every
1-2 days.

GASTRIC TORSION, with bloat and pain in dogs can be relieved in minutes by AP. The
main points are PC06, ST36, CV12, BL21. The stomach tube can be passed easily after the
torsion is relieved (Blakely, 1985). Megaoesophagus and "choke" can sometimes be helped
by PC06, ST36, CV12,17,22, BL13,17,21.

FUNCTIONAL DISORDERS: AP is successful in many functional disorders such as

vomiting, diarrhoea, autonomic upsets, shock etc. Table 3 lists AP points which may be used
in many common conditions.

MINOR HORMONAL DISORDERS: AP can activate hypothalamus-pituitary and the

endocrine system, if the target cells are capable of responding. It is of use in mild human
disorders of the thyroid, adrenal, pancreas and gonads.

AP has been used to treat hormonal infertility, pseudopregnancy and skin conditions
associated with hormonal upsets in small animals. It could be tried in mild cases of diabetes
mellitus also. Table 3 includes points used in female and male infertility. In pseudopregnancy, points active on the ovary/tubes/uterus (Table 2) should be added. The success rate
in oligospermia is not as high as in female hormonal infertility but it is worth trying in
valuable stud dogs.

OBSTETRICS: AP can be very useful in inducing birth (oxytocin-effect) and in treating

dystocia in women. It is also useful in dystocia in other species. The most important points in
obstetrics (dystocia etc) are points active on the pelvic ligaments, cervix/vagina and uterus:
animal-BaiHui (GV03 = lumbosacral space) or human GV03 (one space anterior to
lumbosacral); GV04 and BL23 (near L2-L3); points from BL25-34 and points on the outer
BL line in the lumbosacral area.

Needling points on the lumbosacral area (especially animal-Baihui (GV03)) helps cervical
dilation. The other points help relaxation of the pelvic ligaments and uterine contraction. The
net result is more room in the pelvis and better contractions. Needling should be continued for
10-15 minutes before further obstetrical intervention.

4. AP ANALGESIA FOR SURGERY

Electro-AP can induce hypoalgesia sufficient for surgery. Dogs are good subjects for AP
analgesia. Cats are very poor subjects. Indications include: cases in which general anaesthetic

poses a high risk (severely shocked, debilitated or toxic cases; subjects with severe disease of
the lung, heart, liver or kidney etc). AP analgesia is also suitable for caesarian section, as it
has no depressive effects on the foetus.

Advantages include: (a) can be used in "cocktail anaesthesia", or to reduce greatly the dose
of anaesthetic or sedative needed; (b) suitable in high-risk cases (c) suitable in Caesarian
section (d) suitable in prolonged surgery (up to 10 hours) (e) autonomic functions remain
stable (f) faster post-operative recovery of appetite, gut and bladder function etc; faster postoperative healing and less infection; reduced post-operative pain (g) simple and inexpensive;
can be used in national disasters etc, using manual needling alone.

Disadvantages include: (a) operative success without the need for chemical anaesthetics or
sedatives etc varies from 50-95%, depending on the skill of the operator and the tolerance of
the patient to prolonged restraint; (b) very good restraint is necessary; all sensory inputs
except pain are registered and full motor power is retained; (c) light, deft surgery is needed,
not for ham-fisted surgeons; (d) prolonged manipulation of viscera/organs or traction on
mesentery can induce nausea/vomiting; (e) poor relaxation of abdominal muscles can cause
"ballooning" of viscera; (f) an induction period of 10-20+ minutes is necessary; (g) it is not
suitable for intra-thoracic operations in animals.

POINTS USED FOR AP ANALGESIA IN DOGS: Point combinations vary with the
operative site and between operators.

a. BL23 (bilateral): suitable for most operations in dogs (Kitazawa)

b. SP06 (bilateral): suitable for most operations in dogs but Electro-AP (EA) of SP06 may
cause convulsions in some dogs (Kitazawa).

c. LI04; ST36; InKoTen (between metacarpals 3 and 4) and BoKoKu (between metatarsals 3
and 4). All bilateral (8 points). Suitable for most operations (Kitazawa) but BL23 (bilateral) is
better (Kitazawa).

d. PC06, TH08 (bilateral). Suitable for thorax, neck, head and thoracic limb (Ishizaki). Local
points may be added (Ishizaki).

e. ST36, SP06 (bilateral). Suitable for abdominal, perineal and pelvic limb (Ishizaki). For anal
surgery, needles left and right of anus are added (Ishizaki).

f. SP06, ST25,36 (bilateral) + periincisional needles was very successful in

ovariohysterectomy in toxic pyometra (Arambarri et al 1975).

g. SP06 and GB34 were successful in caesarian section (Janssens).

Other point combinations, including ear points, are possible. Jan Still (Vet School, Medunsa,
South Africa) has published a number of successful studies on AA in dogs and cats.

APA procedure: The animal is restrained in a special harness or by tying the limbs to the
corners of the operating table. The needles are inserted deeply into the points. Limb points,
such as ST36, SP06, TH08, PC06, are transfixed (i.e.) needle is pushed out through the skin
on the opposite surface of the limb. The needles are taped or sutured in position to prevent
dislodgement. The needles are connected in pairs to the electro-stimulator. Frequency is 2-15
Hz, square or spike, biphasic wave. Voltage is increased slowly to the tolerance of the animal.
Voltage and frequency may be increased gradually every few minutes. After 15 minutes,
pinprick, towel clamp or scalpel prick tests are applied every 5 minutes in the vicinity of the
operative site. When pain reaction to test is negative, surgery can begin (usually 10-20
minutes after onset of stimulation). An indwelling intravenous catheter is advisable for routine
use, in case short-acting barbiturates are needed for intubation (for gaseous anaesthesia) in the
event of failure or severe vomiting. If pain reaction occurs during incision of skin or serosa or
at the closure stage, small amounts of local anaesthetic may be injected. Alternatively, the
voltage and frequency of the stimulator may be increased to tolerance. The stimulator is
switched off at the end of the operation. For further details contact the author. A detailed
review with references is available.

AP IN POST-OPERATIVE COMPLICATIONS
Post-operative complications include pain, inappetance, nausea/vomiting, retention of urine or
faeces, wound infection and delayed healing. Even if it is not used during surgery as a means
of inducing hypoalgesia, AP can be used post-operatively to speed the restoration of normal
function and to improve wound-healing. The selection of AP points depends on the clinical
signs and/or the target organs or functions to be helped.

Tables 1, 2 and 3 list points for various body regions, organs and conditions. For example,
dogs after abdominal incision may require treatment for abdominal pain and constipation.

Points can be selected from Tables 2 and 3 for these conditions. Treatment would be for 10-20
minutes twice daily for the first 2-3 days; then daily for 3-4 days.

In retention of urine, catheterisation time can be reduced greatly by needling points active on
the bladder and micturition centres. These points include BL28, CV03 (bladder Shu and Mu
points); BL31-34 (active on urinary-genital function) and SP06 or KI03 (active on lower
abdominal functions).

To assist wound healing, local points (near the incision) can be used, or TENS may be used
across the incision-site. In cases where wound healing is unsatisfactory, points from the
immunostimulation list could be added to points for the affected area.

5. PRACTICAL METHODS OF AP POINT STIMULATION

1. AP Point injection (0.5-1.5 ml/point) is safe and fast; it requires only a few seconds/point
but can be painful where many points need treatment. The injection-solution may be distilled
deionised water, saline, procaine saline (0.5-1.0%), vitamin B12 solution, isotonic saline,
Impletol, homoeopathic solutions, or combinations etc.

AP point-injection is ideal in dogs which need medication which is suitable for intramuscular
or subcutaneous use. In those cases, the dose can be diluted and distributed via the AP or TPs.
Injection of TPs with Impletol is the classic method of TP therapy.

The method also is suitable if AP is indicated but the practitioner believes that the client may
be unreceptive to the idea. In that case, sterile saline, glucose-saline, dilute procaine or
vitamin B12 solution etc can be injected into the correct points. A variation of this technique
is to use the Dermojet (high-pressure spray penetration of the epidermis). This may be painful
and animals learn to fear it after a few sessions. The Dermojet is very useful in cats.

2. Simple needling: Having located the tender points and/or the classic points relevant to the
case, sterile, stainless-steel needles 26-30 gauge/ 2.5-7.5 cm long are inserted 1-4 cm deep.
Depth and direction of needling vary with the points. The finest and shortest needles possible
are used but in fractious animals, thicker needles may be used to facilitate insertion and
removal of the needles.

Aim to induce DeQi (Teh Ch'i): Classical AP recommends pecking and twirling of the
needles for 15-30 seconds after needle insertion. The needles are "pecked" (up and down) and
"twirled" (rotated in opposite directions, 90o left, then 180o right then 180o left etc, to avoid
twisting the tissues around the needle; the latter causes unnecessary pain). In humans, needle
twirling in the correct position induces a strong paraesthesia radiating along the course of the
nerve or Channel. This is called DeQi (the arrival of the energy), or the Propagated
Channel Sensation (PCS). If this sensation is not obtained, the needle is not at the correct
position and/or depth and the results are poor. In that case, the needle is withdrawn slightly,
redirected, pushed in and twirled again, until DeQi is obtained.

Animals may react to needle twirling by trembling, or defensive action, but often they give no
clear sign of DeQi. After attempting to induce DeQi, the needles are retained in position for
15-20 minutes; every 5 minutes, or so, the needles are twirled for a few seconds. Just before
removal, the needles are twirled for a few seconds again. Some experts claim that leaving the
needles in situ for 20 minutes without twirling is adequate.

One should not needle major arteries, body cavities, bone or joint spaces, nipples or vital
organs etc. It is permitted (indeed mandatory in many cases) to keep soft tissue and nerve
trauma to a minimum.

3. Electro-AP (EA): This is most valuable in the induction of AP analgesia for surgery but
EA can be used routinely in AP therapy also. The needles are inserted to the correct depth and
are connected in pairs to the output sockets of an AP electro-stimulator. To avoid the
possibility of cardiac fibrillation, any one pair of leads should not cross the spine between
vertebrae C2 and T10, i.e. each pair of electrodes should be on the same side of the spinal
cord in these areas. Crossing the midline in the lumbosacral area is accepted.

For surgical AP analgesia the needles are taped firmly in position to prevent their being
dislodged during the operation. The power is turned on and the output controls advanced from
zero to tolerance. The needles usually beat to the frequency of the stimulator (at frequencies
of 2-15 Hz). At higher frequencies, the muscle goes into local spasm, i.e. the needle vibration
is not obvious. The best wave form for AP analgesia (APA) is square wave or spike wave
biphasic. In electro AP therapy, the output voltage is set lower than in APA. In therapy, the
stimulation is maintained for 5-20 minutes. In APA, it is maintained until near the final
closure stage. Although EA looks impressive to the owner of the animal it has little if
anything to offer (above simple needling) for most AP indications. Exceptions are: peripheral
and central nerve paralysis and in APA for surgery. EA is preferable in these cases.

If more needles are used than can be stimulated simultaneously, the leads are alternated
between needles as required.

4. Ultrasound: Standard equipment may be used. A contact medium (jelly or solution, or

water) should be used between the probe and the points. Some instruments have a range of
probes of different diameters for various parts of the body (including probes for use in the
rectum, vagina, ears and nose for local infections etc in these orifices). Output is set at 0.251.0 W. Time of application is 15-60 seconds/point. The technique is painless, non-invasive
and very often effective. Long hair may make contact difficult or impossible.

If results are disappointing after the first few sessions, point injection or simple AP should be
tried.

5. LLLT-AP: Three types of low-power laser are used: Helium-Neon (He-Ne, red light);
infrared (invisible); diode lacers (not true lasers but emitting light varying from visible to
invisible frequencies). It is not possible to give critical assessment of which type of laser
(visible v invisible; pulsed v unpulsed) is best, as comparative trials need to be done.

Low-power lasers usually produce no sensation of pain. Thus, they are ideal for treating
animals like cats (which are not good subjects for multiple needling) and when treating points
in painful areas of the body such as the ears and digits.

Wavelengths vary from 632 (visible red) to 1100 (invisible infrared) nM. The laser light is
emitted via a fibre-optic cable or other outlet. The power output is low in most lasers (0-10
mW/cm2). Higher power lasers (10-50 mW/cm2) are also available.

Penetration of most lasers is superficial (1-2 cm). Thus, they are especially useful for
superficial conditions such as: skin wounds; trauma; abrasions; ulcers; granulomas; mucosal
ulcers; corneal ulcers (LASER should not be beamed at the retina). It is also useful in
tendinitis and myositis of superficial muscles. The higher wavelengths, higher power outputs
and pulsed lasers may penetrate deeper into the tissues, especially in large animals.

When used on local lesions (such as an infected wound), LLLT (<5 mW/cm2) is applied in
grid movement (moving all the time) to the wound for 5-15 minutes. Higher power lasers (2050 mW/cm2) need much less time. Those claiming LLLT success via AP points claim a great
advantage in the short time of application, 5-30 seconds/point. However, exposure time
depends on mean output power (MOP, in mW). It is essential to deliver sufficient power
density (J/cm2) to the irradiated area. Calculation of optimal laser dose is discussed in the
paper on LLLT.

A survey by IVAS (1984) on LLLT in AP suggested that the local use of LLLT was the main
application. Although there were claims that LLLT could activate AP points (especially those
close to the surface and in the ears), there was not agreement on that claim. In spite of some
claims to the contrary from China and other countries (see "AP for immune-mediated
disorders" by Rogers (1991)), LLLT, according to other users, had failed to influence
organic diseases and deep-seated muscles in many attempts. Also, many respondents found
that AP gave better results than LLLT at that time. However, most of the older lasers emitted
<10 mW/cm2 and their penetration depth was limited. Since than, more powerful lasers (10-50
mW/cm2, with beam interruption (pulsing) at 2000-10000 Hz, are available. These lasers
(especially pulsed Infra-Red lasers) can be used as a substitute for needles in AP, also in
large animals. However, more research is needed on the benefits and limitations of LLLT as
full substitutes for other types of AP stimulation.

LLLT is not thought to be suitable for routine AP analgesia, although Zhou (1984) claimed
good success with 2.8-6 mW He-Ne laser in density and orofacial surgery.

6. FURTHER TRAINING
Possibilities for further training in AP include:

a. Home-study of human and vet AP texts, such as those listed in the references, is essential.

b. Formal study of human AP at specialist AP schools, colleges or seminars is advisable. As

mentioned, transposition of human principles to small-animal patients is relatively easy and is
very successful. Many medical AP societies and study-groups welcome vets as members.

c. Formal study of vet AP is advisable. Courses are given by national vet AP societies or by
the International Vet AP Society (IVAS).

IVAS runs a training course in the USA. It has run the course in Europe and Australia in
recent years. If there is demand for the course and national groups can carry the costs, IVAS
may be able to run the course elsewhere. The total course time is 120 hours, divided into 4
sessions/year.

Each candidate is expected to attend the full course, study the recommended texts, pass a 3hour written examination and submit 5 fully documented case reports. Having fulfilled these
requirements, the candidate receives IVAS accreditation. IVAS also acts as a clearing-house
for clinical and research information on AP and produces a quarterly Newsletter. Contact:
IVAS, c/o David Jagger, 5139 Sugarloaf Rd., Boulder, CO 80302-9217, USA (Fax: 1-303449-8312).
CONCLUSIONS
Concepts of TCM are based on a philosophy of Yin-Yang (balance of opposite forces), Five
Phases (anabolic and catabolic relationships between 5 primitive types), a balance between
humans and nature, the Six External Evils (causing disease by attack from the outside), the
Seven Emotions (imbalance of which causes psychosomatic disease) and the Eight
Principles of classifying disease (Yang-Yin; Excess/Deficient; External/Internal; Hot/Cold).

The concept of Qi (vital energy) flowing in the superficial and deep Channels in a diurnal
cycle is central to AP. Imbalance of Qi (excess, deficiency or blockage) is the cause of
disease. In disease, the AP points related to the affected parts show abnormal Qi, manifested
by hyper- or hypo-sensitivity to palpation and electrical current. Detection of these abnormal
points has diagnostic and therapeutic value. Diagnosis is further aided by the 4 traditional
methods (looking, listening, smelling, touch, including the taking of the "Chinese pulses").
The aim of all methods of TCM is to restore the normal balance and/or flow of Qi, This may
involve dietary, physical, medical, surgical and psychological methods. AP is a relatively
small part of TCM.

Western concepts of AP mechanisms: Examples of diagnostic and therapeutic aspects of AP

were discussed. The neuroendocrine system is the basis of AP mechanisms. Supraspinal,
segmental and intersegmental reflexes (viscero- visceral, somatic and cutaneous; somatovisceral, somatic and cutaneous, cutaneo- visceral, somatic and cutaneous) are involved. AP
has diagnostic and therapeutic value via these reflexes. Adequate stimulation of the correct
AP points activates autonomic, humoral and neuroendocrine functions. The therapeutic
effects of AP can occur only if the natural defence/healing systems can be activated
(autonomic effects, immune response, antiinflammatory effects, endorphin release etc). If
there is no possibility of natural responses (e.g. in severed spinal cord or severely fibrotic
kidneys), AP can not substantially improve the situation.

Methods of choosing AP points are based on many Laws of TCM, the most important of
which is the combination of local points, AhShi points and distant points on Channels
passing through the affected area. In Western concepts this is translated into choosing points
in the same nerve segment, TPs and points in nerve segments related by intersegmental
reflex.

Today, computer databases makes frequency citation analysis possible. This allows computer
ranking of points from many reference sources, so that prescriptions can be generated from
the top 6 or 7 points in order of ranked scores. This is very useful to those whose study of AP
is still in the early stages.

GV26 (the philtrum point) is excellent in emergencies and first aid. TPs, local points and
points such as LI11 (in forelimb problems), BL23,40 (in lumbar and hindlimb problems) and
GB34 (in hindlimb problems) are very useful in treating myofascial, musculoskeletal and
vertebral disc problems. Points useful in obstetrics include animal GV03 (BaiHui,
lumbosacral space), GV02 (WeiKen, sacrococcygeal space) and BL22-30 (paravertebral area
from L2-S4). Some of those points may be combined with SP06 and one or two points from
the low abdomen (such as ST29, CV04, SP13, KI01) to treat problems of the reproductive
system and its functions.

It is very important to identify and treat TPs in myofascial and musculoskeletal problems and
in some problems of the internal organs. Reflex tenderness of paravertebral (Shu (BL
Associated)) points and thoracoabdominal (Mu (Alarm)) points has diagnostic value.

Advantages and disadvantages of AP analgesia (APA) for surgery were discussed. APA is
unlikely to replace safe, fast, effective drug anaesthesia. However, in severely toxic patients
and in caesarian section where the pups are very valuable, APA has a role. It also has a role in
national/international disasters such as large-scale warfare, where drugs may be in short
supply.

The most practical methods of AP stimulation for busy practitioners are the methods of pointinjection, simple- or electro- AP, TENS and ultrasound. Although LLLT has applications as a
local stimulant in local superficial problems, it can not be recommended as a complete
replacement for needles at this time. The higher the power output, the more likely LLLT is to
replace the needle, i.e. lasers of 20-50 mw/cm2 are more likely to be useful as needle
replacements than those of 1-5 mw/cm2.

Some possibilities for further training were discussed; you are strongly recommended to join
IVAS, irrespective of your degree of AP expertise. IVAS can help beginners to learn but it
also wishes to learn from expert practitioners.

For those with the motivation to study the traditional methods, the rewards are great: new
insights into philosophy, especially the philosophy of health and healing; a special bond of

friendship with like-minded colleagues; a superior success rate in the use of AP in clinical
practice or research.

However, many vets in busy practice and who have families, mortgages and heavy social
commitments may be unable to spend the time, energy, and money needed to study AP in
depth along strictly traditional lines. It is possible for such people to obtain good to excellent
results with AP without an in-depth study of the method, provided certain minima are
observed:

1. Reasonable study of the more important AP points and laws;;

2. Study of the use of TPs;
3. Use of a very comprehensive AP cookbook or access to a computerised database;
4. Restriction to single-symptom conditions.

Though beginners can expect good results in many simple conditions, practitioners who have
not studied AP in depth can not expect good results in multi-symptom conditions.
Inadequately trained practitioners may bring themselves and the AP system into disrepute if
they attempt to use AP as the sole therapy in complex cases.

ACKNOWLEDGEMENTS
I thank Shelly Altman (North Hollywood, CA, USA), David Jagger (Boulder, CO, USA),
Luc Janssens (Wilryk, Belgium) and Jen-Hsou Lin (Taipei, Taiwan) for their comments and
corrections of an early draft of this paper and colleagues in many countries, especially those
named in the text for sharing their experiences of AP with me.

REFERENCES
BASIC HUMAN TEXTS
Anon (1993) Essentials of Chinese AP. (Coll. Trad. Chin. Med., Beijing, Shanghai, Nanking)
Foreign Languages Press, Beijing. 432pp.
Anon (1974) The Barefoot Doctor's Manual. Running Press, Philadelphia. 948pp.
Anon (1975) Newest illustrations of the AP points (Charts and Booklet). Medicine and
Health Publishers, Hongkong.

Anon (1977) Basic AP: a scientific interpretation and application. Chinese Acup. Res.
Foundation, Box 84-223, Taipei, Taiwan.
Austin,M. (1974) AP therapy. Turnstone Books, London, 290pp.
Chan,W.W., Lin,J.H. & Rogers,P.A.M. (1996) A review of AP therapy of canine paralysis and
lameness. Veterinary Bulletin, In Press.
Cheng Xinnong et al (1987) Chinese AP and Moxibustion. Foreign Languages Press,
Beijing. 432pp.
Chung,C. (1983) The AH SHIH Point. Illustrated guide to clinical AP (Chen Kwan Books,
5-2, 1F, Chung Ching South Road, Section 3, Taipei, Taiwan), 212pp.
Connolly,D. (1979) Traditional AP: The Law of the Five Elements. Centre for Trad. AP.
American City Bldg. Columbia, Maryland 21044, 197pp.
Ellis,A., Wiseman,N. & Ross,K. (1989) Grasping the Wind. Paradigm Publications,
Brookline, Massachusetts, 462 pp.
Lee,J.F. & Cheung,C.S. (1978) Current AP Therapy. Med. Interflow Publ. House, Hong
Kong, 408pp.
O'Connor,J. & Bensky,D. (1983) AP: A Comprehensive Text. Shanghai College of Trad.
Med. (Eastland Press, Chicago), 750pp.
Oleson,T.D., Kroening,R.J. & Bressler,D. (1980) An experimental evaluation of auricular
diagnosis. Pain, 8, 217-.
Overview. Proceedings of the 1979 Symposia on AP and Moxibustion, Peking. Abstracts of
534 papers. 517pp. Available (in English) from East Asia Books, 103 Camden High Street.,
London.
Pontinen,P. (1982) AP Seminar for Swedish Physicians (contact: AP and Pain Research
Department, University of Tampere, Finland).
Ulett,G. (1982) Principles and practice of physiological AP. (Warren Green Inc., 8356
Olive Blvd., Missouri 63132), 220pp.
Wu Wei Ping (1973) Chinese AP. Health Science Press, Wellingborough, Northants, UK,
181pp.

TEXTS ON VET AP
Altman,S. (1981) AP for animals (c/o 5647 Wilkinson Ave., North Hollywood, CA 91607,
USA, 281pp.

Blakely,C.S. (1985) AP in gastric torsion in dogs. Vet AP Newsletter, 11, January-March, p.

34.
Brunner,F. (1980) AP der klein Tiere (German). (WBV Biologisch Med. Verlag, Ipweg 5,
D4070 Schorndorf, Germany, 320pp.
Gilchrist,D. (1981) Manual of AP for small animals. Also: Greyhound AP (1984) Published
privately, c/o 219 Byrnes Street, Mareeba, Australia, 4880.
Janssens,L., Altman,S. & Rogers,P.A,M. (1979) Respiratory and cardiac arrest under general
anaesthesia: treatment by AP of the nasal philtrum. Vet. Rec., 105, 273-.
Janssens,L. (1984) Atlas of the AP points and Channels in the dog (c/o Oudestraat 37,
Wilrijk 2610, Antwerp, Belgium).
Janssens,L. (1984) Treatment of disc disease and arthritis in dogs. Also trigger points and
myofascial syndromes in dogs. AP Training Seminar, Vet School, Gent (Antwerp) Belgium,
289pp and 1983 VMSAC, October, 1580-.
Janssens,L.A.A. (1987) Myofascial pain syndromes in dogs: the treatment of TPs. In: Some
aspects of small animal AP the clinical scientific approach. (Chapter 13 of the Belgian Vet AP
Society Manual).
Klide,A. & Kung,S. (1977) Vet AP (Univ Pennsylvania Press, Philadelphia), 297pp.
Kothbauer,0. (1983) AP in the ox, horse and pig (in German). (WBV Biologisch Verlag,
Ipweg 5, Schorndorf D4070, Germany).
Lin,J.H. & Rogers,P.A.M. (1980) AP Effects on the Body's Defence Systems: A Vet Review.
Vet. Bulletin, 50, 633-.
Proceedings of IVAS Congresses and Seminars. Contact: IVAS, c/o David Jagger, 5139
Sugarloaf Rd., Boulder, CO 80302-9217, USA (Fax: 1-303-449-8312).
Rogers,P.A.M. (1977) Revival in collapse, shock, respiratory failure and narcotic overdose.
Vet. Rec., 101, 215.
Rogers,P.A.M., White, S.S. & Ottaway, C.W. (1977) Stimulation of AP Points re. Analgesia &
Therapy of Clinical Disorders in Animals. Vet. Annual, 17, 258-.
Rogers,P.A.M. & Bossy, J. (1981) Activation of the Defence systems in Animals and Man by
AP and Moxibustion. Acup. Res. Quarterly (Taiwan), 5, 47-.
Rogers,P.A.M. (1991) AP for immune mediated disorders. In: AP in Animals, Proceedings
167, Postgraduate Committee in Veterinary Science, University of Sydney. pp 124-142.
Rubin,M. (1976) Manuel d'AP Veterinaire pratique moderne. Maloine Publishers, Paris,
85pp (in French).

Schoen,A.M. (1984) Re: treatment of arthrosis in dogs. Vet. AP. Congress, Gent, Antwerp,
289pp.
Westermayer,E. (1980) Treatment of Horses by AP. Health Science Press, Holsworthy.
Devon, UK, 90pp.
Westermayer,E. (1978) Atlas of AP for cattle. WBV Biologisch Verlag, Ipweg 5, Schorndorf,
Germany, 60pp.
White,S.S. (1984) Electro-AP in Vet. Med. Chinese Materials Centre, San Francisco. 122
pages.
Grady-Young,H. (1979) Personal communication on gold bead implantation in hip dysplasia.

TEXTS ON AP ANALGESIA IN SMALL ANIMALS

Anon (1974) The Principles and practical use of AA. Medicine and Health Publishing Co.,
Hong Kong, 325pp.
Arambarri,R. et al (1975) EAA in vet surgery. Revue Med. Vet. 126, 1231-1236.
Ishizaki,S. et al (1977) EAA in high risk dogs. Jap. J. vet. Anaesth., No 8. 21-28 and World
APCongress, Paris Summer, 1978.
Kadono,H., et al. (1977) EEG during EAA in the dog. Jap. J. Vet. Sci., 39, 539-547.
Kitazawa,K., et al. (1975) Experimental studies on EAA in the dog. Proc. 20th World Vet
Congress,
Thessaloniki, 1657-1658 and (1975) Studies on EAA in the dog; confirmation of the effect.
Jap. J. vet. Anaesth., No. 6, 7-14.
Klide,A.M. & Kung,A.H. (1977) Vet AP. University of Pennsylvania Press, Philadelphia.
Lambardt,A. (1975) AA versuche bei katzen. Der Prakt, Tierarzt, 1/1975, 33-36.
Lynd,F.T. (1975) AP analgesia investigations in animals. Internal report, Department of
Laboratory Animal Medicine, Medical School, University of Texas, San Antonio, Texas
78283. 5 pages.
Niboyet,J.E.H. et al. (1973) L'anaesthesie par l'AP. Maisonneuve, 433pp.
O'Boyle,M.A. & Vajda,G.K. (1975) AA for abdominal surgery. Mod. Vet. Pract., 56, 705-707.
Ralston,N.C. & Ralston,B.L. (1978) AA for cystotomy surgery in a dog. Amer. J. Acup., 6,
75-76.

Zhou,Y.C. (1984) (Re lasers as an analgesic in oro-facial surgery and dentistry). Lasers in
surgery and medicine, 4, 297-

TEXTS ON TP AND SCAR THERAPY

Chung,C. (1983) The AH SHIH Point. (Chen Kwan Books, 5-2, 1F, Chung Ching South
Road, Section 3, Taipei, Taiwan), 212pp.
Dorrigo,B. et al (1979) Fibrositic myofascial pain in intermittent claudication. Effect of
anaesthetic block of TPs on exercise tolerance. Pain, 6, 183-.
Fox,W.W. (1975) Arthritis and allied conditions: a new and successful approach.
Ranelagh Press, South Hill Park, London.
Huneke,F. (1961) Das sekunden phanomen (the instantaneous phenomenon). Karl F. Haug
Verlag, Ulm, Germany (in German).
Kajdos,V. (1974) Neural therapy: its possibilities in everyday practice. Amer. J. Acup. 2, 113.
Kellgren,J.H. (1939-42) On the distribution of pain arising from deep somatic structures with
charts of segmental pain areas. Clinical Science, 4, 35-.
Khoe,W.H. (1979) Scar injection in AP. Amer. J. Acup., 7, 15.
Lewit,Karel (1979) The needle effect in relief of myofascial pain. Pain, 6, 83-.
Malzack,R. et al (1977) TPs and AP points for pain: correlations and implications. Pain, 3, 3-.
MacDonald,A. (1983) Trigger mechanisms and myofascial pain. III Nordic Congress on AP,
May 1983.
Also: Annals Roy. Coll. Surg. Eng. (1983), 65, 44-.
Moss,L. (1972) AP and you. Paul Elek Books, London.
Pontinen,P. (1982) AP Seminar for Swedish Physicians (contact: AP and Pain Research
Dept., Tampere University, Finland).
Rogers,C. (1982) AP therapy for post-operative scars. Amer. J. Acup., 10, 201-.
Symposium on Myofascial Trigger Points. (Simons/Travell/Rubin/Melzack/Reynolds).
Archives of Rehabil. Med., 1981. March Issue, 97-117.
Travell,J. & Simons,M. (1984) Myofascial pain and dysfunction - the Trigger Point
Manual. Part 1. (Williams & Wilkins, Baltimore & London), 713pp.
Travell,J. & Simons,M. (1985) Myofascial pain and dysfunction - the Trigger Point
Manual. Part 2. (Williams & Wilkins, Baltimore & London).

JOURNALS ON AP AND ALLIED FIELDS

AP and Electrotherapeutics Research (Pergamon Press, Oxford, UK).
AP in Medicine (British Medical AP Society, Newton Lane, Lower Whitley, Warrington,
Cheshire WA4 4JA
AP Research Quarterly (C.A.R.F. Box 84-223, Taipei, Taiwan).
American J. Acup. (1400 Lost Acre Drive, Felton, California, USA).
American J. Chinese Medicine (Box 555 Garden City, New York, USA).
Bulletin de l'Association Veterinaires Acupuncteurs de France (3 rue Letellier, Paris 75015,
France)
Chinese Medical J (English). Guozi Shudian, Box 399 Peking, China.
Internat. J. Chin. Med., 5266 Pomona Blvd., Los Angeles CA 90022, USA.
Lasers in Surgery and Medicine
Scandinavian Journal of AP and Electrotherapy, c/o AP and Pain Research Department,
University of
Tampere, Finland. (No longer in print)

AP SUPPLY HOUSES (NEEDLES, BOOKS, EQUIPMENT ETC)

Acumedic, 101-103 Camden High St., London NW1 7JN, UK
John Scarborough & Partners, Orchard Hse, West Bradley, nr Glastonbury, Somerset BA6
8PB, UK
Mayfair Medical Supplies, Rm 501-3, 5/F, Far East Consortium Bldg., 204-206 Nathan Rd.,
Kowloon, Hong Kong (Fax 852-3-721-2851)
Table 1
Examples of point selection for local areas in humans. The list is not exhaustive. Use
AhShi + local points + 1-2 distant points according to the Channels involved.
AHSHI,
AFFECTED AREA

esp. in area

LOCAL POINTS

DISTANT POINTS

Head
BL40,60;

Neck
BL60;

Thoracic spine
BL23,46,

Shoulder ms,

Z 03,09; GB20, GV20,26;

LI04; LU07;

neck, temple

ST08

ST44

Shoulder ms,

GB20,21; BL10,11; GV14,16; SI03; GB39; LU07;

neck to carpus SI15; X 35

A 23; LI04

Paravertebral

GV 05,08,09,12,13; X 35;

GV01; GB30;

BL13

40,60

and back
Shoulder
TH05

Neck to carpus LI15; TG14; BL11; SI09,11; LI11; SI03; ST38;

GB21

Elbow
GB34

Neck to carpus LI10,11,12; LU05; SI08;

TH05; LI04; SI04;

HT03; TH10; PC03

Carpus

Neck to carpus TH04; LI05; SI04,05,06;

LI04; TH05; HT05

LU09
Metacarpus

Neck to carpus A 22; LI03,04,05; PC07,08

PC06; TH05; LU07

Fingers
PC07,08;

Neck to carpus A 22; LI03; TH03; SI03

LI04,05; SI07;
LU07, TH05; HT07

Lumbar spine,
GB30,34,

Paravertebral, BL22,23,25,27,42; GV03,

BL46,40,57,60;

lower back

thigh & leg ms GV04; X 35

SI03; GV26

Sacrococcygeal Paravertebral, GV01,02,03; BL27,28; X 35

GV26;
thigh & leg ms
SI03, GB34,39;

BL40,60; GB34;
BL23,40,60

Hip

Paravertebral, GB29,30,31
thigh & leg ms

Stifle

Tarsus

Paravertebral, L 16; BL40; GB34; SP09;

BL60; KI03; ST41

thigh & leg ms

ST35

Paravertebral, ST41; BL60; KI03; GB40

GB39

thigh & leg ms

Metatarsus

Paravertebral, L 08; LV03; ST41,42,43,44; BL57,59,60; BL61

thigh & leg ms SP03,04

Toes

Paravertebral, L 08; SP04; KI03

GB34; SI06; BL40

thigh & leg ms

Table 2
Examples of point selection for specific human organs. The list is not exhaustive. Use 1-2
local points + 1-2 distant points according to the Channels involved. Mu and Shu points
are especially useful.
AFFECTED ORGAN
Shu POINT

LOCAL POINTS

DISTANT POINTS

Mu POINT

Bladder, lower
BL28

CV03,04; BL28,54;

SP06; BL23,32,33,

CV03

ureter

ST27,28; GB26

38,58; CV06;
KI02,03

Bronchi
BL13

BL13,43; GV12; CV17

LU05,09,10; ST36,40 LU01

Cervix uteri
BL28

CV03,04; GV03; ST28;

SP06

CV03

TH03,05; LI04,11

see KI

BL32; KI12
Ear, balance
see KI

TH17,21; GB02; SI19

SI03; BL23
Eye, vision
see LV

Gallbladder,
BL19

BL01,02; Z 09; TH23;

GB20; LI04; LV03

ST01,02; GB01,14;

GB37

GB24; GV09; BL19; CV10

GB34,40; ST36;

bileduct

see LV

GB24

SI04; PC06; L 23

Heart
BL15

BL14,15; CV14,17

HT05,07,09; PC05-07 CV14

Kidney, upper
BL23

BL22,23; GB25

KI01,03,07; SP06,

ureter

SP09;BL58,60; CV04

Large intestine CV04,06,08; GV04; ST25;

BL25

ST36,37; SP06;

BL25

BL27,29,53

GB25

ST25

Liver
BL18

BL18,19,49; GV09; LV14

LV03; ST36; GB34

Mouth

ST04; GV26,27; CV23, Z 20

LI04,07,11; PC08

Nose
see LU

LI20; Z 03,14; GV23;

LI04,11; GB20,41;

BL02,07

LU03

Ovary, upper
BL23

Y 17; KI15; ST25,27;

SP06,09; ST36

GB25

tubes

GB26; BL23,24,25

Pancreas
BL20

BL20,21; CV11,12

BL17,18,19; A 09

LV13

Pericardium
BL14

BL14,15; CV17

PC06,07

CV17

ST36,37; SP06;

CV04

Small intestine CV04,06,08; GV04; ST25;

BL27

Spleen
BL20

Stomach/duod.
BL21

Throat

BL22,25

BL27,29,53

LV13; BL20,51; CV12;

ST40; SP02,03;

ST25; SP15

BL18

CV11,12,13; ST21;

ST25,34,36,44;

BL18,20,21

BL22; CV06

ST09; CV23; SI17

LI04,11; GB20;

LV14

see LU

LV13

CV12

LU05,10,11; CV22;
KI03; ST44
Trachea
see LU

CV22; BL11

BL13; ST40

see LU

Urethra, penis, CV03,04; BL28,34

BL28

CV07; ST25; SP06;

CV03

vagina

KI04

Uterus, lower
BL28

Y 18; CV03,6; ST29;

LI04,10; ST36;

tubes

BL25,30,32; GV04; KI15;

SP06,09,12

GB26,27

Table 3

CV03

Examples of AP points for some common human conditions. If the condition is the main
problem, use 4-8 points. If it is a minor problem, treat the main problem and add 1-2
points for the minor condition +/- western treatment.
Abdominal pain: Lower: ST25,36; CV04,06; SP06,09; KI10; GB27; L 13
Abdominal pain: Middle: ST25,36; CV06,08; SP14
Abdominal pain: Upper: ST36; CV12; PC06; BL51
Abdominal distension: ST25,36; CV06,12
Anaemia: LI11; ST36; CV04,06,12; BL17
Angina pectoris: PC06; BL15; HT07
Anorexia, inappetance: ST21,36; CV12; BL20; GV07; KI17
Arterial hypertension: LI11; ST09,36; LV03; SP06; GB20
Biliary colic: GB24,34; BL19; ST36; GV09; LV03
Bladder weak, frequency: BL28; CV03,04,06; SP06; LV03
Conjunctivitis: LI04; BL01; ST01; Z 09; LV03; GB20
Constipation: ST25,36; TH06; BL25,43; SP15; CV06,12; SP03; KI04
Cough: BL13; LU05,07; CV17,22; ST40.

Cough, sputum excess: ST40

Cystitis: BL23,28,54,38,58; ST28; KI02,03; CV03; GB26,29; SP06

Diabetes mellitus: KI02; CV12; SP06; BL20; ST36
Diaphragm spasm, hiccough: BL17; PC06; GB24
Diarrhoea, dysentery, enteritis: BL20,22,25,27,53; ST25,36,37; SP04,06,09;
CV04,06,08
Dyspnoea, asthma: BL13; NX04; CV17,22; PC06; ST40; LU05
Dystocia: GV03,04; BL25,27,29,32; SP06
Eczema, pruritus: LI04,11; SP06,10; ST36; local point
Emergencies, shock, coma, anaesthetic apnoea: GV26; KI01; A 01
Faecal incontinence: ST36; SP06; BL32,54; X 35
Fever: LI04,11; GV14; LU11; ST36; A 01; Ear Apex
Haemoptysis: LU05,10; BL17
Immune system, to stimulate: LI04,11; GV14; ST36; SP06; CV04; GB39; BL23
Indigestion: ST25,36; CV12; SP06; BL21; PC06

Infertility male, spermatorrhoea: SP06,09; CV03,04,06; BL23,31,32,33,34,52;

ST36; GV03,04
Infertility female, hormonal: CV03,04; Y 18; BL26; GV03
Influenza: GV14; LI04,11; GB20; BL12
Jaundice: GV09; BL17,18,19,20,48; KI16; ST36
Nephritis: BL22,23,58; CV04; KI07; SP06
Oedema, ascites: SP06,09; BL20,23; CV09,11,15; LI06; ST25,26
Oedema, of ankle: Add KI03
Oligospermia: BL23; KI11; Y 13,15; BL32
Pain, acute traumatic: GB34 ipsilateral; local point
Palpitations, tachycardia: HT05,07; PC06,07; BL15; CV14
Pharyngitis: LI04,11; LU05,10,11; CV22; ST09,44; KI03
Placental retention: BL60,67; CV03
Polyuria, diabetes insipidus: BL23; GV04; KI07; SP06; CV03,4; LV13
Restlessness, insomnia, agitation: HT07; SP06; PC06; BL15; ST36
Rhinitis, sinusitis, colds: LI04,20; ST02; BL07; Z 03; GB20; GV23
Sciatica: GB30,34; BL25,32,37,40,54,60
Sweating, to reduce: SP02; LI04; LU09
Sweating, to increase: KI07; LI04.

At night, add HT06; LV02; SI03

Tenesmus, anal prolapse: GV01,20; BL57; CV08

Urine incontinence: BL23; SP06,09; ST36; LV01; CV03,04,06
Vertigo, Meniere's disease: GB20; ST36; LV03; Z 03; PC06; GV20
Vomiting, nausea: ST36; PC06; CV12,13

QUESTIONS
Channel codes used in these questions are: LU, LI, ST, SP, HT, SI, BL, KI, PC, TH, GB,
LV, CV, GV.

1. One of the following statements is not correct. Indicate the incorrect statement:
(a) The Chinese described hundreds of AP points with diagnostic and therapeutic properties in
humans at least 2000 years ago.
(b) The AP points occur on the head, neck, trunk and limbs.

(c) The classical Channel points have connections with each other and with specific internal
organs and functions via the Channel network.
(d) There are 12 bilaterally symmetrical pairs of main Channels and 2 central Channels
(dorsal and ventral)
(e) The main AP points are located deep in the body, on the deep (internal) path of the
Channels.

2. One of the following statements is not correct. Indicate the incorrect statement:
(a) Each of the main symmetrical Channels connects with one "upstream" and one
"downstream" in the daily energy (Qi) circuit.
(b) Each of the main symmetrical Channels controls both superficial and deep functions.
(c) Traditionally, the energy (Qi) in three Channels flows from thorax to fingers (LU, PC,
HT); in three from fingers to face (LI, TH, SI); in three from face to foot (ST, BL, GB) and
in three from foot to chest (SP, KI, LV).
(d) Energy circulation follows a 24-hour rhythm, peaking in LU about mid-day.
(e) In disease, certain points along the Channel become sensitive to palpation, heat and
electric current. Stimuli applied to the sensitive points can normalise the energy flow, helping
the adaptive responses to restore balance.

3. One of the following statements is not correct. Indicate the incorrect statement:
(a) The BL Channel begins at the inner canthus of the eye and ends at 5th toe.
(b) BL67 can influence the eye and BL01 can influence the 5th toe.
(c) All BL points can influence ST function.
(d) BL13,14,15 (region T3, T4, T5) influence the lungs, pericardium and heart.
(e) CV03,12,17 influence the bladder, stomach and heart respectively.

4. One of the following statements is not correct. Indicate the incorrect statement:
(a) The Conception Vessel (CV) is in the dorsal midline and the Governing Vessel (GV) is in
the ventral midline

(b) The CV and GV Channels are said to be reservoirs of Qi and contain many important AP
points.
(c) AP has DIAGNOSTIC aspects as well as therapeutic aspects. The organs influence the
points.
(d) Diagnostic reflex points include the paravertebral (Shu) and the abdominal/thoracic (Mu)
points.
(e) In appendicitis (large intestine, LI), ST25 (Mu, McBurney's point) and BL25 (Shu,
paravertebral point between L4-L5) may be tender.

5. One of the following statements is not correct. Indicate the incorrect statement:
(a) AP points have a two-way relationship with the organs. Organ pathology alters point
sensitivity (diagnostic) and stimulation of the sensitive point has therapeutic effects on the
affected organ.
(b) When the organ or its function becomes normal, disturbed AP point sensitivity returns to
baseline.
(c) Some AP effects can be explained by supraspinal reflexes.
(d) Many useful AP points lie outside of the classical Channels.
(e) Trigger Points (TPs) have no diagnostic value in AP.

6. One of the following statements is not correct. Indicate the incorrect statement:
(a) TPs are seen in pain syndromes, especially in myofascial syndromes.
(b) TPs have no fixed location but may appear in the musculature, where they may be
palpated as "nodules" or areas of localised spasm.
(c) Heavy pressure on (or needling of) the TP causes severe pain but only in the local area
around the TP.
(d) Scar tissue frequently triggers muscle- or organ- pain or dysfunction elsewhere.
(e) TPs occasionally arise near the Golgi apparatus of tendons and at motor points (where the
motor nerve enters the muscle).

7. One of the following statements is not correct. Indicate the incorrect statement:

(a) In clinical human cases which present no TPs, beginners who use TP therapy only can get
good results by needling the area of subjective pain.
(b) The quickest and easiest way to convince sceptics of the benefits of AP therapy is to
persuade them to experiment with TP therapy. It can give 55-65% success in suitable cases.
(c) TP therapy needs no knowledge of AP points or of the detailed laws of AP.
(d) The classic text on TP therapy is by Travell & Simons.
(e) Janssens, Belgium (1984) documented TP locations in dogs.

8. One of the following statements is not correct. Indicate the incorrect statement:
(a) In emergencies (severe shock, apnoea, coma) the following points are useful: GV26,
KI01, Tip of Tail, terminal points on digits.
(b) GV26 has a marked sympathicomimetic effect and it improves cerebral circulation.
(c) In emergencies with coincidental cardiac arrest, points with cardiac effects should be
added (PC06, BL15, CV14 etc). If these are added, needling for 5-15 seconds gives excellent
results.
(d) PC06 is the most often used point for cardiac conditions.
(e) AP is excellent in treating myofascial pain; pain and stiffness in arthropathy; hip
dysplasia; spinal pain (root "disc" syndromes); acute traumatic pain; pain from smooth muscle
spasm (various types of colic and bronchospasm etc).

9. In examining dogs for TPs, one of the following statements is not correct. Indicate the
incorrect statement:
(a) Muscle pain in the left neck is often associated with some tenderness in the right
lumbosacral area and vice-versa.
(b) Normal dogs show no aversive reaction to manipulation of the neck or limb muscles.
(c) The paravertebral area is checked by running the thumbs down along the muscles on 2 or 3
lines (1, 2 and 3" from the mid-line), applying firm pressure, first left, then right, from the
first thoracic to the base of the tail.
(d) Nervous dogs may give occasional "false positive" reactions to finger pressure but a
recheck differentiates the true from the false reaction.
(e) Palpation of the true TP usually elicits a strong yelp but the dog rarely attempts to bite the
examiner.

10. Only one of the following statements is CORRECT. Indicate the CORRECT
statement:
(a) In hip dysplasia, gold bead implants around the acetabulum give less than 30% clinical
success.
(b) In disc disease and arthrosis of large joints, AP gives less than 30% clinical success.
(c) Successful AP therapy is often seen in spite of positive X-ray lesions.
(d) AP treatment of vertebral arthrosis is different to that in disc disease.
(e) Neurological examination is not important before AP treatment of spinal disc syndromes.

1 = e 2 = d 3 = c 4 = b 5 = e 6 = c 7 = a 8 = c 9 = e 10 = c

ACUPUNCTURE IN CATTLE AND PIGS

GENERAL INTRODUCTION
Acupuncture (AP) is not miraculous; it has its failures. There are many reviews on the role of
AP in the body's defence systems (Anon 1979a; Rogers et al 1977, 1981; Lin & Rogers 1980;
Rogers and Limehouse 1990). It works by activating the physiological defence mechanisms of
the body, thereby helping the body to help itself. It helps to restore function to all organs, parts
and functions of the body if the following requirements are met:
a. the natural homoeostatic, adaptive and defence systems of the body are capable of
responding,
b. appropriate AP points are used,
c. adequate stimuli are applied

Many serious and chronic disorders can be helped by AP: paralysis after a cerebrovascular
accident; chronic pain; arthritic pain etc. Post-CVA paralysis may need 10-40 sessions of AP.
In human patients, a long course of therapy is acceptable if there is a reasonable chance of
success. However, in animals, attempts to treat many problems which could be helped by AP
are judged to be uneconomic or unrealistic because of the work and veterinary fees involved
in prolonged therapy. Most animal owners do not wish for a therapy which may need at least
6 treatment sessions. There are some exceptions, especially in valuable animals and in greatly
loved family pets etc. Owners of racehorses, grey-hounds, pedigree breeding females and
valuable stud males may accept AP for their animals. Because of the value of dairy cows,
purebred beef cows and stud bulls, AP has a definite and wide range of indications in cattle.
However, profit margins in pig production are very small and a pig, even a fattener, is worth
little in comparison to the veterinary fees. Thus, many herd-owners would not consider AP
for individual pigs if more than 1-2 sessions were needed. Therefore AP has few economic
indications in pigs in the Western system, except in adult breeding stock (sows, gilts and
boars). Furthermore, because of the difficulty involved in handling pigs, diagnostic AP using
Shu, Mu and Trigger Points (TPs) has little practical role in pigs.

Most concepts in these papers are based on the human system of AP and on the results of
transposition of the human system to dogs and horses.

My practical experience of AP in cattle is very limited. I have studied the literature on cattle
AP and have seen it used by experts such as Oswald Kothbauer, Walter Greiff and the late
Erwin Westermayer.

My practical experience of AP in pigs is zero but I am familiar with the literature and have
seen it used by Kothbauer, Lin and Westermayer. In spite my relative inexperience of AP in
cattle and pigs, the general concepts discussed in these papers can be applied successfully in
practice.

The material for the seminar will be presented in two parts:

1. GENERAL CONCEPTS OF ACUPUNCTURE
2. SPECIFIC CLINICAL EXAMPLES OF AP IN CATTLE AND PIGS
SUMMARY
1. Modern concepts of AP mechanisms include mediation by the peripheral and central
nervous system, the autonomic, neuroendocrine and endocrine systems. AP diagnosis may be
pragmatic, using "western concepts" of the major symptoms and signs to identify the organs
or parts involved. It can be assisted by reactivity at Shu, Mu, TPs and AhShi points. The
importance of these reactive points in diagnosis and therapy is emphasised. In AP therapy,
the stimulus is given to reactive areas linked to the affected organ, part or function. Signals
are sent to the spinal cord and brain by the sensory nerves. The output response is via
segmental, intersegmental and supraspinal reflexes and autonomic, neuroendocrine or
endocrine mechanisms. These responses may be specific or generalised.

2. Vets can learn the human Channel system easily. Great emphasis is put on the AP points of
the paravertebral (BL) Channel, the paravertebral HuaToJiaJi (X 35) points and the midline
Channels, CV (ventral) and GV (dorsal). Beginners should learn the use of these points first.
Methods of point selection for therapy can include "Prescription" or "Cookbook" AP. Points
for various conditions in humans are listed.

3. Points in cattle can be located by subjective transposition of the human AP system. The
author's transposition is given for the main points in the cow. It is left to the reader to do the
exercise for the pig.

4. Although many methods of point stimulation are used, injection, stapling and simple
needling of the AP points are the most practical methods. Moxa can be used in chronic cases
and "cold" diseases. Electro-AP (EAP) is almost essential for good surgical hypoalgesia.
Laser-AP has some enthusiastic users (especially in horses, small animals and humans). The
higher power Lasers (mean output power 20-50 mW) may have a role as a substitute for
needles in cattle and pigs but more research is needed on this.

INTRODUCTION

Acupuncture (AP) in large animals differs from AP in small animals, in that there are
traditional AP charts and methods for large animals but none for small animals. In small
animals, AP is practised by one method only, the transposition of concepts of human AP to
the animal. In this method, the location, function and uses of the human AP point system are
applied to the small animal, making suitable adjustments for differences in anatomy and nerve
supply to the various organs.

In large animals, occidental vets, unable to obtain or decipher the oriental traditional
veterinary texts, developed a similar transposition system of AP for large animals. Therefore,
two systems of AP in large animals exist today: the Traditional system and the Transposition
system.

In Part 1 of this seminar, four main topics will be discussed:

1.1 Modern concepts of AP (mechanisms and diagnosis)
1.2 The human system of AP and methods of choosing points
1.3 Location of some important AP points in cattle by transposition
1.4 Methods of stimulation of the AP points in cattle and pigs

1.1 MODERN CONCEPTS of AP (MECHANISMS AND DIAGNOSIS)

There are some fundamental concepts in Traditional Chinese Medicine (TCM) which are
acceptable to workers trained in the "western" style also: The organism (psyche and soma) is
influenced by external environment. External forces include: diet, poisons, climate, trauma,
infections, extra-terrestrial forces etc.

The organism (psyche and soma) is influenced by internal environment. Internal forces
include: genetics, basic resistance (vital energy, Qi, immune competence, autonomic and
neuroendocrine balance, psychological balance etc), balanced blood circulation, especially
microcirculation in vital organs such as brain, heart, kidney and liver.

The body, its organs and functions is one complete unit. One function or part can influence
another. Disease in one part is reflected in changes in other parts.

1.1.A AP mechanisms

The body has its own adaptive-defence-healing systems. All good medicine (western or
eastern) attempts to activate the homoeostatic mechanisms to keep the various organs,
functions and energies in perfect balance. Imbalance = disease. Balance = health.

When an organ, part or function is imbalanced (in disorder) changes occur elsewhere via
viscerocutaneous, viscerosomatic, viscerovisceral reflexes. These changes can aid diagnosis
(see later). The reverse is also true. Stimuli applied to the skin, superficial muscles and the
nerves related to an affected organ can induce homoeostasis in the organ. The effect is
mediated by reflexes (cutaneovisceral, somatovisceral etc), as well as by autonomic,
neuroendocrine and endocrine mechanisms.

Thus, diagnostic or therapeutic change at one part, reflected elsewhere, is mediated by the
nervous, neuroendocrine and endocrine-humeral systems. Segmental, intersegmental and
supraspinal reflexes are involved.

In many painful conditions, especially of myofascial origin (muscle pain, sprain, rheumatism,
myositis etc), localised areas in muscle and fascia may act as TPs. TPs arise also in arthritis
and in disorders of thoracic, abdominal and other internal organs. They often lie in the
paravertebral area but may occur anywhere in the body. Reactive (tender) points on scar
tissue, traumatised periosteum or infected tooth sockets can also contain TPs.

A TP is a local focus of irritation which maintains the clinical pain (and sometimes autonomic
disorders) elsewhere long after the original cause has disappeared or resolved. As long as the
TPs remain, the clinical condition will not resolve fully. It is vital to locate and neutralise the
TPs. This requires a careful, inch-by-inch search of the body, as the patient is usually unaware
of the TPs until they are probed or needled. They are very painful when probed or electrically
stimulated and they refer pain to the area of clinical complaint, which may be near the TP, but
often is quite far away.

The concept of the AhShi point is most important in TCM. AhShi means "Ah Yes!" or "Ouch
!", the exclamation of the human patient when the point is probed or needled. The AhShi is a
point that is reactive (tender) to palpation pressure. However, there are two types of reactive
point: local tenderness only and local tenderness plus referral of pain elsewhere (TP). Thus,
all TPs are AhShi points but AhShi points are not all TPs. Among the AhShi points, the TP
is the most important diagnostically and therapeutically.

TPs are of use in diagnosis because they arise in predictable locations in relation to areas of
subjective pain in humans. The most comprehensive text on human TPs is by Travell and
Simons (1984, 1985) but other articles on TPs are given in the references at the end of part 2.

TPs are poorly researched and documented in animals and Janssens (1984) is one of the first
vets to document TPs in dogs although all vets using AP will have used TPs (possibly classed
as AhShi points) routinely. Much more work is needed to document animal TPs to the extent
that Travell and Simons have done for humans.

In humans and dogs, the location of TPs often corresponds with that of documented AP
points on the Channels. This is especially seen in the Shu (paravertebral Reflex) and Mu
(Alarm) points in humans (see later).

TP therapy is a physical therapy similar to simple AP. Dry needling, ultrasound, injection of
procaine or non-isotonic B12/saline solution or other agents at the TPs frequently results in
instantaneous relief of pain and the associated functional disorder (e.g. tremor or autonomic
disorder). TP therapy alone, without any knowledge of AP, can give 60-70% success in
suitable cases of human or animal disease.

The abdominal and thoracic organs are innervated by branches from spinal nerves as well as
branches from the cervicolumbar sympathetic and craniosacral parasympathetic nerves.
According to the principle of reflex action, stimulation of any point in an area whose nerve
supply is common to that of an affected organ should influence that organ and any irritation of
the organ should be reflected in changes in reactivity at the body segments innervated by the
common supply.

Thus, in diagnostic and therapeutic AP, relationships between an affected organ and its AP
points, TPs and AhShi points are mediated by the peripheral and central system and their
reflexes (Mann 1977). However, there are many examples which show that points NOT in the
same or nearby spinal segments can have powerful therapeutic effect also. For example, in
acute spasm of neck muscles in humans, immediate relief may follow needling of points
GB39 or ST38 on the lateral side of the lower tibial area. Also, the schools of AP which use
Earpoints in humans claim that needling the reactive earpoints which correspond to the
affected organ or joint etc can have very good therapeutic effect. Diagnostic or therapeutic
action at points distant from the problem can be explained by intersegmental or supraspinal
nerve reflexes.

Earpoint AP is not sufficiently developed in animals to be a reliable alternative to body point

AP at this time. However, there is increasing evidence in many species (horse, ox, dog, rabbit)
that the animal ear contains reflex points for major organs and parts, as is the case for man
(Oleson et al 1980). No practical details of ear AP in cattle or pigs can be given in this
seminar.

1.1.B AP diagnosis
In TCM, disease is classified in many ways: the Eight Types; the Channel involved; the
effects of the Perverse Climatic Evils etc. Diagnostic tests included reading the Chinese
Pulses, looking, listening, feeling and smelling.

This type of diagnosis would be meaningless to those not trained in TCM. For those fully
trained in TCM, however, the traditional diagnostic descriptors and methods indicated the AP
points necessary to correct the imbalance of vital energy.

In recent textbooks from China and in AP (as practised, for instance in the Veterans Hospital
Taipei), little attention is given to esoteric aspects of diagnosis and choice of points for
therapy. Instead, diagnosis is by "western" methods and choice of points is by pragmatic
"Cookbook" prescription. However, the Shu and Mu points are regarded as very important in
diagnosis of human problems.

When a major internal organ is imbalanced, predictable areas along the spine (the Shu or
Reflex points along the bladder Channel) and on the anterior or lateral side of the thorax or
abdomen (the Mu or Alarm points) often become reactive (tender) to pressure palpation.
Tables 1 and 2 and figures 1 and 2 show the location of the Shu and Mu points in humans.
The combination of Shu and Mu point (or points near them) is also very helpful in treating
abnormal function of an affected organ.

In Traditional Chinese Vet Medicine (TCVM), the Channel system is poorly developed and
pulse diagnosis is rarely used in animals. Therefore, in TCVM, diagnosis depended mainly on
local knowledge, knowledge of seasonal diseases and especially on searching for the reactive
points and identification of the major signs and symptoms.

Vet AP, as practised in the west, is only a small part of a total (holistic) approach to health
care. AP is sometimes used alone, sometimes with other therapies. In most cases, it is NOT
used at all. When it is used, diagnosis is based mainly on western concepts of
pathophysiology, with identification of the major signs, symptoms and organs involved and

the reactive points. In vet AP, treatment can be pragmatic also. Reactive points and points for
the affected organ or part with points for the major symptoms are needled, with useful results.

Diagnosis by AP methods can complement diagnosis by western methods. For example, a

western diagnosis may be impossible in some cases of a "downer cows" i.e. cows recumbent
after calving, despite injections of Ca, Mg, P salts and despite elimination of all the common
causes of recumbency. In this case, "downer cow" is not a diagnosis. It is merely a descriptor.
The vet might suspect weakness of the liver (fatty liver) and lumbosacral strain as being the
most important causes of the recumbency. Treatment might be non-specific liver tonics
(Parenterovite or Flor de Piedra (homoeopathic) together with AP at points from vertebra
T10-L3 (for its effect on liver, kidney and adrenals) and point BaiHui (lumbosacral space)
with Zu San Li (3 body inches (tsun) below the patella and lateral to the tibial crest) for their
effect in hindquarter weakness and general vitality.

In other cases no attempt is made to make an AP diagnosis. For instance, in acute purulent
interdigital inflammation in cattle the western diagnosis of "foul-in-the-foot" due to
B.necrosis and C.pyogenes would be treated usually by antibiotic or sulphonamide injection,
with (maybe) footbaths of 5% copper- or zinc- sulphate.

1.2 THE HUMAN SYSTEM OF AP AND WAYS TO CHOOSE POINTS

1.2.A The human AP system
In TCM, the Vital Energy (Qi) was thought to circulate in pathways through-out the body.
Each pathway (Channel) had a superficial and deep course. The superficial course ran in the
skin and muscles and had linking branches to other superficial Channels. The deep course
penetrated to the interior of the body to link with its organ and with other Channels.

Thus, the body with all its parts, organs and functions was seen as a unit, bathed in a sea of
Vital Energy (Qi), which flowed through the superficial and deep course of the Channels.
Along the superficial course were specific zones or points where the Energy was
concentrated. These were the AP points: points where energy could enter or leave the body
under the normal adaptive conditions and where the body could be harmed (by trauma, as in
the martial arts) or helped (as in AP) by stimuli applied to them.

The AP points had diagnostic value: reactivity to palpation along a Channel suggested disease
of that Channel or its organ. They also had therapeutic value: AP stimuli to the points of the
affected Channel and other related points could restore normal function in the affected organChannel system.

TCM describes 12 bilaterally symmetrical Channels. AP points on each one reflect and
control the metabolic and TCM functions of the same organ, the anatomical structures
traversed by the Channel and the organs which are near the Channel. For instance, the
stomach (upper abdomen) lies under the CV, KI, ST, SP, LV, GB, BL and GV Channels.
Points on any of these Channels, especially points in areas innervated by spinal nerves T8T12, can influence stomach function.

Each point on a Channel influences the same basic functions as its Channel but especially the
local structures and functions. Some points have special, wide-ranging functions. These
special points included the 60 POINTS OF COMMAND (the Five Element points: 12 x 5 =
60) which were used in Energetic AP and which will not be discussed further. They also
included special points, such as SOURCE (Yuan), PASSAGE (Luo), ACCUMULATION (Xi),
TONIFICATION and SEDATION points.

As well as the 12 pairs of Channels, two other Channels were described: the RenMo (CV)
and the DuMo (GV) (table 3). They run in the ventral and dorsal midline respectively and
have powerful effects on the internal organs, especially those which lie close to or posterior to
the CV or GV points.

The points of the paravertebral (BL) Channel, the HuaToJiaJi points (see later) and those of
the CV and GV Channels are most important in AP. AP students should learn the uses of
these points at the start of their studies. They can study other points and Channels later.

Details of the human Channel system and the AP points are in standard texts (Anon 1980a;
Lee and Cheung 1978; O'Connor and Bensky 1983).

1.2.B Methods of choosing AP points in humans

A diagnosis is necessary before selecting points for therapy. The diagnostic methods of TCM
are very strange and are unacceptable to many western-trained professionals. Those interested
in the methods may wish to read Connolly (1979), Porkert (1983), Austin (1972) Wu Wei
P'ing (1973) and Anon (1980a).

A much more simple method of choosing points is based on determining the main signs and
symptoms and the organs, parts or nerves affected. Then points are chosen by the application
of about 13 Ancient Laws and two modern laws, or Cookbook AP is used. This method is

discussed in the paper "Choice of points for particular conditions" which is attached and
which you are invited to read before going on to the next section (1.3).

CHOICE OF ACUPUNCTURE POINTS FOR PARTICULAR CONDITIONS

SUMMARY
1. Veterinary acupuncture (AP) is based primarily on human AP principles and the choice of
points for particular conditions is very similar to the choice for similar human conditions.
2. Using a Hewlett-Packard Minicomputer, data from over 55 textbooks and clinical articles
were stored. Frequency-ranked prescriptions for >1100 clinical conditions were generated
from the computer database.
3. The Top Twenty Points from each prescription were extracted from the database summary.
From this list, the most important points for major body regions (head, neck, thoracic limb,
thorax, nose, throat, shoulder, elbow, lung, stomach, etc) and common symptoms (shock,
nausea, vomiting, diarrhoea, fever, etc) were extracted.
4. Appendix 1 comments on the use of the point Index, the structure of the Index and the code
and name of each point. Appendices 2 and 3 list the points. Examples of methods of point
selection for specific conditions and for more complex syndromes (combinations of
symptoms) are given in the text.
5. Advantages and disadvantages of the COOKBOOK METHOD of point selection are
discussed in relation to holistic (traditional) AP.
INTRODUCTION
Western veterinary AP is based primarily on transposition of human AP principles to animal
patients. To select effective points for therapy, one makes appropriate adjustments for
differences in anatomy, location of peripheral nerves, and temperament of the animal (Rogers,
1980b; Molinier, 1983; Westermayer, 1981). There are some texts on traditional veterinary
AP and some Western experts have produced texts which are based on traditional points.
Others have written texts on the transposition method. Advantages and disadvantages of the
transposition method have been discussed elsewhere (Rogers, 1982b).
Studies of the electrical resistance of skin in dogs, horses and cattle have confirmed the
existence of REPP (reactive electropermeable points) at locations predictable from the human
AP system (Janssens; Krueger; Greiff; Kothbauer). In AP research with primates, laboratory
animals (mice, rats, guinea pigs, rabbits) and larger species, the human transposition system is
the one used routinely to locate points such as LU01; LI04,11,15,20; ST09,25,36; SP06,09;
HT07; BL points; PC06; TH05,08,14,17; GB20,30,34; LV03,14; GV26 etc. The clinical and
experimental effects of stimulating these points have been confirmed worldwide in the past 10
years in many animal species (laboratory, farm, domestic and zoo).
Uses of the computer in AP and the advantages and disadvantages of computer -generated
prescriptions were discussed elsewhere (Rogers 1984 a, b). Many professionals still refuse to
use a computer. I believe that this refusal stems from fear (that they will not be able to master
it) and ignorance of what a modern computer can and cannot do. Traditionally-trained

acupuncturists may scorn the idea of cookbooks (although they use their own favourite
prescriptions - a poor Cookbook). They would be horrified at the idea of computerising AP.
COOKBOOK AP: Many have told me that "prescription AP", especially the free availability
of prescriptions, do AP a disservice. They assume that the cowboys (quacks, charlatans, getrich-quick merchants) will proliferate and thrive if such information is freely available. I do
not believe this. I would prefer to see AP develop rapidly. This will not happen if we must
wait for a high percentage of the professions to develop to Master Acupuncturist status. The
use of AhShi therapy and cookbooks brings more professionals into the active AP field than
any other method that I know.
This paper discusses computer-based AP prescriptions for selected areas and symptoms under
3 main headings
: computer AP databases
: prescriptions for major body areas, functions, subregions
: prescriptions for common symptoms
It has taken me more than 11 years to amass these data. Therefore I ask each of you to treat
the material as copyright. You are welcome to use it for clinical, study and research purposes,
but not for commercial publication in text, computerised, microfiche form, etc. You are free
to make personal copies for friends or colleagues, but only on condition that they also agree to
respect the copyright.
The Channel and Point coding used throughout this text is: LU, LI, ST, SP, HT, SI, BL, KI,
PC, TH, GB, LV, CV, GV; ST08 (TouWei) is on the temple, BL41 (FuFen) is at T2 and
BL40 (WeiZhong) is in the popliteal crease. This is the same as that used by IVAS. The
alphanumeric code and name of each point is shown in Appendix 1. As there is no
internationally accepted coding system to-date, you are urged to check my coding system
(Appendix 1) at this stage and to compare it with the one which you use. This is most
important to prevent confusion and error.
COMPUTER AP DATABASES
The larger the database, the more points are filed under any given region, symptom or
condition. However, the first 6-10 points listed (in order of descending citation score) are the
most important for routine use. For example, in the most recent summary of the database, 401
points were listed from a base of 44 texts for the treatment of sequelae (hemiplegia,
paralysis) of CVA or polio. The Top Ten points were:
Ranking
Point
Score

10

LI04 LI11 ST36 GB34 ST06 GB30 ST04 LI15 TH05 GB39
.86

.79

.77

.74

.73

.72

.68

.66

.62

The Maximum score possible was .964. The bottom 10 points were:

.62

Ranking
Point
Score

392

393

394

395

396

397

398

399

400

401

CV13 CV17 BL65 LI01 ST23 BL07 KI20 GB06 GB43 LV06
.02

.02

.02

.02

.02

.02

.02

.02

.02

.02

The scores have been rounded up or down to the second decimal place. Clearly, the first list
would be expected to give better therapeutic results than the second list above.
However, selection of the Top Ten points in the above list would not necessarily be the best
selection for a CVA sequel which was primarily mutism or aphasia. For such cases, the top
10 points are:
Ranking
Point
Score

10

CV23 GV15 HT05 LI04 Z 21 TH03 GB02 TH17 NZ32 SI19

.82

.72

.44

.37

.27

.23

.23

.21

.20

.18

(From a total of 71 possible points listed by 27 texts, maximum possible score was .952)
The differences between the Top Ten points for CVA and the Top Ten points for aphasia
underline the need for formulating specific questions for the computer search. Where
possible, one should search the database for general data (CVA), general region (head, neck,
thoracic limb etc), specific region (arm, leg, hip, etc), specific nerve (mandibular,
hypoglossal, radial etc). Where specific symptoms are marked (aphasia, incontinence, etc)
they should also be searched.
The greatest volume of data refers to the abdomen and its organs/functions. Although there
are points listed for "abdomen", "digestive upsets", "reproductive disorders" etc, these lists
should be used as guidelines for general study or general consideration. In specific cases, it is
preferable to search under the most relevant symptom or condition, such as "vomiting",
"diarrhoea", "constipation" etc, rather than "digestive upset" or "metritis", "infertility",
"impotence", "oligospermia" etc, rather than "reproductive disorders".
The database covers >1100 headings (regions, organs, conditions, symptoms, etc). The
printout of the complete listing for the Top Twenty points runs to some 160 pages of fullwidth (132-character) computer paper. In one hour, it is not possible to cover these data.
Therefore, I have chosen to list the Top Twenty points for about 130 of the major body
regions and their subregions and organs (Appendix 2). The Top Twenty points for about 130
of the more common symptoms are also listed (Appendix 3).
PRESCRIPTIONS FOR MAJOR BODY AREAS, FUNCTIONS, SUB-REGIONS AND
COMBINATIONS OF SIMILAR CONDITIONS
In the database (see Appendices 1,2,3) points are filed under separate condition codes such
as:
040201 Shoulder area (unspecified conditions)

040202 Clavicle: APA for fracture reduction

040203 Shoulder: APA for dislocation reduction
040205 Shoulder, scapula : pain .. ache.. .arthritis etc
040211 Shoulder, scapular: paralysis
040219 Deltoid: myofascial syndrome
Using the computer, it was possible to combine information to retrieve all points used in, for
example, all conditions of "shoulder, clavicle and scapular area" (a total of 181 points from 45
references). In this way, the entire database was summarised by amalgamation of data for
major body areas, functions, subregions and combinations of similar conditions.
The Top Twenty points and their scores are listed in Appendix 2. These lists should prove
useful in the study of AP and as reference material for teaching seminars. They do not,
however, supplant the lists of points for specific symptoms but should be seen as general
guidelines in the choice of points.
PRESCRIPTIONS FOR COMMON SYMPTOMS
The database was searched for a cross-section of common symptoms, especially those relating
to the musculoskeletal system (pain, paralysis) and to major body functions. The Top Twenty
points and their scores for some 130 symptoms or conditions are listed in Appendix 3. It must
be remembered that only the Top Twenty points are given here. There are many other points
which could be considered, especially if a number of symptoms occur together. In
complicated cases, for example, neurogenic vomiting and dehydration in the dog, points for
the main symptom (vomiting: PC06; ST36; CV12; ST25) could be combined with supportive
therapy (fluid replacement).
In cases of anaesthetic emergency or respiratory arrest, main points (GV26, KI01) could be
combined with artificial respiration (though the latter is seldom needed if the points are
stimulated strongly). In cases where cardiac arrest has also occurred, point PC06 (very
powerful on heart and lungs) could be added to GV26, KI01, and open or closed heart
massage, defibrillation or other methods would be added.
Please scan Appendices 1, 2 and 3 now, and then return to the discussion which follows.
MASTER POINTS FOR CHANNEL THERAPY
Apart from the 66 Command Points, there are other powerful points to redistribute Qi
between imbalanced Channels. These are the Shu-Back Association (Reflex) Points, the MuFront Alarm Points, the Luo-Passage (Connecting Points between the Phase-Mate Channels
within one Phase), the Xi-Cleft Points, the Test Points, the Ryodoraku (Japanese Points), and
the HE (Sea Points). The latter points are not the same as the HO points on the Channels. In
addition there is an Hour Point (the Phase point of a Channel, for example the Earth Point
of SP, the Water point of BL etc). SP21 is the Great Luo point (Luo point of all the Yin
Channels).

Taken together, the 66 Command/Su Points, plus the Shu, Mu, Luo, Xi, Test, Ryodoraku,
HE, Hour and SP21 Points are called the Master Points of AP.

Affected COS

The Five Phase Points

Tonic Sedat.

Wood Fire Earth Metal Water

point point

Yuan

Luo

LV (Wood-Yin )

01

02

03

04

08

08

02

03

05

GB (Wood-Yang)

41

38

34

44

43

43

38

40

37

HT (Fire-Yin )

09

08

07

04

03

09

07

07

05

SI (Fire-Yang)

03

05

08

01

02

03

08

04

07

PC (Fire-Yin )

09

08

07

05

03

09

07

07

06

TH (Fire-Yang)

03

06

10

01

02

03

10

04

05

SP (Earth-Yin )

01

02

03

05

09

02

05

03

04

ST (Earth-Yang)

43

41

36

45

44

41

45

42

40

LU (Metal-Yin )

11

10

09

08

05

09

05

09

07

LI (Metal-Yang)

03

05

11

01

02

11

02

04

06

KI (Water-Yin )

01

02

03

07

10

07

01

03

04

BL (Water-Yang)

65

60

54

67

66

67

65

64

58

Xi-

RYODO

HE

Cleft

HOUR

Test

-RAKU

(SEA)

point

point

point

point

point

Affected COS

Shu

Mu

LV (Wood-Yin )

BL18

LV14

06

01

08

03

GB (Wood-Yang)

BL19

GB24

36

41

33-39

40

GB34

HT (Fire-Yin )

BL15

CV14

06

08

07-09

07

SI (Fire-Yang)

BL27

CV04

06

05

03-04

05

ST39

PC (Fire-Yin )

BL14

CV17

04

08

04

07

TH (Fire-Yang)

BL22

CV05

07

06

04-10

04

BL53

SP (Earth-Yin ) BL20

LV13

08

03

09

02

ST (Earth-Yang) BL21

CV12

34

36

34-36

43

ST36

LU (Metal-Yin ) BL13

LU01

06

08

06

09

LI (Metal-Yang) BL25

ST25

07

01

11

05

ST37

KI (Water-Yin ) BL23

GB25

05

10

07

05

BL (Water-Yang) BL28

CV03

63

66

59-60

65

BL54

1. In disorder of the associated Channel-Organ System (COS), there is usually tenderness

on palpation of the Yuan, Mu, Shu and Test points. The Test points may feel cold in Yin
states and hot in Yang states. The RYODORAKU points are electro-sensitive diagnostic
points used in Japanese diagnosis. Their readings are hypo- in Yin and hyper- in Yang states.
2. All MASTER points, except Shu, Mu and HE points, are on their respective Channels
and lie between the elbow and finger or between the knee and toe.
3. The Yuan-Luo combination uses the Yuan of the affected Channel with the Luo of the
Phase-Mate Channel, i.e in lung disease, LU09 (Yuan of LU) plus LI06 (Luo of LI).
An examination of most of the listings in Appendices 2 and 3 shows that the Top Ten points
obey the basic laws of choosing AP points. In summary, these laws suggest a choice of points
from:
a. AhShi points (including Trigger Points, tender scars, fibrositic nodules etc)
b. Local points (which also meet condition (d)).
c. Distant points on the Channel through the affected area or on the Channel of the
affected organ. A chain of points on the affected Channel is said to be specially powerful.
d. Points on the affected nerve, the nerve supply related to the affected organ or area, or in
the same or a nearby spinal nerve segment.
e. Encircling the problem area; "Fore and Aft" points; combination of Yin side and Yang
side points (medial/lateral; anterior/posterior).
f. Combination of Mu and Shu (Front Alarm + Back Association) points.
g. Combination of affected Yuan and Luo of Mate (Source Point of the affected Channel
plus Passage point of its Phase-Mate Channel (LU-LI; ST-SP; HT-SI; BL-KI; PC-TH;
GB-LV).
h. Xi-Cleft point of affected Channel.
i. One or more of the Five Phase Points (Energetic balancing points).
j. Symptomatic points (traditionally known to have marked effect for the specific symptoms,
for example, GV26 in shock, emergencies; PC06 in nausea or vomiting).
k. Extra-Channel points ("New" or "Strange" points, points not on the Main Channels),
especially those effective for the condition, e.g. NX04 (TingChuan) in asthma.
l. Points on the Phase-Mate of the affected Channel (e.g.) ST points in spleen diseases; SP
points in stomach diseases.

m. TianYing point (OT02, centre of the goitre etc).

n. One point on each of the 4 limbs (e.g. LI04 and ST44, both bilateral, in tonsillitis or
toothache).
Let us examine the Top Ten points from some prescriptions (Appendices 2,3) in detail under
three basic headings:
1. Local conditions or regions
2. Conditions of specific internal organs or their functions
3. Generalised conditions and complex syndromes.
In each of these conditions, codes (a) to (n) mentioned above are used to show the laws
observed by the points in the Top Ten list.
1. LOCAL CONDITIONS OR REGIONS: Let us pick problems of the eye, nose, neck,
shoulder, elbow, lowback, hip and knee (stifle) as examples from Appendix 1:
EYE: BL01 (b); LI04 (c, as the LI Channel connects to ST Channel at the eye); GB2O
(c);also Wood (GB,LV) controls the eyes; ST01 (b); Z09 (b, k); BL02 (b); ST02 (b); GB14
(b,c (Wood)); TH23 (b); BL18 (liver controls eyes. BL18 is Shu point of liver, b). The
combination BL01, ST01, Z 09, GB14 meets law (e) above and is very useful in eye diseases.
7/10 of these points are local points.
NOSE: LI04 (c,g,i,j); LI20 (b); GB20 (j); GV23 (c); LI11 (c,i,j); GV14 (c,j); Z 03 (b,k);
BL07 (c); LI19 (b); ST02 (b). The combination LI20, Z 03, ST02 also meets law (e). 4/10 of
these points are local points.
NECK: GB2O (b); GV14 (b); LI04 (c,g,i); BL10 (b); SI03 (c,i.j); LI11 (c,i,j); OT01 (AhShi
point - a); GB21 (b,c depending on site of problem); GB39 (c,j); SI15 (b). The combination
GB20,21, BL10, GV14, SI15 also meets law (e). 5/10 of these points are local.
SHOULDER area: LI15 (b,j); LI11 (c,i,j); TH14 (b,j); Sl11 (b); Sl09 (b); LI04 (e,g,j); OT01
(a); Sl10 (b); OT05 (local points, b); BL11 (d ,j ). A combination of SI09, LI15 and a new
point l" above anterior axillary crease is known as the "shoulder triplet". The combination
meets law (e) above and has powerful effects in shoulder conditions. 6/10 of these points are
local points.
ELBOW: LI11 (b,i,j); TH05 (c,j); LI04 (c,g,i); HT03 (b,i); LU05 (b,i); LI10 (b); OT01 (a);
LI12 (b); TH10 (b); SI07 (c). 6/10 of these points are local.
LOWBACK: BL23 (b,j); BL40 (c,i,j); GB30 (c, linked to lowback via BL Channel, d,j);
BL60 (c,i,j); GB34 (c (via BL link), i,j); BL25 (b); BL37 (c); GV04 (b); BL57 (c); BL31 (b).
4/10 of these points are local.
HIP: GB30 (b,j); GB34 (c,i,j); GB29 (b); GB31 (c); BL40 (c via link to GB Channel, i,j);
BL60 (c,i,j); OT01 (a); GB39 (c,i,j); ST36 (d,i); LV08 (-). Although only 2/10 of these points
are local, 2 of the top 3 points are local.

KNEE: GB34 (b,i,j); BL40 (b,i,j); L 16 (b,k); ST35 (b); SP09 (b); ST36 (c,i); ST34 (b);
LV08 (c); OT01 (a); GB31 (c). The first05 of these points are the most commonly used
combination (obeying law e) and all are local points.
In the eight local conditions discussed above, seven have a local point as the first in the list
(the 8th has a local point as second on the list).
2. CONDITIONS OF INTERNAL ORGANS AND THEIR FUNCTIONS: Let us consider
the Top Ten points in five of the conditions in Appendix 2. Close examination of other lists in
the appendices will show that they follow similar logic.
PLEURA: BL42, BL47, BL43, KI23, KI22, BL13, GB32 (7/10 points) are on the thorax or
dorsal paravertebral area (local). Two of the other three (ST12, BL11) are at the thoracic inlet
and the 10th point (GB44) obeys law (c).
HEART, PERICARDIUM: Only 3 of the Top Ten (BL15, BL14, CV17) are over or near the
organs. They obey laws (b), (d), (e) and (f). Six of the remainder (PC06, PC07, HT05, PC05,
PC07, PC04) are on the HT or PC Channel (laws c, i, j). The 10th point (ST36) is a Master
Point, with many functions, including effects on HT and PC.
COUGH, GENERAL: BL13, CV22, GV12, BL12, CV17 (5 of the top 10 points) are over
the thorax, trachea or dorsal paravertebral area. They obey laws (b), (d), (e), (f), (j). Three
points (LU05,07, 10) are on the LU (lung) Channel (laws c, i). The remaining two points
(ST4O, GV14) meet laws c and i.
LIVER: 6/10 points (BL18,19,20,48; GV09; LV13) are over or near the liver. They obey
laws b, d, e, f, j. The remaining four points (LV03, ST36, GB34, SP06) are master points.
They obey laws c, g, i, j.
GENITALIA FEMALE AND REPRODUCTION: 6/10 points are in the lumbosacral
innervation area (low abdomen or l/s paravertebral area). They are: CV03,04,06; GV04;
GB26; BL32. They obey laws (b), (d), (e), (j). The four remaining points (SP06,10; LV03;
ST36) are Master Points with major effect on low abdomen and its functions. They obey laws
(c), (i), (j).
2a. IF AN ORGAN OR FUNCTION HAS NO NAMED CHANNEL, points can be
chosen from combinations relating to the nearest organs, or Channels, or functions. For
example, suppose there were no entries for the following organs:
Thymus: consider points from combinations for heart, lungs, stomach (nearest organs) and
immunity (a closely allied function).
Diaphragm, oesophagus: consider heart, lung, stomach combination.
Appendix: consider lower right abdomen and large intestine combinations + immunity.
Adrenal (beside kidney): consider kidney combinations.
Ovary, tubes, uterus: consider kidney, bladder, low abdominal and large intestinal
combinations.

Vagina, vulva, scrotum, testicles, penis: these are controlled by the 3 Leg Yin Channels
(SP, LV, KI). Consider points on these Channels + points for low abdomen, bladder.
3. GENERALISED CONDITIONS AND COMPLEX SYNDROMES: Generalised
conditions include metabolic, hormonal, toxic, general autonomic upsets, etc (such as gout,
diabetes, food poisoning, shock, neurasthenia, etc). Although one symptom may be dominant,
it is usual to have a number of symptoms and abnormalities occurring together.
For example, in gout, the presenting symptom may be pain in the big toe (or other joint), but
other symptoms could include liver enlargement + pain; headaches; irritability; blurred vision;
tiredness, etc. The comprehensive treatment would entail dietary advice (possibly involving
food allergy/intolerance testing) and increased fluid intake. AP would be aimed at the more
severe symptom (say toe pain) but other points (especially LV and GB) would be aimed at the
other symptoms. The liver is central in gout and many allergies. Treat the liver.
In diabetes mellitus, polyuria, neuropathy and other signs can arise. Dietary advice, together
with points for diabetes (see Appendix 2) the local regions affected by neuropathy and the
kidney (Appendices 1 and 2) would be indicated.
In food poisoning, vomiting and diarrhoea would be tackled by points such as CV12, PC06,
ST25,36,37 but other symptoms (dehydration, prostration etc) would best be tackled by fluid
replacement. Medication (kaolin, chlorodyne) can assist the gastrointestinal symptoms.
In shock, points like GV26, KI01, ST36, PC06 can be of immediate help but accurate
diagnosis of the pathology is essential and would indicate other interventions (surgery, if
severe internal bleeding; fluids, stimulants, warmth, etc where indicated).
In neurasthenia, insomnia, excitement etc, the HT and PC Channels control these
functions in traditional belief. Consider HT, PC points.
DISCUSSION
1. IN MOST LOCAL PROBLEMS (joint, muscle, superficial organ etc) the best
prescription combines AhShi points and local points + distant points on the affected or
related Channel. It is important to check the location as regards the nerve supply and the
Channel. For example, the best combination for pain in the medial epicondyle of the humerus
will not be identical to the best combination for the lateral epicondyle. However, in traditional
AP, it is not enough to pick any local point. (Some local points are better than others, or, at
least, are more frequently recommended than others).
Modern neurophysiological concepts of AP stress that adequate stimulation of the affected or
related NERVES will produce results as good as the traditional method but adequate clinical
or research testing of the traditional versus modern (nerve theory) methods has not been done.
For the moment, I give the benefit of the doubt to the traditional system, which has stood the
test of time.
2. IN DISEASE OF INTERNAL ORGANS, the most important points lie near the organ in
the thoracoabdominal area or in the paravertebral area (the Mu, Shu and Huatochiachi (X 35)
points, CV and GV points). Where the organ has a named Channel (LU, LI, ST, SP, HT, SI,
BL, KI, PC, GB, LV) it is common to include one or more points on that Channel (distant as

well as local points). Also, the course of the Channel is important. For example, the liver,
kidney and spleen Channels traverse the inner thighs and groin area. Distant points on these
Channels are important in genital and lower abdominal conditions.
In general, if a symptom or abnormal function can be traced to a specific COS, treat that
COS. If more than one symptom/organ system is involved, choose a combination of
points which will influence all the major symptoms or upset organs.
3. IN ACUTE SERIOUS CONDITIONS, WITH MULTIPLE SYMPTOMS AND
PATHOLOGY, it is unwise to rely solely on AP. AP can often give considerable help (using
points as indicated by the main symptoms and pathology) but conventional or unconventional
(complementary) therapies may need to be used as well.
4. IN CHRONIC COMPLICATED CASES, where immediate life-threatening symptoms or
pathology are absent, one can rely more on AP as the main therapy (in cases amenable to
treatment). At all times, however, the aim of good medicine is to help the patient to the
greatest extent, with the minimum of side effects. Therefore, it is good practice to use
whatever complementary therapies seem best indicated.
Analysis of the database indicates that points from the list: LI04,11;
ST25,36; SP06; HT07; BL23,40; PC06; TH05; GB20,34; LV03; CV06,12;
GV04,12,14,20,26 arise in a high proportion of cases. In complex cases, if one has difficulty
in deciding on a prescription, it is advisable to include a few points from that list.
LIMITATIONS OF COOKBOOK AP: How would one treat the following syndrome? The
patient had the following symptoms (at different times) during a period of 6 years, beginning
two years after radical right lung surgery: recurrent haemorrhagic nephritis; cystitis; rightsided sciatica; right- sided paravertebral pain (C6 - T4 area); right-sided headache and bouts
of acute conjunctivitis (right); right ear tinnitus; waking at night with severe pain along the SI
Channel of the arm to the little finger, with the arm in spasm.
To try cookbook prescriptions in such a case would be second-rate AP. There was obviously a
connection between all these symptoms (all relate to SI, BL, KI) and most were right sided
symptoms. On examination, the patient's thoracotomy scar was badly twisted, with adhesions
on the right BL line. This was the clue. Blockage of the Qi flow (traditional concept) or
reflex irritation effects (Western concept) could cause all of these symptoms via the Chinese
SI-BL-KI energy cycle. Treatment was physiotherapy + injection of the scar plus a few
AP sessions using BL points. All symptoms were successfully cleared. Cookbooks have their
limitations and Chefs do not need them.
CONCLUSIONS
Cookbooks or computerised prescribing is very valuable for beginners and for those working
in a clinic. However, one should not rely too much on machines or computers. Computers
need electrical power. In national disaster and warfare, and in many of the developing
countries, electrical power, batteries etc may be unavailable where they are needed most.
Therefore, it is important for the development of medicine and veterinary medicine that as
many professionals as possible should study the basics of AP. This learning process can be
accelerated by interaction with a computerised database (Rogers 1984a). Adequate knowledge

of AP will enable it to be used more widely in field work (large animal work, medics and
paramedics in the bush).
Although the data reported here (Appendices 1,2,3) are but a small fraction of the database, it
is obvious that for most conditions, the Top Ten Points usually will be worth considering.
However, in some complicated cases, points not in the Top Ten may be most relevant. The
statistical method is very useful for population medicine, but it may be disastrous for the
unfortunate patients who need individually designed care.
As a general rule, if a Cookbook prescription does not produce definite results by 2-3
sessions, it is necessary to (a) change the choice of points, or (b) consider other therapies, or
(c) regard yourself as unable to assist.
The enthusiastic amateur AP practitioner will get useful results with the COOKBOOK but
more complicated or deeply rooted problems require more holistic (traditional + modern +
complementary + intuitive) therapy. Therefore, I strongly encourage you to continue your
study of Chinese AP in depth. To get the best results, use the cookbook as the first-line of
attack (in conditions amenable to AP) but be prepared to fall back on traditional and other
methods if results do not follow quickly (Rogers 1984b). This assumes that the user is trained
in basic AP and is able to interpret the point selections.
When using the prescriptions given in this paper, please note (a) the number of references in
the prescriptions, (b) the maximum possible score, (c) the score of each point in the list
(calculated by ratio to the maximum possible score), and (d) the variation in scores between
points. If there are few references, the prescription may be of doubtful value. If the maximum
possible score is (say) .90 and the max. score for any point is (say) less than .40, the
prescription may be doubtful. If there is little variation between the scores and all scores are
greater than .40, various combinations of points should be equally effective.
Remember that the best prescriptions usually combine AhShi points, LOCAL points,
DISTANT points and (if internal organs are involved) Mu + Shu + Yuan + Luo
combinations. Thus, the wheel turns full circle. The traditional methods of point selection
were best after all. Modern technology has merely re-invented the wheel !
REFERENCES
Greiff, Walter; Janssens, Luc; Kothbauer, Oswald (1970-1983). Verification of AP point
locations in nimals by electrical methods and by experimental and/or clinical results.
Kothbauer, Oswald ( 1983). Veterinary AP - Ox, Swine and Horse. Verlag Welsermuhl, Wels,
Austria, 334 pp.
Krueger, C. (1976). AP point topography in the horse. Am. J. Acup. 4, 276-.
Molinier, F. ( 1983). Localisation of veterinary AP points. Rev. d'Acup. Vet. (Paris), No. 17
(4), 6-.
Rogers, P.A.M. (1982a). The study of AP: Sources and study techniques IVAS Annual
Congress, Cincinnati, Ohio (33pp + appendix).

Rogers, P.A.M. (1982b). The study of AP: Points and Channels in animals. Ibid. (23 pp).
Rogers, P.A.M. (1982c). The choice of points for AP therapy. Ibid. (26 pp).
Rogers, P.A.M. (1984a). Computer applications in the study and clinical use of AP. IVAS
Annual Congress, Austin, Texas, 13 pp.
Rogers, P.A.M. (1984b). Traditional versus cookbook AP. Ibid. 40 pp.
Westermayer, E. (1981). Channels and ancient points, especially in cattle. IVAS Annual
Congress, Cincinnati, Ohio, 21 pp.
Yu Chuan & Hwang Yann-Ching (1990) Handbook on Chinese Veterinary AP and
Moxibustion. FAO Regional Office for Asia and the Pacific, Bangkok, 193pp.
1.3 LOCATION OF IMPORTANT AP POINTS IN CATTLE BY TRANSPOSITION
Location of AP points in animals can be by:
a. following Traditional Texts (see part 2).
b. by reference to charts based on results of provocation experiments or clinical association of
reactive points with disease of specific organs
c. by Transposition from humans.

Oswald Kothbauer (Austria), documented the paravertebral reflex (Shu) points in cattle. He
injected irritant solutions into specific organs (cervix, ovary, uterus, kidney etc) and then
searched for provoked reflex changes in the paravertebral area, using an electrical "Pain Point
Detector". This instrument detected points of low electrical resistance (high conductivity).
High conductance corresponded with reactivity to pressure-probing and the points could also
be found by searching with a blunt scissors or other probe. When the reflex points were
located by the probe (electrical or mechanical), the cow reacted by kicking or trying to escape
or vocalising etc, due to increased reactivity to palpation or pain stimuli applied to the reflex
point.

Figures 3a-3c show Kothbauer's diagnostic points. They are in two categories:
a. Reflex points and Alarm points. The relationships to the organs are shown in Table 4. The
Reflex points are located mainly on the BL Channel in the transposition system.
b. Alarm points are located more ventrolaterally.

Both types of points are located in areas linked to the affected organs by the spinal nerves.
They are also located at or near areas predictable from a knowledge of the Shu and Mu points
in humans. Thus, Kothbauer's points are very similar to paravertebral TPs, Shu and Mu
points in humans and have similar diagnostic and therapeutic uses.

Through years of clinical observation, Kothbauer, Greiff, the late Dr. Westermayer and others
have documented "pain points" (reactive points, AhShi points, TPs) in the paravertebral area
in cases of specific organ pathology. In general, these points agree with Kothbauer's points.

Provocation experiments has been done in pigs also (Schupbach 1985). He injected irritant
solution into the body or horn of the uterus of mini-pigs. Using computer-controlled infra-red
thermography, he located specific zones on the skin of the lumbosacral area which became
"Hot Spots" within 10-40 minutes (average 25 minutes) after irritation of the body or horn of
the uterus. These "Hot Spots" related well with classical AP points known to be related to the
uterus and cervix (points over the iliac wing, lumbosacral space, sacral foramina and anterior
coccygeal area (BL26.3,27-34, BaiHui, WEIKEN etc). Figure 4 shows the reflex "Hot Zone"
and the warmest point (WP). In his experiments, Schupbach attempted to correlate "hot
Spots" with points of low electrical resistance. The correlation was NOT significant. Many
low resistance points were found but infrared thermography was more accurate at locating the
reflex zones.

In further experiments (at the Vet School, Zurich), Schupbach used electrodes implanted in
the uterus of mini-pigs to monitor myometrial activity following needling of the main "Hot
Spot" (BL26.3, over the iliac wing). AP stimulation caused definite increase in uterine
contraction.

Pending future systematic, detailed study of reflex points in animals, the human transposition
system is still very useful. However, transposition of human point locations to animals is
subjective because of anatomical differences between species and because of the experience
and individual concepts of the practitioner. Points like BL23, ST36, GB34, LI11, GB20,
BaiHui (lumbosacral space) present no problem but points on the digits and points in the
intercostal spaces or along the vertebrae are more controversial, because of differences in
digital anatomy and vertebrae.

Humans have the following number of vertebrae: Cervical (C) = 7; Thoracic (T) = 12;
Lumbar (L) = 5; Sacral (S) = 5.

In cattle/pigs, the number is: C=7/7; T=13/15; L=6/6; S=5/5 respectively. Thus, one author
may differ somewhat from another in locating points. I believe that this is not very important
for clinical success using AP. All the evidence suggests that AP works via the nervous
system. Therefore, AP stimuli given NEAR "correct" points would be expected to have
similar effects to those from stimulation of "correct" points. Considerable scope exists for
individual preference in location and selection of AP points.

Although the published and personal communications of Kothbauer, Westermayer and Yu &
Hwang (1990) have been the main source of my information for cattle AP, the transposition
of each point has been mine (taking my Masters' locations as well as human locations into
account).

There is no internationally accepted nomenclature or charting for the transposition of

points from humans to animals at this time. The International Vet Acupuncture Society
(IVAS) plans to produce an agreed set of Standard Charts. Pending this development, each vet
must construct a personal set or must use a set, such as by Kothbauer or Westermayer. In this
paper, I attempt to construct a transposition for the cow. Thus, in the section that follows,
some locations agree closely or exactly with those of my Masters; some do not. Responsibility
for any errors is mine.

These locations may be used with the Cookbook prescriptions given in the attached paper
("CHOICE OF POINTS FOR PARTICULAR CONDITIONS").

Figure 5 shows the transposition of the Shu and Mu points from human to cow.
Figure 6 shows the transposition of the Shu and Mu points from human to pig. I do not
attempt to prepare a complete transposition system for the pig. (Try this yourselves). The
same principles may be used in pigs, as in other species.

Some points in humans are not so important to know. Others are essential. The same comment
applies to animal AP. In the descriptions of point locations which follow, I have omitted some
points. This was for one of four reasons:
a. they are inaccessible;
b. they are not important (other points can be used instead);
c. their location can be estimated from that of points on the same Channel; or
d. their location is very uncertain because of anatomical difficulties.

The Chinese names of the more important points are given below but the names of ALL
points are given in APPENDIX 1 of the paper on the "Choice of points for particular
conditions".

In the sections which follow, the following abbreviations are used:

A.= artery
ant.= anterior
ant. to= in front of
C4= 4th cervical vertebra
CCJ= chondrocostal junction (rib-cartilage)
Co4= 4th coccygeal vertebra
ext.= external
ICS= intercostal space
int.= internal
J.= joint, junction
L4= 4th lumbar vertebra
lat.= lateral
M.= muscle
med.= medial
N.= nerve
post.= posterior
SCJ= sternocostal junction
S4= 4th sacral vertebra
T4= 4th thoracic vertebra
TMJ= temporomandibular-joint
units of measurement: 1H (1 hand) = 4 fingerwidths; 1F=1 fingerwidth
"= inch or tsun or cun or Chinese Unit of body measurement
V.= vein
CV line= Conception Vessel line=ventral midline (anus to navel to lower lip)
GV line= Governing Vessel line = dorsal midline (anus to lumbosacral space to inside of
upper lip)
TRANSPOSITION OF THE HUATOJIAJI (X 35) POINTS TO COWS AND PIGS
HuaToJiaJi points, (X 35 in the computer lists), are not on the Channel system of humans.
They lie between the GV Channel and the medial line of the BL Channel in the area C1-S5,
one pair (left and right) for each vertebra. The HuaToJiaJi points lie over the wing of each
vertebra, near the junction with the body of the vertebra. They are most important points,
named after Hua-To, a great doctor in ancient China. They are used mainly as LOCAL points,
influencing LOCAL problems and also influencing organs or organ functions nearby. For
instance, in neck problems, one might use X 35 points at C1 and C7 vertebrae, with TPs and
SI03 with BL62 or ST38 or GB39.

In nephritis, one might include X 35 points in the area L1-L4. In fatty liver (hepatic
degeneration after calving): include X 35 in area T9-L1. The X 35 points are not shown in the
figures, as they are easy to find and to use. As the spinal nerves travel at an angle backwards
from the vertebrae, it is better to choose X 35 points anterior (ant.) to the organ or part you
wish to influence but always consider reactive points, wherever they are.

TRANSPOSITION OF THE LUNG (LU) CHANNEL TO COWS (CHART 1)

LU01 Zhong Fu (Central Storehouse); in ICS3 (human ICS2), behind the shoulder joint.
(The tip of the olecranon is over rib 5).
LU05 Chi Ze (Elbow Marsh); lat. to biceps tendon at the ant. med. side of elbow joint.
LU07 Lie Que (Sequence Broken); 1F above radial styloid, above ant. med. side of carpus.
LU09 Tai Yuan (Great Abyss); 1F below radial styloid, ant. to radial A., above med. carpus
LU11 Shao Shang (Little Metal-Merchant); at horn-hair junction on post. med. side of
forelimb dewclaw...

TRANSPOSITION OF THE LARGE INTESTINE (LI) CHANNEL TO COWS

(CHART 2)
LI01 Shang Yang (Metal-Merchant Yang); ...??
LI02 Er Jian (Second Space); ...??
LI04 He Gu (Meeting Valley); 2F distal to and behind the proximal head of the medial
metacarpal bone. Note: LI04 and LV03 are two of the most often used points in human AP;
they have many functions in common and often are combined, especially for wandering aches
and pains ("aching all-over") and in generalised or systemic conditions; they have the same
relative positions on the hand and foot respectively.
LI05 Yang Xi (Yang Cleft); post. med. side of radial-carpal joint, below and behind radial
head
LI10 Shou San Li (Arm Three Li) (3 Li = 1 mile); at the ant. lat. side of elbow, 2F ant. inf. to
lat. condyle of the humerus, 2U distal to LI11
LI11 Qu Chi (Bend Pool); at the ant. lat. side of elbow, just ant. to the joint, in the crease in
front of the elbow when the limb is flexed
LI13 Shou Wu Li (Arm Five Li); 3 U proximal to LI11, on a line between LI11 and LI15.

LI15 Jian Yu (Shoulder Bone); at the point of the shoulder, in front of the shoulder joint, on
the deltoid m., between the acromion and the greater tubercle of the humerus, about 3F
anterior to TH14
LI18 Fu Tu (Support the Prominence); lat. neck, 1H above jugular vein and 1H behind
mandible, on the sternomastoid m., level with the tip of the Adam's apple.
LI20 Ying Xiang (Welcome Fragrance); just post. sup. to lat. canthus of nostril

TRANSPOSITION OF THE STOMACH (ST) CHANNEL TO COWS (CHART 3)

ST01 Cheng Qi (Containing Tears); on inf. bony rim of orbit, directly below pupil
ST04 Di Cang (Earth Granary); 0.5 U behind the oral canthus
ST06 Jia Che (Jaw Chariot); in the masseter m., 2F on line from post. angle of mandible to
the eye
ST07 Xia Quan (Lower Gate, Below the Joint); at the TMJ, below zygomatic arch, over
centre of sup. ramus of mandible
ST09 Ren Ying (Persons Welcome); lat. inf. neck, just above carotid A., level with laryngeal
projection
ST11 Qi She (Qi Abode); just ant. to rib 1 at SCJ.
ST12 Que Pen (Empty Basin); just ant. to rib 1 below point of shoulder, on the sup. border of
the cutaneous colli m., med. and prox. to LU02
ST18 Ru Gen (Breast Root); in ICS6, 2 spaces behind olecranon, on olecranon-tibial crest
line
ST19 Bu Rong (Not Contained); in ICS7, 3 spaces behind olecranon, on olecranon-tibial
crest line
ST20 Cheng Man (Assuming Fullness); in ICS8, 4 spaces behind olecranon, on olecranontibial crest line
ST21 Liang Men (Beam Gate); in ICS9, 5 spaces behind olecranon, on olecranon-tibial crest
line
ST21-01 (Kothbauer's Ma18); on milk vein, 1H behind xiphoid, level with ICS9
ST22 Guan Men (Gate Door); in ICS10, 6 spaces behind olecranon, on olecranon-tibial crest
line
ST23 Tai Yi (Great Unity); 1/3 distance from ST22 to ST25, on olecranon-tibial crest line

ST24 Hua Rou Men (Slippery Flesh Gate); 2/3 distance from ST22 to ST25, on olecranontibial crest line
ST25 Tian Shu (Heavenly Pivot); 2 U lateral to navel, between ICS12 and the navel, on
olecranon-tibial crest line
ST26 Wai Ling (Outer Mound); 1/3 of the distance ST25 to ST28, on olecranon-tibial crest
line
ST27 Da Ju (Great Giant); 2/3 of the distance ST25 to ST28, on olecranon-tibial crest line
ST28 Shui Dao (Water Path); level with ant. edge of base of udder, on olecranon-tibial crest
line
ST29 Gui Lai (Return Coming); in abdominal wall, med. to patella
ST31 Bi Guan (Thigh Joint); in the tensor fasciae latae, 1H on line ant. edge of hip to patella,
ant. to the femur, about midway between iliac wing and patella.
ST35 Du Bi (Calf's Nose); between lat. and middle patellar ligaments, below patella
ST36 Zu San Li (Foot Three Li); 7F below patella, 1F lat. to ant. edge of tibial crest
ST37 Shang Ju Xu (Upper Great Hollow); 11F below patella, lat. to ant. edge of tibia
ST38 Tiao Kou (Ribbon/Narrow Opening); midway lat. patella to lat. hock, at ant. edge of
tibia
ST40 Feng Long (Abundant Bulge); level with ST38 but behind tibia
ST41 Jie Xi (Divide Cleft); just below lower head of tibia at ant. lat. hock, between the
extensor tendons of the digits
ST45 Li Dui (Severe Mouth); midpoint of med. side ... of med. hind claw, at hoof-hair
junction

TRANSPOSITION OF THE SPLEEN-PANCREAS (SP) CHANNEL TO COWS

(CHART 4)
SP01 Yin Bai (Hidden White); ...??
SP04 Gong Sun ("Yellow Emperor"); 3F below upper head of med. metatarsal, med. side,
behind metatarsal
SP05 Shang Qiu (Shang Hill) (Shang = the sound of Metal); between the tendons, just below
lower head of tibia, at ant. med. hock

SP06 San Yin Jiao (Three Yin Crossing); 6F above med. hock, just behind the tibia, opposite
GB39
SP09 Yin Ling Quan (Yin Mound Spring); 6F below med. side of patella, behind the tibia
SP10 Xue Hai (Blood Sea); 5F above sup. edge of patella on ant. med. thigh
SP12 Ru Fang Yan (Ju Feng Yen = Mammary Inflammation); on olecranon-tibial crest line,
laterally at the base of the udder, in pit which separates fore- and hind- quarters, on the
external pudendal v., where it runs superficially with its artery under the skin (Kothbauer's
location)
SP13 Fu She (Bowel Abode); on olecranon-tibial crest line, at ant. edge of base of udder
SP14 Fu Jie (Abdomen Bound/Knotted); 2 F above olecranon-tibial crest line, 1H behind
SP15
SP15 Da Heng (Great Horizontal); 2 F above olecranon-tibial crest line, 6F from the CCJ,
between navel and CCJ of rib 13
SP16 Fu Ai (Abdominal Lament); 2 F above olecranon-tibial crest line, 1H ant. to SP15,
behind CCJ of rib 11
SP17 Shi Dou (Food Drain); 2 F above olecranon-tibial crest line, in ICS6, above ST18 and
below GB23
SP18 Tian Xi (Heavenly Cleft); 3 F above olecranon-tibial crest line, in ICS5, above ST17
and below GB22
SP19 Xiong Xiang (Breast Village); 4 F above olecranon-tibial crest line, in ICS4, above
TH10, SI08 and below BL41
SP20 Zhou Rong (Complete Flourishing); on shoulder-femoral trochanter line, in ICS3
SP21 Da Bao (Great Embrace); on shoulder-femoral trochanter line, in ICS8, above GB24
and below BL45

TRANSPOSITION OF THE HEART (HT) CHANNEL TO COWS (CHART 5)

HT01 Ji Quan (Supreme Spring); med. to post. edge of shoulder joint, deep, on chest wall
HT03 Shao Hai (Lesser Yin Sea); med. to ant. edge of elbow joint, deep, on chest wall
HT04 Ling Dao (Spirit-Mind Path); post. lat. side of forelimb, 4F above carpus
HT05 Tong Li (Connection Measure); post. lat. side of forelimb, 3F above carpus
HT06 Yin Xi (Yin Cleft); post. lat. side of forelimb, 2F above carpus

HT07 Shen Men (Spirit-Mind Door); post. lat. side of forelimb, at carpal-metacarpal J.
HT08 Shao Fu (Lesser Yin Mansion); post. lat. side of forelimb, midway down metacarpal
HT09 Shao Chong (Lesser Yin Rushing); sup. med. side of lat. dewclaw on forelimb...??

TRANSPOSITION OF THE SMALL INTESTINE (SI) CHANNEL TO COWS

(CHART 6)
SI01 Shao Ze (Lesser Marsh); post. lat. side of lat. claw of forelimb, at horn-hair J...??
SI03 Hou Xi (Back Ravine); post. lat. side of fetlock J., just behind upper head of phalanx 1
SI06 Yang Lao (Nursing the Old); lat. carpus, just above and behind lower head of radius
SI08 Xiao Hai (Small Sea); between med. epicondyle of humerus and olecranon
SI09 Jian Zhen (Shoulder Upright); in the fossa caudal to the shoulder on the caudal border
of the deltoids and between long and lateral heads of the triceps brachii.
SI10 Nao Shu (Humerus Association Point); behind lower end of scapular spine, on the
cranial border of the deltoid m.
SI11 Tian Zong (Heavenly Gathering); behind scapular spine, 2H below upper edge of
scapular cartilage
SI12 Bing Feng (Controlling Wind); before scapular spine, 9F below upper edge of scapular
cartilage
SI15 Jian Zhong Shu (Shoulder Centre Association Point); 2 U lateral to GV14, at level of
vertebrae C7-T1, on a line from scapular cartilage to the base of ear
SI16 Tian Chuang (Heavenly Window); on lat. neck, 3F behind and 2F below post. angle of
mandible
SI18 Quan Liao (Cheek Bone-hole, Zygoma Crevice); on face, at lower end of zygomatic
arch, on line from lower edge of orbit to post. angle of mandible
SI19 Ting Gong (Listening Palace); between ant. edge of root of ear and TMJ

TRANSPOSITION OF THE BLADDER (BL) CHANNEL TO COWS (CHARTS 7, 8)

The BL Channel is the most important one for vets. It has applications in nearly every
condition which can be helped by AP.

Points BL12-30 inclusive, and their mate points, BL41-54, are most important points in AP.
They reflect and control the functions of all the thoracic and abdominal, pelvic and mammary
organs. In the transposition system, their locations are relatively easy to remember with the
help of the following guidelines:

a. The BL Channel has two lines on the thoracolumbosacral area

b. Line 1, the inner BL line, contains points BL12-35. BL12 lies just medial to the midpoint
of upper edge of scapular cartilage. BL13 lies 2F from the GV line just above the
posterosuperior angle of the scapular cartilage, level with the posterior edge of the spine of
T5. Between BL14-30, the line runs about 1H (4F) from the GV line (dorsal midline). Points
27,28,29,30 lie lateral to the 4 sacral holes (foramina) respectively, about 1H from GV line.
Points 31,32,33,34 lie respectively between these points and the GV line, about 2F from the
GV line, OVER the 4 sacral holes. Thus, points BL27,31 relate to sacral hole 1 and points
30,34 relate to hole 4 respectively. Point BL35 lies 3F from GV line level with the junction of
coccygeal vertebrae 2.

BL21 lies on line 1 (1H from GV line) behind the last rib, in front of the transverse wings of
vertebra L1.

BL17 (diaphragm/haemorrhage point) lies midway between BL13 and BL21. It can be used
to locate any point between BL13-21 by counting the required number of spaces forwards or
backwards from BL17.

BL26 lies on line 1 (1H from GV line) between the transverse wings of vertebrae L5-L6, 3-4
F ant. to the ant. edge of the wing of the ilium.

Between BL21 and 26 inclusive, each BL point falls one vertebral space apart. Thus any point
between BL21-26 can be found by counting backwards from BL21 or forwards from BL26.

Between BL26 and 27 is a most important point for the uterus. Kothbauer calls it BL27 but in
my system of transposition, I call it BL26.1. It lies just ant. to the ant. edge of the iliac wing,
1H from GV line, at the post. edge of the transverse wing of L6.

Thus, using locations of BL13,17,21,26 and the sacral holes, all points between BL12-35 can
be transposed easily.

c. Line 2, the outer BL line, contains points BL41-54 inclusive. For most of its course, it lies
about 1H (4F) lat. to line 1 (2H lat. to the GV line). The most difficult points to remember in
this set are BL41,42,43,53,54. BL41,42,43 lie in intercostal spaces 4, 5, 6 respectively just
below the posterior edge of the scapula. BL53 lies 1H lat. to BL28. BL54 lies 1H lateral to
BL30. BL36 (old point BL50) lies 1H below the tuber ischii on the posterior midline of the
thigh, 2H from the CV line of the perinaeum. Points BL44-52 are easy to transpose. They lie
2H from the GV line. BL50 lies lat. to BL21, just behind the last rib. All the other points in
the series BL44-52 can be located by counting one vertebral space for each point, forwards or
backwards, as needed.

Thus, points BL41-52 are easy to find, once you remember that BL52 (beside BL23) is level
with the space between the transverse wings of L2-L3 and BL41 is in ICS4, below the
scapular edge. (The olecranon lies over rib 5).

Note also that the following pairs of points have similar functions: BL12,41; BL13,42 etc to
BL23,52. Each of these pairs is related to the same spinal nerve and the same ICS.

The formula to remember is: S(36 to 47) = F(12 to 23) + 29,

where S = BL point number on the second BL (outer) line and
where F = BL point number on the second BL (inner) line.

Thus, if you know that BL17,18,19 are useful in haemorrhage/liver disorders, you can be sure
that points BL46,47,48 have similar actions. (The numerical difference between the point
codes in series 2 and series 1 is 29).

Approximate positions for the main BL points are:

BL01 Jing Ming (Eye Brightness); just above med. canthus of eye
BL02 Zan Zhu (Collecting Bamboo); 2F above med. canthus of eye
BL10 Tian Zhu (Heavenly Pillar); 5F from GV line over the centre of wing of atlas, 1F post.
med. to GB20

BL11 Da Shu (Great Shuttle); at J. of scapula and its cartilage, at level of space between
spines of C7 and T1 (long needle behind scapula)
BL12 Feng Men (Wind Door); just behind midpoint of upper edge of scapular cartilage, just
post. to spine of T4, in ICS4; its outer paired point is BL41
BL13 Fei Shu (LU Shu); 2F from GV line just above post. sup. angle of scapular cartilage,
level with post. edge of spine of T5, in ICS5; its outer paired point is BL42
BL14 Jue Yin Shu (PC Shu); 1H from GV line, level with post. edge of spine of T6, in
ICS6; its outer paired point is BL43
BL15 Xin Shu (HT Shu); 1H from GV line, level with post. edge of spine of T7, in ICS7; its
outer paired point is BL44
BL16 Du Shu (GV Shu); 1H from GV line, level with post. edge of spine of T8, in ICS8; its
outer paired point is BL45
BL17 Ge Shu (Diaphragm Shu); 1H from GV line, level with post. edge of spine of T9, in
ICS9; its outer paired point is BL46
BL18 Gan Shu (LV Shu); 1H from GV line, in 3rd last ICS (10), level with post. edge of
spine of T10; its outer paired point is BL47
BL19 Dan Shu (GB Shu); 1H from GV line, in 2nd last ICS (11), level with post. edge of
spine of T11; its outer paired point is BL48
BL20 Pi Shu (SP Shu); 1H from GV line, in last ICS (12), level with post. edge of spine of
T12; its outer paired point is BL49
BL21 Wei Shu (ST Shu); 1H from GV line, just behind last rib, level with post. edge of spine
of T13; its outer paired point is BL50
BL22 San Jiao Shu (TH Shu); 1H from GV line, between lat. wings of L1-L2, 1 space
behind BL21; its outer paired point is BL51
BL23 Shen Shu (KI Shu); 1H from GV line, between lat. wings of L2-L3, 2 spaces behind
BL21; its outer paired point is BL52
BL24 Qi Hai Shu (Energy Sea Shu) (uterus/reproductive point); 1H from GV line, between
lat. wings of L4-L5, 4 spaces behind BL21
BL25 Da Chang Shu (LI Shu); 1H from GV line, between lat. wings of L5-L6, 5 spaces
behind BL21
BL26 Guan Yuan Shu (Gate Origin (chief blockage) Shu); 1H lateral to Bai Hui, 6 spaces
behind BL21; this is a key point for the uterus and cervix
BL26.1 1H from GV line, on post. edge lat. wing of L6, just ant. to iliac wing. It is an
important UTERUS point (= Kothbauer's BL27)

BL26.2 2F post. lat. to BL26.1, on ant. edge of iliac wing (=Kothbauer's BL28, Uterus point)
BL26.3 1H post.-med. to tuber coxae, over the wing of the ilium. This is a most important
uterus point (Kothbauer, Westermayer, Schupbach). It corresponds with Kothbauer's point
BL28-1).
BL27 Xiao Chang Shu (SI Shu); 1H from GV line, 1 space behind BaiHui, level with sacral
hole 1
BL28 Pang Guang Shu (BL Shu); 1H from GV line, 2 spaces behind BaiHui, level with
sacral hole 2; its outer paired point is BL53
BL29 Zhong Lu Shu (Middle of Back Shu); 1H from GV line, 3 spaces behind BaiHui,
level with sacral hole 3
BL30 Bai Huan Shu (White Circle (anus/perinaeum) Shu); 1H from GV line, 4 spaces
behind BaiHui, level with sacral hole 4; its outer paired point is BL54
BL31 Shang Liao (Upper Bone-hole (foramen)); 2F from GV line, 1 space behind BaiHui,
over sacral hole 1
BL32 Ci Liao (Second Bone-hole (foramen)); 2F from GV line, 2 spaces behind BaiHui,
over sacral hole 2
BL33 Zhong Liao (Central Bone-hole (foramen)); 2F from GV line, 3 spaces behind BaiHui,
over sacral hole 3
BL34 Xia Liao (Lower Bone-hole (foramen)); 2F from GV line, 4 spaces behind BaiHui,
over sacral hole 4
BL35 Hui Yang (Meeting Yang); 3F from GV line, level with J. of coccygeal vertebrae 2-3
BL36 Cheng Fu (Receiving Support); on post. midline of thigh, 1H below tuber ischii, 2H
from CV line
BL40 Wei Zhong (Bend Centre or Supporting Middle); post. midline of stifle area, level with
centre of patella
BL41 Fu Fen (Attached Branch); in ICS4, below post. edge of scapula. (Olecranon is over rib
5). Its inner paired point is BL12.
BL42 Po Hu (Corporeal-Soul Door); in ICS5, below post. edge of scapula. Its inner paired
point is BL13
BL43 Gao Huang Shu (Subcardiac Diaphragm-Pleural Shu); in ICS6, below post. edge of
scapula. Its inner paired point is BL14
BL44 Shen Tang (Spirit-Mind Hall); in ICS7, directly below spine of T5, 2H from GV line,
1H lat. to its inner paired point, BL15

BL45 Yi Xi (Sighing Laughing); in ICS8, directly below spine of T6, 1H lat. to GV line, 1H
lat. to its inner paired point, BL16
BL46 Ge Guan (Diaphragm Pass); in ICS9, 2H lat. to GV line, 1H lat. to its inner paired
point, BL17
BL47 Hun Men (Ethereal Soul Door); in ICS10, 2H lat. to GV line, 1H lat. to its inner paired
point, BL18
BL48 Yang Gang (Yang Head-rope); in ICS11, 2H lat. to GV line, 1H lat. to its inner paired
point, BL19
BL49 Yi She (Thought Abode); in ICS12, 2H lat. to GV line, 1H lat. to its inner paired point,
BL20
BL50 Wei Cang (Stomach Granary); just behind last rib, 2H lat. to GV line, 1H lat. to its
inner paired point, BL21
BL51 Huang Men (Diaphragm-pleural Door); between transverse wings of L1-L2, 2H lat. to
GV line, 1H lat. to its inner paired point, BL22
BL52 Zhi Shi (Willpower-Ambition Chamber); between transverse wings of L2-L3, 2H lat.
to GV line, 1H lat. to its inner paired point, BL23
BL52.1 over the iliac wing, 1H med. from tuber coxae (uterus point = Kothbauer BL26).
BL53 Bao Huang (Bladder Diaphragm-pleura); 2H from GV line, 1H lat. to BL28, level
with sacral hole 2. Also paired with BL32
BL54 Zhi Bian (Sequential Limit); 2H from GV line, 1H lat. to BL30, level with sacral hole
4. Also paired with BL34
BL60 Kun Lun (Kunlun (Mountains)); lat. hock, between tibia and Achilles tendon, opposite
KI03
BL61 Pu Shen (Slave Root); lat. hock, at upper third of os calcis
BL62 Shen Mai (Ninth Vessel); lat. hock, at tibial-tarsal J.
BL63 Jin Men (Golden Door); post. lat. hock, at tarsal-metatarsal J.
BL65 Shu Gu (Restraining Bone); post. lat. fetlock, 2F above the joint, behind the metatarsal
BL66 (Foot) Tong Gu (Passing Valley); post. lat. fetlock, 2F below BL65
BL67 Zhi Yin (Reaching Yin); post. lat. side of lat. claw, at horn-hair J.

TRANSPOSITION OF THE KIDNEY (KI) CHANNEL TO COWS (CHART 9)

KI01 Yong Quan (Bubbling Spring); at lower third of metatarsus, behind the bones, med.
side...??
KI03 Tai Xi (Greater Cleft); med. hock, between Achilles tendon and tibia, opposite BL60
KI10 Yin Gu (Yin Valley); 6F behind the stifle J., at post. med. side of limb
KI11 Heng Gu (Pubic Bone); 2F from CV line at ant. edge of base of udder
KI16 Huang Shu (Diaphragm-Pleural Shu); 2F lat. to the navel (CV08)
KI22 Bu Lang (Walking Porch); in ICS7, beside sternum
KI27 Shu Fu (Transporting Point Mansion); in ICS1, beside sternum

TRANSPOSITION OF THE PERICARDIUM (PC) CHANNEL (HEART

CONSTRICTOR, CIRCULATION-SEX) TO COWS (CHART 10)
PC01 Tian Chi (Celestial Pool); in ICS4, med. to olecranon
PC03 Qu Ze (Bend Marsh); med. to med. condyle of humerus just above elbow J.
PC04 Xi Men (Cleft Gate); meeting of upper and middle third of radius, med. side, behind
radius
PC05 Jian Shi (Intermediate Messenger), also called Ye Yan (Night Eye, chestnut); midpoint
of radius, med. side
PC06 Nei Guan (Inner Gate); at lower to middle third of radius, med. side, behind radius,
directly opposite TH05
PC07 Da Ling (Great Hill); radial-carpal J., med. side, behind radius
PC09 Zhong Chong (Central Hub); at the post. edge of the interdigital cleft...??

TRANSPOSITION OF THE TRIPLE HEATER (TH) CHANNEL TO COWS (CHART

11)
TH01 Guan Chong (Door to the Thoroughfare); at the ant. of the lateral front claw, just
above the hoof-hair junction...??
TH05 Wai Guan (Outer Gate); at lower to middle 1/3 of radius, posterolat. edge of the
radius, directly opposite PC06
TH08 San Yang Luo (Three Yang Connection); on the posterolateral edge of radius, about
1/3 of the distance between the carpus and olecranon

TH10 Tian Jing (Heaven's Well); 1 U proximal to the olecranon.

TH14 Jian Liao (Shoulder Bone-hole); directly over the shoulder joint, in line with the
scapular spine
TH15 Tian Liao (Heavenly Bone-hole); just in front of the junction of the anterior upper
angle of the scapula and the scapular cartilage
TH16 Tian You (Celestial Window); on the lateral neck, just cranial to the wing of the atlas,
level with BL10 and SI17, just caudodorsal to the mastoid, on the dorsal edge of the
sternocleidomastoid m., or 2 U caudal to TH17...??
TH17 Yi Feng (Screen from the Wind); behind and below the posteroinferior junction of the
ear and the head
TH23 Si Zhu Kong (Silken Bamboo Hollow); in temporal fossa, just above and behind the
posterosuperior edge of the orbit

TRANSPOSITION OF THE GALLBLADDER (GB) CHANNEL TO COWS (CHART

12)
GB01 Tong Zi Liao (Pupil Bone-hole); at the lateral edge of the orbit
GB14 Yang Bai (Yang White); directly above the pupil of the eye, in a depression in the
supraorbital process (supraorbital foramen).
GB20 Feng Chi (Wind Pool); over the wing of the atlas
GB24 Ri Yue (Sun Moon); in ICS8, 1 ICS caudal to LV14, on a line between shoulder- and
stifle- joints
GB25 Jing Men (Capitol's door); at the tip of the last rib
GB30 Huan Tiao (Circle Jump); above and behind the hip joint, needled towards hip joint
GB31 Feng Shi (Wind Market); on the lateral thigh, 2/3 way down the femur and just behind
it, on the cranial border of the biceps femoris
GB33 Xi Yang Guan (Knee Yang Joint); just behind lat. condyle of femur, just above tibia,
level with LV08
GB34 Yang Ling Quan (Yang Tomb/mound Spring); 1H below stifle J., just behind tibia
GB39 Xuan Zhong (Suspended Bell); 6F above lat. hock, just behind tibia, opposite to SP06
GB40 Qiu Xu (Mound of Ruins); ant. lat. hock, at tibial-tarsal J.
GB41 Zu Lin Qi (Foot Near Tears); post. lat. hock, at metatarsal-tarsal J., behind metatarsus

GB44 (Foot) Qiao Yin (Orifice/cavity Yin); on the ant. lat. side of the lat. claw, just above
the coronary band...??

TRANSPOSITION OF THE LIVER (LV) CHANNEL TO COWS (CHART 13)

LV01 Da Dun (Great Pile); on the ant. med. side of the med. claw, just above the coronary
band...??
LV03 Tai Chong (Great Surge-pouring); 2F distal to and behind the proximal head of the
medial metatarsal bone. Note: LI04 and LV03 are two of the most often used points in human
AP; they have many functions in common and often are combined, especially for wandering
aches and pains ("aching all-over") and in generalised or systemic conditions; they have the
same relative positions on the hand and foot respectively.
LV04 Zhong Feng (Middle Mound/seal); ant. med. hock, at tibial-tarsal J., ant. to tibia
LV05 Li Gou (Woodworm Canal); 2/5 of the distance from hock to stifle J., at med. side of
tibia
LV08 Qu Guan (Bend Spring); med. to med. condyle of femur, just above tibia, level with
GB33
LV13 Zhang Men (Camphorwood Door); just above CCJ of rib 12, 2F above olecranonpatella line
LV14 Qi Men (Cycle Door); in ICS7, 2F above olecranon-patella line

TRANSPOSITION OF THE CONCEPTION VESSEL (CV) TO COWS (CHARTS

14,15)
CV01 HuiYin, on the CV line, between anus and vulva; in males, 1F below anus.
CV02 on the CV line of the perinaeum, 2H below CV01
CV03 on the CV line of the perinaeum, 3H below CV01
CV04 on the CV line of the perinaeum, 4H below CV01
CV05 on the CV line, just ant. to ant. base of udder
CV06 QiHai on the CV line, 1/3 of the distance between ant. edge of ant. base of udder and
navel
CV07 on the CV line, 2/3 of the distance between ant. edge of ant. base of udder and navel
CV08 ChiZhong on the CV line, centre of navel

CV12 ZhongWan on the CV line, midway navel to tip of xiphoid cartilage

CV14 on the CV line, tip of xiphoid cartilage
CV15 on the CV line, xiphisternal J.
CV17 SHANZhong on the CV line, midsternum, at SCJ of rib 6
CV18 on the CV line, midsternum, at SCJ of rib 5
CV22 on the CV line, at the manubrium sterni
CV23 on the CV line, below point of jaw, above larynx
CV24 in the middle of the lower lip

TRANSPOSITION OF THE GOVERNING VESSEL (GV) TO COWS (CHARTS 16,17)

This is also a very important Channel for vets. GV points can be used in problems of the
head, thoracic limb, thoracic area and organs, abdominal area and organs, lumbosacral area
and pelvic limb. GV points rank second in importance to BL points and have similar effects
and uses to the HuaToJiaJi points.

GV01 CHANG CHIANG GV line, between anus and root of tail

GV02 WEI KEN on the GV line, in the sacrococcygeal space
GV03 Bai Hui in the lumbosacral space on the GV line
GV04 MING MEN between the spines of L2-L3 on the GV line
GV05 TIAN PING in the thoracolumbar space, on the GV line
GV09 between the spines of T8-T9, on the GV line
GV12 SAN TAI between the spines of T3-T4, on the GV line
GV14 TA CHUI between the spines of C7-T1, on the GV line, 2F ant. to scapular cartilage
GV19 between the occiput and the atlas, on the GV line
GV26 RenZhong midpoint of line joining the lowest point of each nostril
GV28 YU TANG on dental pad, at openings of nasopalatine ducts

Those who study AP should understand that learning the LOCATION of points is merely a
MENTAL aid to knowing WHERE to apply the AP stimulus for therapy. The exact location is
NOT critical, as long as the stimulus is applied to a relevant nerve pathway or to tissue whose
nerve supply is closely linked to that of the affected organ or part. In practice, AP becomes a
highly individual art-science. Practitioners develop their own preferences on point location,
their own point combinations and their own protocols for AP therapy. It is quite likely that 10
experts, asked to treat the same sick animal, would use 10 different combinations of points.
This does not make a mockery of the claim to a scientific basis for AP ! It merely illustrates
the richness and variety of the clinical approach.

A close examination of the points used by the experts would show that they ALL follow basic
principles of AP: Reactive Points (AhShi points, TPs, sensitive points); Local Points; points
in the nerve supply common to affected part; Distant Points on the Channels through
affected area etc. Students of Vet AP should begin with basic concepts. These can be adapted
with experience and skill later.

1.4 METHODS OF STIMULATION OF THE AP POINTS

Point injection (with conventional or less conventional medicines: Kothbauer, Westermayer,
Greiff, Turnbull, Piper) is the most common method used in busy practices. A common
solution for injection is 1% procaine or Vit B12 (1 mg/ml). These two (procaine + B12) are
often mixed and used together. For febrile conditions, Procaine Penicillin (5-10 ml) may be
injected at BL40 and 5 ml at BL15,16,17 bilaterally (Piper).

Needling (19-21 gauge hypodermic needles, 10-100 mm long (Westermayer), or special solid
AP needles (Kothbauer)) is also commonly used. Moxa may be burned on the needle or
applied direct to the skin by taping a moxa cone to the point and lighting it. Cases for moxa
include chronic or cold diseases, rheumatism, repeat breeder cows, anoestrous sows etc.
However, one may use needling as an alternative, even in such cases.

Implantation of surgical staples at the AP points is another quick and easy method. The
staples are left in position until they fall out by themselves. Point stapling is claimed to be
successful in horses but there are few references to its use in cattle and pigs. Thus, at this
time, stapling must be regarded as an experimental method only.

Laser-AP has given good results in many conditions in horses, small animals and humans.
Trials with carbon dioxide 3W mean output power Laser on GV01 gave very good results in
lambs with clinical or experimentally- induced dysentery (Yu Chuan et al 1983). Infrared or
He-Ne Laser also gave excellent results in infertility in cows (Yu Chuan et al 1983). GradyYoung (1985) also claimed excellent results for cold Laser in cattle with shipping fever

(Pasteurella pneumonia). He irradiated reflex points for lung function. He also claimed good
results in virus infection (Herpes) in horses.

As cattle and pigs are large animals with thick skins, it seems likely that lower power Lasers
(mean output power <10 mW) may not penetrate deep enough to activate the deeper AP
points. Higher power Lasers (20-50 mW) are more likely to be useful in large animals but
considerable research needs to be done before they can be recommended as adequate
replacements for the more traditional methods in routine AP. Until more data on Laser are
available, it should be regarded as an experimental method only.

A more complete discussion of the methods used in clinical AP is attached - the paper entitled
"TECHNIQUES OF STIMULATION OF THE AP POINTS". Please read that paper now,
before going on to Part 2 of the seminar.

Many western vet acupuncturists prefer to COMBINE AP WITH WESTERN METHODS,

especially if the condition is serious. For instance, in acute infections, antibiotics can be
injected at the appropriate AP points. In acute hypomagnesaemia (convulsions) or
hypocalcaemia (paresis) Ca and Mg solutions can be injected at the relevant AP points and
the remainder of the mineral solution can be given intravenously or subcutaneously, as
needed.
This concludes Part 1 of the seminar.
SUMMARY
1. Part 1 discussed the Transposition System. Cow charts were prepared. The Cookbook
Prescriptions from human texts (APPENDIX 2 and 3 of the paper on the CHOICE OF
POINTS FOR PARTICULAR CONDITIONS) can be used with those charts. These charts are
not absolute; they are only guides. Your own mental constructs will allow you to apply a
similar transposition to the pig.

Part 2 examines AP therapy in specific cases, having first mentioned briefly the traditional
texts on Cattle and Pigs.

2. AP treatment of the following conditions in cattle is discussed in some detail, mainly

following the transposition system but using, where necessary, points from Kothbauer's
system and the traditional system:
a. disorders of fertility and the urogenital system

b. disorders of the gastrointestinal tract

c. disorders of the liver and metabolic disorders
d. disorders of the musculoskeletal system
e. disorders of the respiratory system
f. AP for surgical hypoalgesia in cows

3. AP treatment of the following conditions in pigs is discussed:

a. disorders of fertility and the urogenital system
b. disorders of the gastrointestinal tract
c. disorders of the musculoskeletal system
d. AP for surgical hypoalgesia in pigs

INTRODUCTION
Part 1 (General concepts of AP), STRESSED the importance of the Transposition System.
For western vets, this is easier to learn and to use than the Traditional Chinese Veterinary
Medical (TCVM) system. However, some TCVM points in large animals are very important
and have no counterpart in the human system. Therefore, it is necessary to learn some of the
TCVM points.

This paper (Part 2) will discuss AP as practised by western vets under two main headings:
2.1 the TCVM points
2.2 specific examples of AP analgesia and therapy in cattle and pigs

2.1 Traditional Chinese Vet Medical (TCVM) points

Some textbooks in Chinese, Japanese and other oriental languages describe the location and
uses of TCVM points in horses, cattle, pigs, camels, goats and other animals. Because of
difficulty in translation, many of these texts are unknown to western vets. For example, Dr.
Jen Hsou Lin has published his book, but in Chinese. We need translations of the good texts
on TCVM into western languages as an urgent priority. This would help in the study and
research of vet AP in the west. However, some texts have been translated already (Klide &

Kung 1977; Westermayer 1978, 1980; Rubin 1976; White 1985) and other texts use a
combination of traditional, transposition and provocation methods to describe the location,
function and uses of the points (Kothbauer 1983).

There are dozens of textbooks on human AP. Some of the better ones are listed in the
references below. However, there are many differences in nomenclature, point functions, point
location and point combinations for therapy between these human texts. The same problem
exists for the TCVM texts.

There is a great need for scholars to produce an INTEGRATED text which would amalgamate
the data available from all sources and produce a standardised text for each species.

The text by Dr. Lin will be used to show some of the differences and difficulties between the
TCVM and the human transposition system. Figures 7-12 show the location of the TCVM
points in cattle and pigs (Lin 1985). Comparison of these figures with those of human texts
(for example Anon 1980a) shows that some TCVM points are located in positions which
agree with the human transposition system: ST36 (Zu San Li); GV04,12,14,26 (Ming men,
Shen chu, Ta chui, Ren Zhong); CV08,12 (Chi chung, Zhong Wan).

However, many TCVM points have names, locations or functions which differ from those of
human points. For example, Bai Hui is on the head in humans. It is coded GV20 and is used
in headache, dizziness, nervous exhaustion and prolapse of the uterus or rectum.

In animals, Bai Hui is in the lumbosacral space, one space behind GV03 in humans. It is a
most important point in animals (reproductive, urinary, intestinal problems and all conditions
of the lumbosacral area and hindlimbs).

In humans, a "Strange point" (ShihChiChuiHsi) is in the lumbosacral space. Its human uses
are lumbago, leg pain, pelvic limb paralysis, gynaecological disorders etc (Anon 1975).

Some important TCVM points (horse, cow, pig):

Figure 13 shows some of the TCVM points used for Electro-AP (EAP) analgesia (EAPA)
for surgery in horses and cattle (Sun et al 1980). These points also have therapeutic uses.

Bai Hui GV line, in the lumbosacral space (= New human point Shih Chi Chui Hsi)
San Tai GV line, in the T3-T4 or T4-T5 space (SHEN CHU, = human GV12)
Shen Shu 2.5 tsun lat. to BaiHui
Tian Ping GV line, in the thoracolumbar space (= New human point Chieh Ku)
Wei Chien GV line, at the tip of the tail
Wei Gan GV line, in coccygeal 2-3 space
Wei Ken GV line, in the sacrococcygeal space (YAO Shu, = human GV02)
Yao Pang 1 below tip of transverse process of L1. Needle ant. inf. towards
body of last thoracic vertebra.
Yung Chi between transverse processes of L5-L6 (= human BL26)

Ancient TCVM charts for the cow and pig show key AP points for the main thoracic and
abdominal organs in the paravertebral area (see table 5 and figures 5 and 6). These are the
TCVM Shu points, see Part 1 (1.3).

As in humans, reactivity at the Shu point and other TPs in the cow can be very helpful in
diagnosis. Reactive Shu points need to be treated directly, or indirectly (for example by the
use of Ting Points, or other Master Points). However, in the pig, because of difficulty in
handling and the tendency to squeal at the slightest restraint, the Shu and TPs are of little
diagnostic value but if diagnosis is made on other grounds, they are useful in therapy.

One of the most disturbing differences between TCVM and Transposition is the discrepancy
in the location of the TCVM Shu points and the human Shu points. Many points of the
human BL Channel (paravertebral Channel) do not appear on the TCVM charts but it seems
certain that stimulation of the animal in regions corresponding to the (missing) points would
have similar effects to those in humans, because of similarity of spinal innervation. It would
be very valuable to repeat provocation experiments in cows and pigs, similar to those done
already by Kothbauer and Schupbach. Systematic provocation and mapping of the reflex
zones would quickly determine which of the two systems (TCVM or Transposition) is the
more accurate. In practice this may not matter much, as it is well known that each organ in the
thorax and abdomen is innervated by branches from 3-5 spinal nerves. Therefore, one would
expect some overlap in the locations of Shu points and many possible Shu points for each
organ, both longitudinally as well as laterally.

A look at table 4 shows that this is the case for the cow (Kothbauer). Table 5 shows that
TCVM Shu points are omitted for PC, TH, KI, BL organs in the cow and pig and the
location differs somewhat from that suggested by transposition from humans. Those interested
in the traditional system may study the relevant texts.

TCVM is more easily learned by Orientals than by Occidentals. This is because the TCVM
texts give point names by their Chinese character, making it much easier for the reader of
Chinese to understand the system. Few westerners have sufficient motivation to study TCVM
because of the difficulties involved. Some of these difficulties would be reduced if a new,
integrated ("Standardised International") text could be prepared for each species, with alphanumeric point codes and western translation of the point names.

2.2 Specific examples of AP analgesia and therapy in cattle and pigs

Appendix 2 and 3 of the paper "Choice of points for particular conditions" contain the "Top
Ten" points for the main body areas and for the more common clinical conditions in humans
which respond to AP. These prescriptions were produced by computer analysis from a large
database of human AP text-books and clinical articles. These prescriptions may be applied to
vet AP in the transposition method, using CHARTS 1-17 (Part 1 of this seminar).

However, some specific examples of AP treatment follow. Unless otherwise stated, the point
coding used in the following section is based on the transposition method (see CHARTS 1-17
in Part 1 of the seminar). Where Chinese point names are used, they refer to the TCVM
locations.

2.2.1 Disorders of fertility and the urogenital system in cattle

AP is useful in the following conditions: anoestrus, silent heat, repeat breeder (where the
problem is hormonal or embryonic death) and cystic ovary (follicular or luteal cysts). It has
also been used in bulls to improve libido, to increase sperm counts and in impotence and
lumbosacral pain. It can influence the pelvic ligaments, cervix and uterus, vagina and vulva.
Therefore, it helps in cases of dystocia, placental retention, delayed involution of the uterus
after calving, postpartum uterine infection etc. It is also of great help in reposition of the
prolapsed uterus and in returning the postpartum uterus to normal tone.

The most important points relating to reproductive function and genitalia are in the
lumbosacral area, especially:
ovary, testis: BL22,23,51,52; GV04,05, especially BL23 (Kothbauer, Piper);

tubes, uterus horn: BL24,25;

uterus: BL26,26.1,27,28,31,32; GV03;
cervix, vagina, penis: GV02,03; BL29,30,31,33,34.

The other Channels crossing the lower abdominal area are: CV, KI, ST, SP, LV and GB. (See
a chart of the human abdominal Channels). Points on these Channels may also influence the
genitalia and reproductive system. For example:

ovary, tubes, testis: CV06,07; KI15; ST26; SP14; GB25,26

uterus horn: CV05; KI14; ST27; SP13; GB27
uterus body: CV04; KI13; ST28; SP12; GB28
cervix: CV03; KI12; ST29; GB27, 29, 30
vagina, vulva, penis: CV01,02; KI11; ST30; LV12

Distant points on the three YIN Channels of the foot (LV, SP, KI) may be added (especially
SP06; LV05) but local points on the back, flank and belly will usually suffice.

Kothbauer and Greiff also mention injection of 2% procaine solutions in the paracervical area.
To do this requires a very long needle (50 cm) inside a sterile insemination straw. The straw is
introduced per vaginam to touch the vaginal wall lateral to the cervix. The needle tip is
extended 20-30 mm through the vagina to lie beside the lateral wall of the uterus body. 10-20
ml of 2% procaine is injected on each side. This procedure can influence genital and
reproductive functions.

Infertility (anoestrus, silent heat, repeat breeder, cystic ovary, nymphomania) (Westermayer,
Kothbauer, Lakshmipathi, Fung, Greiff, Turnbull, Piper etc): Points are chosen, depending on
the signs and diagnosis, as below. Particular attention is given to reactive points on the
lumbosacral and paralumbar area, especially BL, GV and GB points. If one had to use just
one single point, BL26 (bilaterally) is the most important. It can be used on its own (bilateral)
or combined with BL23,27; GV03. Point BL26.1 (BL27 in Kothbauer's coding) is also very
useful in reproductive disorders (Kothbauer, Piper).

In disorders of the hormones, endocrine points may be added, as required: thyroid (CV23;
GV16; ST09,10; GB21,22); pituitary (TH22; GB20; GV20; ST08); pancreas (BL20,49;
SP06; ST21); adrenal (BL22,23,51,52; GV04). Ovary points, especially BL23 are combined
with endocrine points and points such as BL26, BL26.1 for cases with small inactive ovaries
(Kothbauer, Piper).

AP point treatment may be of many types: simple needling (25-50 mm deep, 10-20
minutes), EAP (5-15 minutes; 5-35Hz), injection of the AP points with saline, homoeopathic
preparations or procaine-based neural-therapeutic agents, moxa and needle-moxa. All these
methods appear to work. Treatment can be for 1-3 times at intervals of 3-7 days. Mate at the
next oestrus if the uterus seems to be free of infection. Oestrus may occur 1-80 days after AP
in anoestrus cows and 1-10 days after AP in cycling cows.

A recent paper claimed excellent results in anoestrus cows using Laser (He-Ne, 632.8 nm,
mean output power 6mW, 7.5mA, 1.5-3.0 mm light spot) focused on YINTI (the clitoris) from
a distance of 5-30 cm. Treatment was 10 minutes/day for 6 days. Then rest 3 days and repeat,
if needed. Serum progesterone levels were measured 10-30 days before and 30-100 days after
AP. They confirmed that He-Ne Laser on Yinti (the clitoris) had a luteolytic effect and
tended to synchronise oestrus. The research continues (Yu Chuan 1983).

Reposition of prolapsed uterus (Westermayer, Kothbauer, Kuussaari, Turnbull): The main

points are GV02,03,04; BL53,34,32,30,28,26,24 (or BL54,52,33,31,29,27,25,23; CV02). The
needles are placed to a depth of 25-50 mm. The farmer may twirl the needles for a few
seconds each, repeating every two minutes, while the vet is preparing for surgery. Within 15
minutes, the congestion is much less and the uterus can be returned easily without the need for
epidural anaesthesia.

It helps if the hindquarter is raised or if the cow is standing. After the reposition, a restraining
harness or vulval sutures may be used.

Dystocia (Westermayer, Kothbauer, Kuussaari): The same points are used as in reposition.
Relaxation of the ligaments and cervix can give great assistance and the uterus contracts more
vigorously and in a more coordinated manner in response to AP at those points.

Retained placenta, delayed involution of uterus, metritis, toxaemia (Westermayer,

Kothbauer, Muxeneder): AP can help to restore normal size, muscle tone and function of the
uterus postpartum. If the cow is very sick, western medicine is used (in shock, infection,
toxaemia). However AP can also help. Guided by the main signs, points for toxaemia (liver:

BL18,19,47,48; adrenal: see above); inappetance (stomach: BL20,21,49,50; ST36; liver: see
above); lumbar area (BL22-27,51,52); shock (GV26; WEICHIEN; BL15,44; PC06); uterus
(see above) etc are chosen.

In postpartum conditions, the cow is often cold. In such cases, moxa is preferable to AP, or
moxa can be burned on the needles. Such cases are treated every 1-2 days for 2-5 times.
Particular attention is given to any reactive points which may be found in the lumbosacral
area.

Greiff injects homoeopathic solutions in the AP points but it is beyond the scope of this paper
to attempt to describe the homoeopathic drugs and their uses.

Neonatal apnoea: In cases where the calf is born alive but fails to breathe, needling of GV26,
TIP OF EAR point and WEICHIEN is very good (Kothbauer, Kuussaari).

Reluctance to suckle: To increase the suckling reflex in calves, Kothbauer needles GV28 (at
the openings of nasopalatine ducts on the dental pad).

Urinary disorders: The more common urinary disorders in cows which can be helped by AP
are nephritis, cystitis, dysuria and urinary (fluid) retention. The most important points are:

Kidney: (BL22,23,24,51,52; GV04,05; ST25; SP15; KI16; GB25; LV13; CV07,08;

HuaToJiaJi in area T12-L3). SP13 is the Mu point of the kidney.
Ureter: (BL25,26,27; GV03; ST26,27; SP14; KI14,13; GB26; CV05,06; HuaToJiaJi in
area L3-S1)
Bladder: (BL28-34,53,54; GV02,3; ST28,29; SP13; KI11,12; GB27,28; CV02,03,04;
HuaToJiaJi in area S2-S4).

Points are chosen as for fertility problems (reactive points, points for the major affected organ
or for the major symptoms). In serious infections, western treatment (antibacterial drugs) can
be combined with AP.
2.2.2 Disorders of the gastrointestinal tract in cattle

Cows often develop digestive upsets, especially after calving or when on a high intakes of
concentrates at peak lactation. These upsets include: inappetance, acidosis, acetonaemia
(ketosis), fatty liver syndrome, atony of the forestomachs or intestines, abomasal torsion,
diarrhoea, constipation etc. Cattle at pasture may develop tympany (bloat), diarrhoea,
inappetance etc.

When treating digestive disorders, locate any reactive points between vertebrae T8-S4,
especially in the paravertebral area, intercostal area and lateral abdominal areas on the left and
right side. If reactive points are found, they are used. Points for the affected organs (rumen,
reticulum; omasum, abomasum; small or large intestine; liver) or functions (stress- adrenal;
appetite; nervousness etc) are added as needed. Distant points such as ST36; SP06; GB34
may be added to help the effect.

These points are especially useful in indigestion and diarrhoea, especially when combined
with local points on BL, GV, CV Channels or with HuaToJiaJi points locally.

Points for the SPLEEN, PANCREAS, LIVER, ADRENAL are given in 2.2.1. above and the
liver and metabolic disorders are discussed in 2.2.3 below.

Rumen, Reticulum: The most important points are on the left-hand side (Channels GV, BL
and HuaToJiaJi points in the area T8-L1, left side). Points in the intercostal spaces 8-12 may
also be important, as are CV, KI, ST, SP, GB, LV points in the posterior thoracic and anterior
abdominal area (i.e.) the points ST21-24; SP14-17; BL18-22,47-51; KI18-23; GB24,25;
LV13,14; CV10-15; GV05-9 and HuaToJiaJi points from T8-L1.

Omasum, abomasum: The most important points are on the right-hand side - basically
similar to the rumen-reticulum points.

Intestines: Small intestine points are on the right-hand side and more anterior.
Large intestine points are on the left-hand side and more posterior.
In colic, Kothbauer uses BL51-1,51-2,51-3.

The most important points are on the Channels GV, BL and HuaToJiaJi points in the area
L1-S4. Points in the abdominal wall may also be important, as are CV, KI, ST, SP, GB, LV

points in the posterior abdominal area, (i.e.) points ST24-28; SP13,14; BL22-34,51-53; KI1118; GB26,28; CV04-10; GV02-05.

Treatment is as in 2.2.1 above for chronic cases. In acute or serious cases, treatment is given
every 12-48 hours, as needed.

2.2.3 Disorders of the liver and metabolic disorders in cattle

AP can help to restore normal function in metabolic disorders, including: bloat, acidosis,
ketosis, nervousness, hyperthyroidism, convulsions, milk fever and "downer" cows, fatty liver
syndrome etc.

In metabolic disorders, as in all clinical AP, the signs and history and the location of the
reactive points are used to locate the organs, parts or functions affected. Points are chosen
according to this information.

In serious conditions, other treatment (western drugs or oriental herbs etc) should be
considered as the main treatment, with AP as a supplementary treatment.

Kothbauer's points for metabolic disorders are mainly for liver, adrenal and thyroid (see 2.2.1)
but other points are added, depending on the clinical signs and the organs and functions
affected. For example, in ketosis with constipation and drop in milk yield, points for liver,
large intestine, adrenal and udder might be used.

Fatty liver syndrome with milk-fever (hypocalcaemic paresis): Combine points for liver,
parathyroid, shock and circulatory disorders.
Parathyroid points: ST09; CV23; BL23,52.
Circulatory disorders: PC06; BL14,15; CV14,17; ST09,12.
Shock: adrenal points (2.2.1) plus GV26; BL15; WEICHIEN.

2.2.4 Disorders of the musculoskeletal system in cattle (Kothbauer, Westermayer,

Turnbull):

Musculoskeletal disorders in cattle which respond well to AP include:

a. pain, sprain, trauma of muscle, soft tissue, spine and major joints;
b. tendovaginitis, pododermatitis, laminitis;
c. inflammation (arthritis), especially of the shoulder, elbow, carpus, hip, stifle, tarsus,
cervical and lumbosacral vertebrae;

In most cases of arthritis, especially chronic cases, the pain and stiffness is mainly of
MUSCULAR origin (Moss 1972; Fox 1975). If the muscles above and below the affected
joint are in spasm or contain TPs, the spasmolytic effect of AP can result in great clinical
improvement.

d. muscle paralysis due to nerve trauma (suprascapular, radial, facial, obturator, sciatic etc)
and in the DOWNER SYNDROME (postpartum recumbency in the absence of detectable
pathology). The genetic condition of spastic paresis ("straight hocks") in heavily-muscled
European beef breeds can be helped but not cured by AP.

The principles of choosing points for musculoskeletal disorders are:

a. Identify the major affected area(s): neck ? shoulder ? elbow ? lumbar ? hip ? stifle ? etc or
the affected nerve: facial ? suprascapular ? etc
b. Locate the reactive points in the muscles in, above and below the affected area. All TPs
are used. In the case of lumbosacral sprain, search also the thigh and posterior tibial muscles.
Many back injuries are caused by mounting other cattle and may be associated with injury of
muscles in the hindlimb also.
c. Use TPs + 2-3 Local Points + 1-2 Regional Points +/- a Distant Point on a Channel
through the affected area.

Some examples are given in table 6 but APPENDIX 3 of the paper on the CHOICE OF
POINTS FOR PARTICULAR CONDITIONS gives much more detail of points for various
joints, nerves and body areas.

Lumbosacral or hindlimb pain in stud bulls: AP can be of great help in stud bulls who
refuse to mate because of back or hindlimb pain. The principles of treatment are as in a), b), c)
above.

DOWNER COW, postpartum recumbency (Westermayer; Kothbauer; Turnbull; Greiff):

Where causes such as toxaemia, hypocalcaemia, metritis/mastitis/pneumonia, septicaemia,
fractured pelvis or hindlimb bones etc have been eliminated or treated and the cow will not
stand, the cause is often pelvic nerve trauma, sacroiliac or lumbosacral strain. In such cases,
there is usually ischaemia and pain of the muscles nearest the ground. Occasionally there is
also liver degeneration (fatty liver), general weakness due to poor nutrition and prolonged
calving etc. AP combined with mechanical lifting (using a hip-lift) can give excellent results
in 10-20 minutes. Some vets prefer EAP in such cases but point injection, strong needling or
moxa can be successful also.

The most important points are GV02,03,14; BL23,40. Some vets add points from BL2134,50-54 or other hindlimb points (table 6) also. If there is suspicion of forelimb involvement,
add 1 or 2 forelimb points (table 6).

If the cow is depressed or "stupid", GV26 and WEICHIEN can be added. If the examination
suggests the involvement of liver, uterus, gastrointestinal or other pathology, points related to
these organs, especially if reactive, are added (see 2.2.1, 2.2.2, 2.2.3).

Hock swelling and mastitis: Many cows with mastitis, especially of the hind-quarter,
develop tarsal (hock) swelling, especially on the medial side. Westermayer, Kothbauer and
Turnbull report that such cows often show pain points over the posterior sacral area and over
the tuber ischii. In severe mastitis, intramammary antibiotic is advisable and in toxic cases or
cases of suspect septicaemia/ bacteraemia parenteral injection of antibiotics and antitoxins
may be needed. However, the mastitis and hock swelling can be helped by needling the pain
points and other points for the udder and hock (see figure 3a and table 4). One might add
some needles at LOCAL points (table 6) also.

Needling the points for the udder (table 4) can relax the teat sphincter and 200-1000 ml of pus
and infected milk often leaks out spontaneously, within 5-10 minutes of AP stimulation.

In acute mastitis, AP treatment is every 1-2 days. In chronic mastitis or in hock swelling,
sessions can be 2-5 days apart. Point injection or simple needling is effective.

Piper implants gold beads at ST36, BL27 in chronic mastitis, with BL30 (hind-quarter) or
SP18 (forequarter). He also uses Moxa on the needles in chronic cases.

In disorders of milk letdown reflexes in heifers, Kothbauer uses the "MILK HOLE" (his
ST18, at the entry point of the milk vein into the abdomen behind the sternum) with other
udder points.

Peripheral nerve paralysis: AP can help to speed up the return of motor and sensory
function following peripheral nerve trauma. The principles of treatment are: LOCAL points
on or near the affected nerve (and bilaterally), regional points (see table 6), a chain of points
along the nerve (for example BL23,36,40,60; GB30,31,34,39 in sciatic paralysis).

In motor and sensory paralysis, the consensus is that EAP is more effective than simple
needling. However, simple needling has also given good results. In SENSORY paralysis, care
must be taken not to cause electrical burns by setting the output of the electrostimulator too
high. This is less likely to happen in motor paralysis but output settings tolerable by healthy
tissue should be used as a guide to the settings in paralysed areas.

Treatment: intervals of 1-2 days in recent cases and 5-9 days in old cases. If improvement is
not seen by one week after session 6, AP is not likely to be successful.

2.2.5 Disorders of the respiratory system in cattle (Westermayer, Kothbauer, Grady Young,
Turnbull, Piper)
There are claims that AP alone, without antibiotics or herbal medicine, can rapidly and
effectively treat severe infections, such as cholera, dysentery and pneumonia (Anon 1979a,
1980a). AP is successful also in bronchitis, cough, asthma, 'flu etc in humans.

Lower respiratory (lung, bronchi) problems: The main points in cattle are in the area of
vertebrae T4-T8, especially BL, GV and HuaToJiaJi points, BL13-17,42-46; GV09-13 (plus
GV14, if fever is present); HuaToJiaJi beside vertebrae T4-T8.

The other Channels crossing the thorax are ST, SP, KI, GB, LV, CV. Points on these
Channels over the lung area can be used. The arm YIN Channels (LU, PC, HT) also influence
the lung, especially points LU05; PC06.

In lower respiratory problems, a careful search of the paravertebral area T4-T8 or 9 and the
intercostal area and sternal area will usually show some pain points. There are used in AP
therapy.

Few western vets claim good results with AP alone in pneumonia, lung allergy, congestion
and bronchospasm in cattle. This may be because few have tried it. Most would use Western
drugs in such cases and would use AP only as a supplementary treatment. Experts, such as
Kothbauer and Westermayer combine AP with other methods in pneumonia. Grady Young has
reported good success with cold Laser on the LU reflex points (BL13-16 area) in cattle with
shipping fever (Pasteurella pneumonia). If the claim can be verified by other clinicians, the
implications for vet and human medicine are very great. Recently, Nam et al (1996) reported
the results of a controlled trial of AP alone v AP + medication v medication alone in the
treatment of respiratory disease ('flu, bronchitis, pneumonia) in calves. AP was given daily
at ... for ... days. The results showed ...

Upper respiratory problems: AP has been used in many species (man and animals) in
disorders of the nose, sinuses, pharynx, larynx and trachea. These conditions include
inflammation (rhinitis, sinusitis etc), bleeding, signs such as coughing, hoarseness, reluctance
to swallow etc.

The choice of points for upper respiratory conditions would be based on the site of the
problem. (Is the cough due to irritation of the lung, trachea, larynx, pharynx etc or is it
secondary to circulatory failure etc ?).

The main points would be LOCAL (over or near the primary affected parts) but lung Shu and
Mu points (BL13; LU01) might be included and Distant Points such as LU05; LI04; GB20
might be added, depending on the primary affected part.

Example: Rhinitis, sinusitis: Local points would include LI20; GV24,26; YINTANG
(between the eyes in humans). Distant points from LU07; LI04. Shu point for Lung (lung
controls respiratory system): BL13.

Treatment: every 1-2 days in acute cases or 3-7 days in chronic cases.
Technique: personal preference (mainly needling or point injection).

2.2.6 AP for surgical hypoalgesia in cows

Acupuncture analgesia (APA) is not a correct term. It should be called AP HYPOALGESIA,
as it is NOT a true analgesia.

AP as a surgical analgesic has advantages and disadvantages. More details are in the attached
paper "AP ANALGESIA FOR VETERINARY SURGERY".

Teat surgery under APA was reported by Kothbauer in the early 1970s. Since then, he, White,
Lakshmipathi, Miljkovic et al and the Akita AP Research Unit (Cattle Health Centre) have
reported successful laparotomies (Caesarians, rumenotomies etc). However, not all were
perfect successes and Lakshmipathi used heavy sedation before APA.

The main problems of AP analgesia are:

a. Poor results by some operators (Baumgartner and Kanis 1983)
b. Variable results, even in skilled hands (other anaesthetic, such as xylocaine, may be needed
to supplement the APA effect)
c. Adequate restraint is needed whether operating in the standing or lying position
d. Excessive stimulation of the AP points in the GV or paraspinal area may cause the cow to
lie down.
e. No agreement as to the best combination of points for APA
f. Induction period of 20-40 minutes
g. Poor muscle relaxation may impede surgeon

Points and method used in abdominal surgery by various workers were: Figure 13 shows
the location of the main APA points in cattle and horses by Sun et al (1980). Although many
combinations of those points are possible, one might use BaiHui; TIANPING; YAOPANG 1
as the basic set, with more anterior points added for more anterior surgery and more posterior
points added for more posterior surgery.

Kothbauer: usually excellent result. Sometimes, local anaesthetic was needed. Points: BL30;
LV14 (ICS8, level with shoulder). Frequency 3-40Hz

Akita AP Res. Unit: excellent results. Different combinations were tried. Points: TIANPING;
BaiHui together were best. Frequency 30Hz.

Miljkovic et al (1981): good result in 4 caesarians but analgesia was not perfect. Points:
BL30; LV14. Frequency 3-40Hz

Lakshmipathi (1983): excellent results reported but sedation was used. Sedation
(triflupromazine 0.2mg/kg bodyweight). Points: TH08; BL30; LV14; BaiHui; TIANPING;
WEIGAN. Frequency 120-200Hz

Baumgartner and Kanis: Bad results !! Points: GV02; BaiHui; SP18; BL30. Frequency 710Hz

Lin (1984): 2/3 laparotomies needed local anaesthetic to complete. Points: BaiHui;
TIANPING

White (1985): (not full analgesia in one cow). Points: BaiHui (4-6cm); YAOPANG 1 (56cm); GV04 (4cm). Frequency 15-28Hz

At this time it seems unlikely that APA will replace drug anaesthesia but a combination of
both, especially in high-risk cases of in prolonged surgery, seems practical. APA could be
very valuable in national disaster and warfare, when drug anaesthesia may be unavailable.

2.3 AP treatment of disorders in pigs

Klide and Kung (1977) and Kothbauer (1983) discuss AP therapy in pigs and White (1985)
gives some information on EAP in pigs. Most of the points in those texts are TCVM points.
Data from those three sources were combined to produce a summary of the points and
prescriptions for the pig. The data are attached in APPENDIX 1 of this paper.

For fuller details, those texts should be consulted. In general, the selection of points in the
TCVM method is very similar to the selection in cattle or to selection by the transposition
method.

The important criteria of point selection in pigs are:

a. Select some local points (near the affected part or organ)
b. Select reflex (Shu) points when organs are affected
c. Select Distant Points related to symptoms or to the affected organ.
AhShi points are not so important in the pig and Mu points are not mentioned in the pig texts.
Mu points probably exist but have the same difficulty of use as AhShi points in pigs (too
noisy !!).

2.3.1 Disorders of fertility and the urogenital system in sows

Lin et al: In Taiwan, large field trials have confirmed the value of BaiHui and WEIKEN in
gilts and sows. These points induced oestrus in anoestrous females. The anoestrus was of two
types: delay of cycling in gilts (first cycle at 9-13 months) or delay in oestrus post-weaning in
gilts and sows. These conditions pose major problems in very hot climates and AP was as
good as hormone therapy. Many methods (point injection, simple needling, EAP and direct
moxa) were effective. Indirect moxa was not effective. Point GV04 (MINGMEN, in GV line
between L2-L3) was NOT effective in the Taiwan trials (Lin 1984). Repeat the treatment after
14 days if unsuccessful at the first attempt.

Kuussaari got 60% success with points CV01,05,08; BL23,25; BaiHui in anoestrus sows,
using manual or EAP for 10-30 minutes/day for 3 days at an interval of 3-7 days (mean 4-day
interval).

Kothbauer uses points for the uterus and mammary glands in the MMA complex (MetritisMastitis-Agalactia) in sows. These points include BL26,26.1,26.2,26.3,27; BaiHui; SP06; ST
and KI points on the abdomen.

Dystocia: EAP of points BL23-31 is very useful in the gilt or sow (Kothbauer).

Nephritis, cystitis, urinary retention: points for kidney or bladder are used (Kothbauer).
These points are similar to those in cows (see 2.2.1).

2.3.2 Disorders of the gastrointestinal tract in pigs

Lin et al: Field trials of AP in E.coli enteritis in piglets in Taiwan confirmed that AP was as
good as antibiotic (Spiramycin) in treating scour. Points used were: T 4, HL17, HN 8, HN10
(Bai Hui, Chiao Chao, Shan Ken, Yu Tang) /or/ T 18, FL 6, HL1, 7 (Pi Shu, Zu San Li,
Chiao Chao) /or/ HN 8, FL15, T18 (Shan Ken, Ti Men, Pi Shu). All three combinations
were effective when needled for 1 minute/point/day for 3-5 days (Lin 1984).

Kothbauer, White: Indigestion: points behind the last rib (BL21,50) and ST36 are very
good (Kothbauer; White).

2.3.3 Disorders of the musculoskeletal system in pigs

Musculoskeletal disorders in pigs are treated similarly to those in dogs, horses, cattle or
humans. Lumbar or hip pain in boars may cause them to refuse to mount the sow. AP can be
very effective (using points of the BL Channel in the area L3-S1 and BaiHui. If the hip is
involved, points GB30,31,34 can be added). Downer sows postpartum also respond well.

TCVM points for the joints are shown in APPENDIX 1 of this paper and transposition points
for the main joints are in APPENDIX 2 and 3 of the paper on the CHOICE OF POINTS FOR
PARTICULAR CONDITIONS.

Lin reports 25/30 (83%) cure with AP in locomotor disturbance in pigs in Taiwan trials (Lin
1984).

Pigs also suffer from a myopathic form of the Stress Syndrome. The heavy muscles of the
shoulder, back or hindquarters may become very painful and myoglobinuria, with kidney and
liver damage, may occur. The pig may show severe lameness or may seem to be paralysed in
the fore- and/or hind-quarter. Kothbauer and Westermayer have treated many of these cases
using AhShi points (the most painful point in the affected muscles) with points for the area. If
needed, points for the kidney and adrenal (GV04; BL23,52 area) and for liver (BL18-20,4749) may be added.

2.3.4 AP for surgical hypoalgesia in pigs

Chinese texts claim that AP can induce surgical analgesia in pigs. Japanese and Taiwanese
workers have tried it but Western vets do not seem to have done so. Electrical stimulation
should be strong but not too strong.

Lin (1984): a. Inguinal hernia, castration: HUI YIN (CV01), Bai Hui (GV03), 2 cases;
good result but pain when spermatic cord pulled).
b. laparotomy: AN SHEN useless in one case. Zu San Li (ST36) was good but the
peritoneum was very sensitive.
Akita AP Research Unit: abdominal and inguinal surgery: BaiHui, TIAN PING (no
statistics available but results were good)
Chan (1985): points from Chinese text for pig AP analgesia in laparotomy. AN SHEN
(behind jaw, midway base of ear to ventral edge of neck. 10 cm needle guided inside
mandible to lie near last molar. TUAN HSUEH (T 19) (3-6 cm deep); BaiHui (T 4) (3-6 cm
deep); SHEN MEN (T 20) (3-6 cm deep); San Yang Luo (TH08) to YE YAN (PC05)
GENERAL CONCLUSIONS
AP has little value as a SOLE THERAPY in acute surgical cases (such as rumen overload,
severe acidosis, life-threatening bloat, abomasal or intestinal torsion, intussusception,
displacement; rupture of internal organs etc.; fractures or severe trauma etc), acute toxaemia
(coliform or clostridial mastitis), ulcers, severe organic pathology (such as fibrosis of liver
(Senecio, ragwort poisoning) or kidneys (severe chronic urinary infections)). There is little
evidence of useful effect of AP in cancer. However, trials in laboratory animals indicate some
positive results and definite effects on immunostimulation. Similarly, in nutritional
deficiencies (minerals, vitamins etc), environmental errors (calf house too airtight, ammonia
smell etc), AP therapy will have little success on its own. Errors of nutrition and environment
must be corrected.

AP can only work as a SOLE THERAPY when there is sufficient reserve capacity in the
body's defence systems to repair the damage. However, because AP can influence all organs
and functions to some extent (if the input, integration and output pathways are intact), it can
be used as a COMPLEMENTARY therapy to almost any other form of therapy (surgical,
chemotherapeutic, physical etc).

In life-threatening conditions or in severe cases (such as acute, virulent infections), AP is

usually combined with western therapy, such as intra- venous Ca salts in hypocalcaemia,
antibacterials in bacterial infection, surgery in foreign-body reticulitis and pericarditis etc.

AP in cattle and pigs can use the TCVM system, the transposition system, or (more
commonly in western practice) combinations of both systems. This is because some important
TCVM points have poorly documented equivalents in the human system. Western vets
usually find the transposition system easier to learn than the TCVM system, whereas Eastern
vets, who can understand the Chinese written characters may find the TCVM system easy to
learn.

At its present state of development and in spite of its shortcomings and minor discrepancies
with the TCVM system, the transposition system is very valuable in large-animal AP.

In the choice of points for therapy, one must IDENTIFY the organs, parts or functions which
are affected. A careful search for Reactive POINTS associated with the affected parts helps
the diagnosis and indicates the basic AP points for treatment. Also, the best combination of
points to help the patient will usually include some Local Points, Shu and Mu points, points
according to the NERVE SUPPLY and (occasionally) Distant Points for the affected area, or
on a Channel linked to the area, or points for the SYMPTOMS.

Beginners should concentrate on learning the position and uses of points in the paravertebral
area (HuaToJiaJi, BL and GV Channel points) and the CV points. Study of points on other
Channels can follow later. Beginners who lack experience and those who lack confidence in
their own selection of points for therapy may use Cookbook AP, such as outlined in
APPENDIX 2 and 3 of the paper on the CHOICE OF POINTS FOR PARTICULAR
CONDITIONS. Cookbook AP, though frowned upon by those fully trained in traditional
methods, gives good results especially in the less complex cases.

The best method of stimulating the AP points is mainly a matter of personal experience and
preference. Point injection is one of the quickest and most practical methods and is useful in
many cases.

Large-animal AP is still a developing field. Despite centuries of use, many problems remain
to be solved and more rigorous diagnosis and documentation of therapy and results is
necessary.

Provocation experiments, such as those by Kothbauer (cows) and Schupbach (pigs) and the
clinical association of reactive AP points with pathological disorder of specific organs (Piper,
Greiff, Cain, Turnbull, Kothbauer, Westermayer) will refine further the transposition system
into a highly effective diagnostic and therapeutic method.

REFERENCES

Akita AP Research Project, Cattle Health Centre, Akita, Japan. (1980) APA successful
in cattle and pigs. Personal communication.
Altman, S. (1981) AP for animals. Contact the author at 5647 Wilkinson Ave., North
Hollywood, California, USA. 281pp.
Anon (1974) China's New Needling Treatment. Medical & Health Publishing Co.,
Hongkong. 80pp.
Anon (1974) Principles & practical use of AP anaesthesia. Medical & Health
Publishing Co., Hongkong. 325pp.
Anon (1974) The Barefoot Doctor's Manual. Running Press, Philadelphia. 948pp.
Anon (1975) Newest illustrations of the AP points (Charts & Booklet). Medical &
Health Publishing Co., Hongkong. 100pp.
Anon (1977) Basic AP: Scientific interpretation & application. Chinese AP Research
Foundation, Box 84-223 TAIPEI, R.O.C. 313pp.
Anon (1979a) Abstracts from Symposium on AP, MOXA & APA (PEKING). From
East Asia Books, 103 Camden High Street, London, UK. 517pp.
Anon (1979b) Treatment of 100 diseases by new AP. Medical & Health Publishing
Co., Hongkong. 89pp.
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ACKNOWLEDGEMENTS
Dozens of veterinary colleagues in USA, Europe and Australasia have helped me to study AP
since 1973. In particular, colleagues from the International Veterinary Acupuncture Society
(IVAS) have shared their experiences of large animal AP with me. There are too many names
to list them all but some must be mentioned:

Dr. Ichiro Asakura, Kyoto, stimulated me to write the original paper for a training course for
large-animal vets in Tokyo (1985).

The large-animal parts of this seminar are based mainly on the works of Drs. Walter Greiff,
Yann-Ching Hwang, Alan Klide, Oswald Kothbauer, Jen Hsou Lin, Sheila White and the late
Erwin Westermayer. Without them, this paper would not exist !

The human aspects of AP are based mainly on the works of Drs. Chien Chung, Willem Khoe,
Ronald Melzack, Louis Moss, Janet Travell and on many anonymous Chinese authors of
standard human texts. Drs. Felix Mann and Pekka Pontinen sent me copies of their works on
human AP. Their ideas were used.

Drs. Shelly Altman, Marvin Cain, David Gilchrist, David Jaggar, Luc Janssens, Jukka
Kuussaari, Jacques Milin, Dane Piper, Allen Schoen, John Turnbull and the late Drs. Satoru
Ishizaki and Grady Young gave me great help and material over the years.

Heartfelt thanks to all of those people and to many more unnamed and especially to my wife
Mena and our children (Oisin, Conor, Killian, Fionnuala and Ailin) for their patience when
"Daddy is busy !".
Table 1
Location of the SHU (paravertebral, Reflex) points in humans
T=thoracic; L=lumbar; S=sacral; "=tsun or body inch
POINT NAME

ORGAN

LOCATION

BL13 Fei Shu

LU lat. to inf. edge spine T3, 1.5" from GV line

BL14 Jue Yin Shu

PC

T4, 1.5" from GV line

BL15 Xin Shu

HT

T5, 1.5" from GV line

BL16 Du Shu

GV

T6, 1.5" from GV line

BL17 Ge Shu

Diaphragm

BL18 Gan Shu

LV

T9, 1.5" from GV line

BL19 Dan Shu

GB

T10, 1.5" from GV line

BL20 Pi Shu

SP

T11, 1.5" from GV line

BL21 Wei Shu

ST

T12, 1.5" from GV line

BL22 San Jiao Shu

TH

L1, 1.5" from GV line

BL23 Shen Shu

KI

L2, 1.5" from GV line

BL24 Qi Hai Shu

Qi Sea

BL25 Da Chang Shu

LI

BL26 Guan Yuan Shu Gate Origin

=
=

=
=

T7, 1.5" from GV line

L3, 1.5" from GV line

L4, 1.5" from GV line

L5, 1.5" from GV line

BL27 Xiao Chang Shu SI

slightly lat. to foramen S1

S1, 1.5" from GV line,

BL28 Pang Kuang Shu BL

slightly lat. to foramen S2

S2, 1.5" from GV line,

BL29 Zhong Lu Shu

Midback
slightly lat. to foramen S3

S3, 1.5" from GV line,

BL30 Bai Huan Shu

White circle
1.5" lat. to inf. edge spine S4,
slightly lat. to foramen S4 (TP for piriformis M.)

Table 2
Location of the MU (anterolateral thoracoabdominal, Alarm) points in humans.
ICS=intercostal space.
POINT NAME

ORGAN

LU01 Zhong Fu

LU

LOCATION
near coracoid process in lat. part of ICS1

CV17 Shang Zhong PC

CV line, between nipples, level with ICS4

CV14 Ju Que
xiphisternal J.

CV line, 3/4 way between navel and

HT

LV14 Qi Men

LV

in ICS6, directly below nipple (ICS4)

GB24 Ri Yueh

GB

in ICS7, directly below nipple (ICS4)

LV13 Zhang Men

SP
on midaxillary line, just below tip of rib 11
(second last; "floating rib")
CV12 Zhong Wan
ST
umbilicus/xiphisternal J.

CV line, midway between

CV05 Shi Men

mid umbilicus

TH

CV line, 3" above pubic symphysis, 2" below

GB25 Ching Men

KI

just ant. inf. to tip of rib 12 (last)

ST25 Tien Shu

(CV08)

LI

2" from CV line, level with mid umbilicus

CV04 Guan Yuan

mid umbilicus

SI

CV line, 2" above pubic symphysis, 3" below

CV03 Zhong Ji
mid umbilicus

BL

CV line, 1" above pubic symphysis, 4" below

Table 3
Names, code, number of AP points, first and last point of each Channel. LU to LV
inclusive are the 12 bilaterally symmetrical pairs. CV and GV are the midline Channels.
ORGAN-CHANNEL

CODE

SYSTEM

NUMBER

FIRST POINT

LAST POINT

OF POINTS

LUNG

LU

11

ICS1 near coracoid

thumb nail

COLON, LARGE

LI

20

index fingernail

nostril wing

STOMACH

ST

45

orbit below pupil

lat. nail toe2

SPLEEN

SP

21

med. nail toe 1

lat. thorax

HEART
HT
side nail of finger 5

INTESTINE

SMALL INTESTINE

SI

19

axilla
ulnar side of nail

rad.
ant. to ear

of finger 5
BLADDER

BL

67

med. eye canthus

lat. nail toe5

KIDNEY
clavicular space

KI

27

sole of foot

sterno-

PERICARDIUM
3

PC

lat. to nipple

tip of finger

rad. nail

lat. to orbit

HEART CONSTRICTOR, CIRCULATION-SEX

TRIPLE HEATER

TH

23

of

finger 4
GALLBLADDER

GB

44

lat. eye canthus

lat. nail toe4

LIVER
nipple

LV

14

lat. nail toe 1

ICS6, below

CONCEPTION VESSEL

CV

24

between vulva

bottom lip

and anus
GOVERNING VESSEL

GV

28

between anus

inside top lip

and coccyx

Table 4
Kothbauer's pain points in the cow have diagnostic and therapeutic value. They are
often reactive to palpation when the organ is irritated. The codes used here are amended
according to the IVAS convention from those used by KOTHBAUER (see Figures 3a3c). Some points differ in coding and location from those used in the ROGERS
transposition system.
ORGAN

REFLEX (SHU) POINTS

LUNG

BL16,17,44-01,45,45-01,46,

ALARM (MU) POINTS

BL46-01,47,47-01
HEART

BL15

PERICARDIUM

BL14,15; GB21 (PERICARDITIS)

RUMEN
(LEFT)BL48-01
SP12,16,17,18; GB24-1,24-01
CARDIA OF RUMEN

CV17,18 CIRCULATION
(LEFT) LV13-2,14;

BL19

RETICULUM
LV13,13-1; GB24-01,24-1; SP17,17-1,18

(LEFT)
(RIGHT) LV13-2

OMASUM

(RIGHT) BL18,19,49,49-01,49-02
(RIGHT) BL48-03

(RIGHT) SP17,18

ABOMASUM

(RIGHT) BL18,19,49,49-01,49-02

(RIGHT) SP12,17,18

SMALL INTESTINE (RIGHT) BL51-1,51-2,51-3

(RIGHT) ST22

LARGE INTESTINE, (LEFT) BL51-1,51-2,51-3

COLON
LIVER

(RIGHT) BL18,19,20,49,50

(RIGHT) LV13-2,14

GALLBLADDER
GB25,25-1

(RIGHT)

SPLEEN-PANCREAS BL48-01
BLADDER

BL29

KIDNEY

BL22,23

OVARY

BL23

UTERUS HORN

BL27 (ANT. TO ILIAC WING)

SP13

GB27

BL28-1, 47 (ILIAC WING)

UTERUS HORN,

BL28

(PREGNANT)
UTERUS BODY

BL28

CERVIX

GV03

CERVIX (INTERNAL) GV3-01

CERVIX (EXTERNAL) BL31
REPRODUCTIVE DISORDER

BL24

ANOESTRUS WITH SMALL, INACTIVE OVARY

HOCK (TARSUS)

BL30,30-01

UDDER (HINDQUARTER)

BL30,30-01

UDDER (FOREQUARTER)

(NOTE:

CV17,18

KI10
SP18

SP13 CAN DIFFERENTIATE BETWEEN OVARY AND KIDNEY PROBLEMS)

Table 5
Location of SHU points in humans, cow, pig.

Below spine of Thoracic vertebra number

3

HUMAN

LU

PC

HT

GV

KE

COW

LU

HT

PIG

10

11

12

13

LV

GB

SP

ST

KE

LV

GB

SP

LU

HT

KE

LV

GB

14

15

ABSENT )

ST (ABSENT)
SP

ST

ST

Below spine of vertebra number

Lumbar
1

Sacral
5

----------------------

--------------

HUMAN

TH

KI CHI

LI KUA

SI

COW

LI KUA

SI

PIG

LI KUA

SI

BL CHU Bai

KE=diaphragm (diaphragm, blood, haemorrhage)

CHI=ChiHaiShu, Sea of Energy Shu (reproduction, uterus)
KUA=KuanYuanShu, Gate Origin Shu (lower abdominal organs and back)
CHU=ZhongLuShu, Middle of the Back Shu (lower abdominal organs and back)
Bai=BaiHuanShu, White Circle Shu (anus, vagina, metritis)

Table 6
Examples of Local, Regional and Distant Points for musculo-skeletal problems (see
APPENDIX 2 and 3 of the paper "CHOICE OF POINTS FOR PARTICULAR
CONDITIONS" also).
AREA

LOCAL POINTS

REGIONAL POINTS

DISTANT POINTS

Neck

GB20,21; BL10,11

Shoulder

LI15; TH14; SI09,11

GV14; LI11,15

LI04,11

Elbow

LI11; HT03; LU05

GV14; LI11,15

LI04; TH05

Lumbar

HuaToJiaJi (T13-S1)

GV03; BL23

BL40; GB34

GB39; ST38; SI06; TH05

BL23-26,50,51
Sacral

HuaToJiaJi (L6-S4)

GV03; BL23

BL40; GB34

BL27-34,52,53
Hip

GB29,30

GV03; BL23

GB31,34

Stifle

ST35,36; GB33,34;

GV03; BL23

GB39; SP06

BL40; SP09
Hock

BL60; KI03; GB40,41;

GV03; BL23,30,31

ST41; BL62

BL35,53,54

Fig 1. Shu (paravertebral Reflex) points in humans.

Fig 2. Mu (thoraco-abdominal Alarm) points in humans.
Fig 3a. KOTHBAUER'S diagnostic points in the cow
Fig 3b. KOTHBAUER'S diagnostic points in the cow
Fig 3c. KOTHBAUER'S diagnostic points in the cow
Fig 4. Schupbach's "Hot Zone" following irritation of the uterus body and
horn in minipigs. The most consistent
Hot Spot was over the iliac wing, corresponding to BL26.3 in the
transposition system.
Fig 5. Location of the Shu points in cattle by transposition (ROGERS) (1)
and by TCVM (2)
Fig 6. Location of the Shu points in pigs by transposition (ROGERS) (1)
and by TCVM (2)
Fig

7-13

(Lin 1985)

Fig 14-20

(Klide & Kung 1977)

Fig 21-23

(Kothbauer 1983)

Fig 24 (White 1985)

QUESTIONS
The IVAS convention for human point codes puts BL36 in the centre of the buttock crease,
below the tuber ischii; BL40 (WeiChung, WeiZhong, old BL54) in the centre of the popliteal
crease and BL41 as the lateral paired point of BL12.

1. One of the following statements is not correct. Indicate the incorrect statement:

a. Oswald Kothbauer (Austria), documented the reflex (Shu) points in cattle

b. He injected irritants into specific organs (cervix, ovary, uterus, kidney etc) and found
provoked reflex changes in the paravertebral area, using an electrical "Pain Point Detector"
c. The "Pain Point Detector" detected points of high electrical resistance (low conductivity).
Low conductance corresponded with reactivity to pressure-probing.
d. The reactive points could also be found by searching with a blunt scissors or other probe.
e. When the reflex points were located by the probe (electrical or mechanical), the cow
reacted by kicking or trying to escape or vocalising etc, due to increased reactivity to
palpation or to pain stimuli applied at the reflex point.

2. One of the following statements is not correct. Indicate the incorrect statement:
a. HuaToJiaJi points, (X 35 in the computer lists), are not on the Channel system of humans.
They lie over the wing of each vertebra, near the junction with the body of the vertebra,
between the medial line of the BL Channel and the GV Channel in the area C1-S5, one pair
(left and right) for each vertebra.
b. HuaToJiaJi points are most important points, named after Hua-To, a great doctor in
ancient China. They are used mainly as LOCAL points, influencing LOCAL problems and
also influencing organs or organ functions nearby.
c. In neck problems, one might use X 35 points at C1 and C7 vertebrae, with TPs and SI03
with BL62 or ST38 or GB39.
d. In nephritis, one might include X 35 points in the area T1-T4. In fatty liver (hepatic
degeneration after calving): include X 35 in area L4-S2
e. In point selection of AP points for therapy, always consider reactive points, wherever they
are

3. One of the following statements is not correct. Indicate the incorrect statement:
a. In cattle, the BL Channel has THREE LINES on the thoraco-lumbar area
b. BL13 lies 2 fingers from the GV line just above the postero-superior angle of the scapular
cartilage, level with the posterior edge of the spine of T5.
c. BL21 lies behind the last rib, in front of the transverse wing of vertebra L1. BL17 lies
midway between BL13 and BL21. It can be used to locate any point between BL13-21 by
counting the required number of spaces forwards or backwards from BL17.

d. BL26 lies between the transverse wings of vertebrae L5-L6, 3-4 fingers ant. to the ant. edge
of the wing of the ilium.
e. BL27,28,29,30 lie LATERAL to the 4 sacral foramina respectively
f. Between BL14-30, the medial BL line runs about 1 hand (4 fingers) from the GV line
(dorsal midline).

4. One of the following statements is not correct. Indicate the incorrect statement:
a. One of the amazing similarities between Traditional Chinese Vet Medicine (TCVM) in
cattle and pigs and the human Transposition System is the identical locations of the TCVM
Shu points and the human Shu points.
b. Many points of the human BL Channel (paravertebral Channel) do not appear on the
TCVM charts
c. It seems certain that stimulation of the animal in regions corresponding to the (missing)
points would have similar effects to those in humans, because of similarity of spinal
innervation.
d. In practice this may not matter much, as it is well known that each organ in the thorax and
abdomen is innervated by branches from 3-5 spinal nerves.
e. One would expect some overlap in the locations of Shu points and many possible Shu
points for each organ, both longitudinally as well as laterally.

5. Important points relating to reproductive function and genitalia are in the lumbosacral area. One of the following statements is not correct. Indicate the incorrect
statement:
a. ovary/testis points include BL22,23,51,52; GV04,05, especially BL23
b. tubes/uterus horn points include BL24,25
c. uterus points include BL26,26.1,27,28,31,32; GV03
d. cervix/vagina/penis points include GV02,03; BL29,30,31,33,34
e. ovary/testis has no relationship to GB25

6. One of the following statements is not correct. Indicate the incorrect statement:
a. BL44 is the lateral paired point of (=) BL15

b. BL49 = BL20
c. BL52 = BL23
d. BL53 = BL27
e. BL54 = BL30

7. This question refers to traditional veterinary AP points. One of the following

statements is not correct. Indicate the incorrect statement:
a. Animal Yin Ti is in the clitoris; its functions are similar to those of human CV01 and
CV02.
b. Animal Shen Shu (KI Shu) is 2.5 tsun lateral to Bai Hui; some of its functions are similar
to those of human BL23.
c. Animal Tian Ping is on the GV line in the thoracolumbar space; is functions are similar to
human GV05
d. Animal San Tai is on the GV line between the spines of T3-T4; is functions are similar to
human GV12 and BL13
e. Animal Ye Yan (Night Eye, = equine chestnut) is on the medial side of the forearm, at the
midpoint of radius; its functions are similar ro those of PC04 and 05
f. As in humans, animal Xiao Chang Shu (SI Shu) is 2 vertebral spaces anterior to
DaChangShu (LI Shu).

8. This question refers to traditional veterinary AP points. One of the following

statements is not correct. Indicate the incorrect statement:
a. Animal Bai Hui is in the lumbosacral space; its functions are similar to ShihChiChuiHsi, a
New point in humans and human GV03
b. Animal San Yang Luo is on the medial edge of forearm, about 1/3 of the distance between
the carpus and olecranon; its functions are very different from those of human TH08
c. Animal Yu Tang is on the dental pad, at openings of nasopalatine ducts; its functions are
similar to human GV26,27,28
d. Animal Wei Ken is on the GV line, in the sacrococcygeal space; its functions are similar to
those of human GV02
e. Animal Yung Chi is between the transverse processes of L5-L6; its functions (especially on
the uterus and reproductive system) are similar to those of human BL26

f. Animal Yao Pang 1 is below the tip of transverse process of L1; its functions (especially on
the ovary and reproductive system) are similar to those of human BL22.
1=c2=d3=a4=a5=e6=d7=f8=b

A BRIEF HISTORY OF ACUPUNCTURE (AP) AND THE STATUS OF

VETERINARY AP OUTSIDE MAINLAND CHINA
ABSTRACT
Traditional Chinese Medicine (TCM) was practised before 1766 BC but the first medical text
was the Nei Ching Su Wen (Yellow Emperor's Classic of Internal Medicine), c. 300BC. The
Nei Ching detailed the AP system as well as other medical knowledge. Horses were very
important and "horse priests" practised their trade from at least 1766 BC. Many texts on
veterinary medicine were written in the period 221 BC to 1608 AD.
Texts on human acupuncture (AP) were available since the Nei Ching but the first detailed
text on equine AP was Yuan Heng Liao Ma Chi (Treatise on horses), by veterinarians Yuan
and Heng in 1608 AD. The practice of human and equine AP almost certainly predates the
publication of those texts.
Human AP was introduced to Europe by Jesuits returning from Macao and Peking in the late
1500's and early 1600's. Harvieu, a Jesuit, translated the first work on AP into a European
language (French). The practice of AP in Europe fell into disrepute, probably because of poor
training and consequent poor results.
Soulie de Morant, a diplomat returning from Shanghai in 1927, translated more modern
Chinese works into French (Precis de la vraie acupuncture, 1934). This work was the
foundation of the French AP school and spread to Germany and Austria.
European pioneers of modern vet AP in the 1950's and 60's included Kothbauer (Austria),
Milin (France) and the late Westermayer (Germany). American pioneers, coming to the field a
little later than the Europeans, included Altman, Bressler, Cain, Jaggar, Klide and the late
Grady Young.
International publicity on AP, following visits of western professionals to China in 1971 1972, was a factor in the founding of the UCLA Vet AP Research Project in 1973, the
National Association of Vet AP (NAVA) in California and the International Vet AP Society
(IVAS) in 1974. IVAS, now the biggest organisation for vet AP outside the East, has members
or informal contacts in 38 countries. Its aims include working for the full integration of AP
into vet science and the standardisation of training internationally. To this end, IVAS, where
possible, provides intensive courses in countries which require this.
Although human and vet AP has gained much ground in the last 14 years, its status is insecure
in many countries. There are confidence tricksters and Diploma sellers hidden among genuine
AP practitioners. Many academics feel threatened by the esoteric language and concepts of
the purist AP schools and by the apparent difficulty in learning it. Surgeons feel threatened by
claims that AP can treat many conditions which they regard as needing surgery. The drug
industry is not enthusiastic about the wide-scale replacement of drug therapy by AP. (They are
justified in some respects but veterinary chemotherapeutic drugs are likely to remain the
main-stay of western vet medicine for the foreseeable future).
Scarcity of controlled experimentation and clinical trials, together with inflated or biassed
claims by uncritical practitioners fuel the fears and prejudices of its sceptics and its enemies.

IVAS and National groups have much work to do before AP is fully integrated into human and
vet medicine. Thorough documentation of the successes, relapse rates and failures of AP are
needed. AP must be made as simple as possible. To gain scientific acceptance, all unnecessary
AP theory and practice and the more lunatic (advanced ?) fringes of AP must be rejected or
consigned to "special interest groups".
INTRODUCTION
Vet AP is gaining ground internationally. Organised National groups exist in many countries
now. Nuclei of practitioners, at present unorganised, exist in many others. The Antwerp
Congress stimulated great enthusiasm and played a definite role in spreading interest to
Scandinavia. The full IVAS Course was held with about 35 participants in Oslo. A course on
small- animal AP has been held in Denmark and one on horses is planned for October 1988.
(Both of these resulted from Antwerp). The Postgraduate Veterinary Committee of Sydney
University has invited Drs. Luc Janssens and Phil Rogers to give a 5-day intensive Course in
1991.
Theses or Dissertations on AP have been accepted by Vet Schools in Austria, Belgium,
Czechoslovakia, France, Germany and Switzerland. Vet Schools in Mexico, U.S.A., Germany,
are beginning to take AP much more seriously than, say, five years ago. National or State Vet
Associations, for instance in Taiwan, Japan, Austria, Finland, Germany and Belgium have
accepted AP as a valid modality and the American Vet Med Association may has accepted it
as valid in 1988.
On the surface, the future of vet AP seems assured. But is this so ? We must be very careful.
Our baby is very fragile and there are wolves outside the nursery, ready to savage it to death.
A brief history of human and vet AP will be given before discussing its status and its possible
future. Dr. Martin Parkinson, Guildford, U.K. sent me much material on the history and texts
available in 1974 - 1977. More details were taken from Klide & Kung (1977) and Janssens
(1987), to whose reviews readers are referred.
1. BRIEF HISTORY OF HUMAN AP
500-300 BC : Huang Ti Nei Ching (Canon of Internal Medicine) had two parts (Su Wen and
Ling Shu). They outlined TCM theory (YIN/YANG, Five Elements, the meridians, Qi etc).
265 AD : Chen Chiu Chia Yi Ching (Classic of AP and moxibustion)
550 AD : monk Zhi Cong brought Ming Tang Tu (Manual of channels and AP points) and
Chen Chiu Chia Yi Ching to Korea and Japan.
1026 AD : Tong Ren Shu Hsueh Chen Chiu Tu Ching (Manual on points for AP and
moxibustion on a bronze figure)
1220 AD : Chen Chiu Zi Sheng Ching (Classic of AP and moxibustion)
1341 AD : Shi Si Ching Fa Hui Zi Sheng Ching (Enlargement of the 14 Channels)

1601 AD : Chen Chiu Ta Cheng (Compendium of AP and moxibustion by Yang Jizhou. This
has been one of the main sources of information for 400 years).
1575-1675 AD : Human AP was introduced to Europe by Jesuits returning from Macao and
Peking. Harvieu, a Jesuit, translated the first work on AP into a European language (French,
1671). The practice of AP fell into disrepute in Europe, probably because of poor training and
consequent poor results.
1665 AD : Japanese Okamoto Ippo published on the Meridians
1676 AD : Hermann Busschof published "Moxibustion" (Chiu) in English (London)
1683 AD : Willem Ten Rhyne published Dissertatio de Arthride : mantissa schematica: de
Acupunctura (in Latin), London
1693 AD : Japanese Kiosho Kotsuju published on the Meridians
1863 AD : Pierre Dabry published Le Medicine chez les Chinois (Plon, Paris). It included a
section on Vet AP
1927 AD : Soulie de Morant, a diplomat, returned from Shanghai. He translated more modern
Chinese works into French (Precis de la vraie acupuncture, 1934). This work founded the
French AP school. Spread to Germany and Austria.
2. BRIEF HISTORY OF VETERINARY AP
1766-1122BC : The "Horse Priests" responsible for treating army horses
1122- 222BC : Chao Fu, the first DVM
403- 221BC : Nei Ching and Nan Ching probably used by "Horse Priests"
221BC- 220AD : Nei Ching and Nan Ching probably used by horse-doctors
221BC- 220AD: Shen Nung Pen Ts'ao Ching (Herbal medicine) probably used by horsedoctors
221BC- 220AD: A few texts on animal diseases were published
220- 907AD : Chia I Ching and Ch'ien Ching Fang probably used by vets
220- 907AD :: Many vet texts were published
220- 907AD :: Formal vet education
960-1368AD : Formal storage of vet medicines
960-1368AD :: New vet texts and re-writes of older ones

1368-1644AD : Yuan Heng Liao Ma Chi (Horse treatise) - the first text in detail on horse AP
by vets Yuan and Heng, preface by Ting Ping 1608
1368-1644AD :: Ma Shu (Book of Horses)
1368-1644AD :: Lei Fang Ma Ching (Prescriptions for Horses)
1368-1644AD :: Niu Shu (Book of Cattle)
1644-1912AD : Texts on horses, cattle, camels, pigs, nutrition and ploughing
1863AD : Pierre Dabry published Le Medicine chez les Chinois (Plon, Paris). It included a
section on Vet AP
1912-1958AD : 1917 Shanghai School of Vet Med (private)
1912-1958AD :: no formal vet training at national level but various western style schools
existed
1912-1958AD :: 1947 Vet Med Depts. in Agricultural schools
1912-1958AD :: 1955 new translations of horse and cattle classics in modern vet terminology
1912-1958AD :: 1956 2 new Chinese vet journals
1912-1958AD :: 1958 Committee to review Chinese, Japanese and Korean vet classics. Of >
70 known, only 16 survived
1958-1972AD : AP analgesia in man (1969 in animals)
1958-1972AD :: clinical and experimental studies on AP and its mechanisms
1958-1972AD :: many new books on vet med
1972 : Shou I Shou Chai (Handbook of Vet Med) combines Chinese and western methods
1950's and 60's: Vet AP pioneers included Kothbauer (Austria), Milin (France) and the late
Westermayer (Germany). American pioneers included Altman, Bressler, Cain, Jaggar, Klide
and the late Grady Young.
1971-1972 : western professionals report on visits to China
1973 : founding of the UCLA Vet AP Research Project
1974 : National Association of Vet AP (NAVA) in California
1974 : International Vet AP Society (IVAS). IVAS has members or informal contacts in 38
countries. IVAS courses.

1977 : First translation of traditional large animal vet AP texts in English (Klide and Kung
1977).
1980 : Finland accepts AP as valid medical and vet modality
1986 : New South Wales Vet Board accepts AP
1987 : IVAS Congress in Antwerp; great response
1987-1988 : Austria, Germany accept vet AP as valid therapy.
1988 : South Africa and A.V.M.A. (America) recognise vet AP.
1988 : IVAS Training Course in Oslo
1990 : IVAS Training Course in Brussels. IVAS Congress in Noordwyk (Netherlands)
1991 : 5-day intensive postgraduate training course in Sydney Vet School
1992 : Vet AP Course in the Copenhagen Vet School
1993 : IVAS Congress, Tromso, Norway. IVAS Course, Skara, Sweden
1994 : IVAS Course planned for Belgium.
Following the re-introduction of AP to France by Soulie de Morant in 1927, a few vets in
France, Germany and Austria began to use it in the 30's and 40's but little or nothing was
published of their results.
In 1954, the first western thesis on vet AP was published by Benard (Vet School, Alfort,
Paris).
In the late '50s and early '60s Kothbauer (Austria) used classic provocation experiments to
locate the reflex points for the main internal organs in cattle. He injected irritants (Lugol's
iodine solution) into specific organs of cattle destined for slaughter and located the reflex
points using an electrical point detector. He confirmed the therapeutic effect of Kothbauer's
Points in clinical practice. Later, he became the first vet in Europe to use AP analgesia for
surgery in cattle (teat surgery and caesarian section). He has published many articles and a
textbook, mainly on bovine AP. His contribution to AP was recognised by his election to the
presidency of IVAS 1987-1988. Kothbauer, Kuussaari and Westermayer used AP successfully
for the reposition of prolapsed uterus, dystocia and infertility in cows.
Milin (Paris) used AP in small animals since the '50s. He used an electrical point detector on
dogs to locate the points, from which he drew up AP charts. His work confirmed that the
transposition method could be used in dogs. From 1963-, he published his results, mainly in
rhematological, orthopaedic and gynaecological disorders. His contribution was recognised by
his election to the presidency of the French Vet AP Assoc. (l'AVAF) for many years.
European and American scientists and professionals visited China in 1971 - 1972. The
ensuing international publicity given to Chinese science, including AP, fired the imagination

of western clinicians and researchers. Pioneers like Milin (Paris), Kothbauer (Austria) and
Westermayer (Germany), who had been using AP in their practices for 10 - 17 years before
that time, must have felt vindicated at last.
Following correspondence with these pioneers, Rogers & Ottaway (1974) and Rogers, White
and Ottaway (1977) documented the clinical claims in the accessible literature. Since then,
many clinicians and researchers have published reviews, experimental data and clinical
articles in conventional vet publications as well as in specialist AP journals and newsletters.
In the 1970's and 1980's, clinicians, postgraduate students and staff members at some
European and American universities began to publish results of basic and clinical studies on
AP in animals. Some who have made significant contributions are :
Luc Janssens (Antwerp)
Pragmatic, scientific approach to AP. Studies on point locations, AP analgesia, rheumatology,
disc disease, trigger points, arthrosis, resuscitation in dogs
Yann Ching Hwang (Tuskeegee, Alabama)
Studies on piglet diarrhoea; co-editor of FAO Vet AP textbook with Yu Chuan (1990)
Alan Klide (Philadelphia)
First translation of traditional vet AP texts in English. Studies on point injection and laser on
backpain in horses (Martin and Klide 1987).
Jen Hsou Lin (Taipei)
Studies on anoestrus, infertility in gilts/sows and diarrhoea in piglets
Roland Muxeneder (Vienna)
Clinical effects of laser on wound healing, eczema and oedema in horses
T.D. Olesen (Los Angeles)
Confirmation of the diagnostic value of earpoints in humans
Bruce Pomeranz (Toronto)
Published the first experimental evidence (January 1977) that endorphins/enkephalins are
involved in AP analgesia. Rogers, from literature reviews, predicted that in December 1976
M. Schupbach (Zurich)
Infrared thermography to detect points for the uterus in pigs and confirmation of the effects of
stimulating the points
Jan Still (Brno, Czechoslovakia; now MEDUNSA, S. Africa)

Brilliant work on detection of earpoints in the dog and on many clinical applications of
earpoint and bodypoint AP in small animals
Hector Sumano (Mexico City)
Very good work on AP and electrostimulation on wound and burn healing; infertility in cows;
AP analgesia in dogs; non-distemper induced epilepsy in dogs; polyarthritis in parrots.
Erwin Westermayer (Germany; deceased May 1990)
Clinical studies of AP in cattle, especially in relation to metabolic and reproductive disorders.
Two textbooks.
Sheila White (Murdoch, West Australia)
Introduced course on alternative medicine to Murdoch Vet school. Preparing anatomical
charts of the AP points in horses. Textbook on electro-AP in horses.
Charlotte Frigast (Copenhagen Vet School)
Brilliant work on the importance of the cervical nerves for normal gait in horses.
Details of their work, and that of many other pioneers, are given elsewhere in the Course.
Meanwhile, in the U.S.A., vet AP was pioneered by two main groups, the National
Association of Vet AP (NAVA) and the International Vet AP Society (IVAS).
NAVA was founded in California in 1974. It arose from the good clinical results obtained by
the UCLA Vet AP Research Project in 1973. Founder members included Shelly Altman, David
Bressler, Richard Glassberg, John Ottaviano and Hoddy Warner.
IVAS also was founded in 1974. Its founder members included Marvin Cain, David Jaggar
and the late Grady Young. Because of the difficulty of running two vet organisations in a
minority speciality, many members of NAVA joined IVAS and NAVA wound down.
IVAS, now the biggest organisation for vet AP outside the East, has members and informal
contacts in 38 countries. Its aims include to work for the full integration of AP into vet science
and to try to standardise international training. To this end, IVAS, where possible, provides its
basic course (or shorter ones if needed) in countries which require this. Only registered vets or
vet students in their final years may take the IVAS course. The basic course is 120 hours of
concentrated lectures and demonstrations spread over 4-5 weekends in a year. Students are
expected to study selected textbooks. At the end of the course, they sit a 3-hour written
examination. Candidates who pass and who present 5 detailed case reports are accredited as
competent to practice vet AP.
3. THE STATUS OF VETERINARY AP OUTSIDE MAINLAND CHINA
In an attempt to establish the current status of Vet AP outside China, I sent questionnaires to
IVAS members or personal contacts in 38 countries in 1986. Since 1975, I have had requests
for published work on AP from many countries not listed below. These included : Spain, Italy,

African states, the middle East, Israel, Argentina, Costa Rica, Cuba, Brazil, New Zealand,
Korea, the Phillipines and many Soviet Block countries. The 1986 questionnaire did not elicit
replies, or the replies indicated little interest in AP at that time.
The summary which follows comes mainly from the 1986 data, with some updating from
more recent contacts (1990-1993). Countries are listed alphabetically. It is impractical to list
the names of all contacts in a brief paper. Therefore, I will mention only some people who
have been or are active in their countries. I apologise to any who may feel offended by the
omission of their names.
Australia : The NSW Vet Board rejected AP as a vet modality in winter 1985. I was allowed
to see the Committee's report. A medical and two good vet AP clinicians presented the case
for AP. They presented too much anecdotal material and too little scientific documentation in
support of vet AP. A few months later, following the submission of properly documented
arguments, the Board reversed its decision and classed AP in animals as an act of vet surgery.
The result demonstrates the necessity of selecting well briefed people, with good
documentation, to present the case to the official authorities. YIN/YANG, Five Elements and
an uncle whose cat "got better" after AP cut no ice with academics and vet councils !
The official status of vet AP in other Australian states is undeclared. The Australian Vet AP
Assoc was formed in the early '80s. Although training courses and seminars have been run,
only 1.0-2.5% of vets use AP. Sydney University Vet School ran a 30-hour intensive AP
course for postgraduate veterinarians in 1991.
Rebecca Palmer (109 Wannan Place, Ainslie, A.C.T. 2602) was President of AVAA 1988.
Chris Robinson is President in 1993.
Ulricke Wurth (63 Barrabool Rd., Highton, VIC) is AVAA Secretary and editor of its
Newsletter.
Sheila White (Dept. Anat. and Vet Biol., Murdoch Vet School, West Australia 6150, see
section 2) has used AP analgesia successfully in cows.
David Gilchrist published (1981) a short but excellent manual of AP for small animals.
Jean Paul Ly was one of the pioneers of vet AP in Australia. He published good clinical results
in lowback problems in horses and dogs.
Austria : Vet AP is accepted as a valid modality. Pre-1986, < 1% of vets used it but
Kothbauer says its use is increasing rapidly.
Oswald Kothbauer (Windberg 2, Grieskirchen, Oberosterreich) (mixed practice, mainly cattle,
see section 2) has taught AP in Vienna Vet school to > 250 students. Cooperation is good with
the medical AP association and the Ludwig Boltzmann Institute for AP, Vienna.
Ferdinand Brunner (small animal practice) has published on clinical AP and a textbook on
canine AP.
Roland Muxeneder (see section 2) 4230 Pregarten Mitterfeld 2, Austria

Alois Holtzman, Vet School, Linkebahngasse, Vienna is a teacher/researcher in cattle

diseases, especially infertility
Belgium : Vet AP accepted as valid modality. Pre-1986, < 2% of vets used it. Janssens puts
the figure at 10-20% now (the highest % in any country surveyed outside China).
Luc Janssens (Oudestraat 37, Wilryk 2610, Antwerp) (small animal practice, see section 2) is
leader of the Belgian group (BVDA). He has run training courses, recognised by IVAS, for
many years. BVDA has close cooperation with the national medical AP Assoc.
Canada status of vet AP unknown. It is practised by < 0.5% of vets.
Frank Milne, Vet School, University of Guelph, Ontario is interested
Lloyd Mc Kibbin (Wheatley Hall Farm, Wheatley, Ontario) has reported excellent results in
soft tissue pain in horses and in laser treatment of tendon strain.
Ronald Melzack (Montreal University) has confirmed the diagnostic and therapeutic value of
trigger points. He also confirmed that 70% of trigger points in humans correspond with AP
points. His "Gate Control Theory" of pain is modified to include at least two gates, one in the
spinal cord (dorsal horn) and one in the thalamus.
Bruce Pomeranz (Toronto University) has done many studies confirming the role of
neuropeptides and neurotransmitters in AP effects. He has also done studies which confirm a
beneficial effect of electrostimulation on axon regeneration. (The negative electrode is distal
and the positive proximal to the lesion).
China : Although the paper does not cover the status of Vet AP in China, readers may be
interested in the following : Vets may take 6-week intensive training in Vet AP in Beijing from
mid June to end of July each year. Contact Dr. Qinglan Wang, (Vet AP Course teacher Peking)
Coll. Vet. Med., Beijing Agricultural University, Beijing 100094, People's Republic of China
Czechoslovakia : AP is accepted officially as a valid vet therapy but is used by < 0.4% of
vets.
Jan Still (see section 2), with colleagues in the Brno Vet School before he left to work in
Belgium and S. Africa, did major research projects on diagnosis using the ear points in dogs,
therapy of many clinical conditions using ear and body AP points. The results are published.
Jan is now on the teaching faculty of the MEDUNSA Vet School, Pretoria, SA.
Milan Stourac, Petr Jahn and Margita Dostalova are still researching AP in animals at the Vet
School, Palackeho 1-3, 61242 Brno, CSSR
Kraus Miroslav, (ul Zdenka Fibicha 2672/314, 43401 MOST, CSSR) has had success with AP
in resuscitation and disc disease in dogs.
Denmark : The official status of vet AP is unstated. Danish vets have become interested only
recently and c. <1.0% of them use it. The Danish group has increased in numbers between
1988-1993. They have held numerous training courses, including one in 1992 in the
Copenhagen Vet School.

Birgit Petersen, Sophiendal Gods, Veng, Skanderborg 8660 leads the national vet AP group.
She has organised training courses for vets in 1987.
Charlotte Frigast (Bavneved 2, 4171 Gunso, Denmark) has done her PhD Thesis on the
influence of the first 4 cervical nerves on coordination in horses, neurophysiologic
considerations on the use of AP and chiropractic manip-ulation related to biomechanical
dysfunction and pain related to the 5 layers of the medulla. She has proved the importance of
normal vertebral alignment and of cervical proprioceptive afferent stimuli in maintaining
normal gait. Her video, showing the effect of local block of the afferent cervical nerves in
horses should be a mandatory part of the undergraduate course in all veterinary schools.
Finland accepts vet AP as a valid modality since 1980. It was the first country outside the Far
East to do so. c. 10% of vets use AP, but many of them use it in restricted ways (e.g. VG26 for
emergencies or trigger point therapy in myofascial pain).
Jukka Kuussaari (25460 Toija) leads the national group. He is leader of the IVAS Horse Text.
He has had success with AP in horses (myofascial problems, aerophagia), cattle (prolapsed
uterus), dogs (myofascial problems, reprod-uctive disorders, resuscitation).
The vet AP group cooperates well with the medical AP group, led by Pontinen. That group is
researching chronic pain, especially myofascial pain, trigger points, cold laser and TENS.
France : Human and vet AP have been used for a long time and are recognised as valid
therapies. l'Association Vet AP de France (l'AVAF, 115 rue d'Amiens, 6000 Beauvais) runs
training courses in cooperation with the Vet schools. More than 400 vets have been trained.
AP is used by < 3% of vets.
AP research has been done and many Theses on vet AP have been accepted by French Vet
schools. They include theses by Benard, Collignon, Jeannot, Molinier and others.
Jacques Milin (Residence du bois be Boulogne, Dauphine 1, 95290 l'Isle Adam, France) was
President of the national group l'AVAF for many years (see section 2). He was my first contact
in vet AP and was very helpful in my study of AP. He put me in touch with Kothbauer and
Westermayer. I am most grateful to these three, who have enriched my mental life and given
me an insight on health/disease which grows year by year.
R. Arambarri, A. Autefage and A. Cazieux were among the earliest Europeans to experiment
with AP analgesia in dogs.
Andre Demontoy (2 rue du Tage, 75013 Paris) and Frederick Molinier (Dept. Anatomy, Vet
School, Alfort, Paris) have published excellent textbooks on canine AP in 1986.
Rene Jeannot (62 Cours Desbiey, 33120 Arcachon) has documented locations of earpoints in
dogs with known pathology.
Eric Manet, Laboratoire Departmental, 18 Gallieni, 85000 La Roche, Lyon has good results
with AP in functional diseases in dogs.
Dominique Giniaux (320 rue Vieux Chateau, 60520 La Chapelle en Se, France) is one of the
best known equine osteopaths in the world. He stresses the importance of spinal adjustment in

maintaining peak performance in horses. He has also researched Ear AP in horses and dogs.
His ear charts (horse and dog) agree basically with those of other colleagues, such as Jan Still
(South Africa).
In comparison to AP in most European countries, French AP is esoteric, pure, conservative or
traditional, depending on one's point of view. Great emphasis is put on TCM concepts
(methods of diagnosis, TCM classifications of disease, YIN/YANG and Five Element theory
etc). Selection of points is based on those principles. Cookbook methods of point selection are
rejected by many. Real communication between traditionally oriented acupuncturists and
those using the "western" or simplified methods is difficult or impossible.
I believe that use of TCM concepts and terminology is a major cause of the reluctance of
academics/researchers to take AP seriously. This is not a big problem in France because the
French people take philosophy much more seriously than other western nations.
German Federal Republic : Vet AP was accepted as a valid modality in 1988 but < 1% of
vets use it. (Lambardt puts the figure at 5% maximum). Trigger point and neural therapy,
physiotherapy, laser etc are used widely in Germany but in conventional ways. Because of the
few who are interested in Vet AP and the large size of Germany, there is difficulty in
organising a national group.
Erwin Westermayer, one of the great pioneers and a master of the craft, died in May 1990. He
was the father of modern German vet AP (see section 2). His psychic powers were legendary
amongst those of us lucky enough to have known and loved him.
Walter Greiff, Donaustrasse 39, Grenzhof, Memmingen combines AP and homoeopathy by
injecting homoeopathics at the AP points, with excellent results in metabolic and reproductive
disorders in cattle. He is best known as an expert homoeopath. He and Westermayer
succeeded in having Vet AP and homoeopathy recognised by the German authorities.
Others who have published successful AP results are H. and C.H. Kruger (Freystadt) and A.
Lambardt (Unna)
H. Kraft and H. Konig, Munich Vet School are doing some research in AP.
The former German Democratic Republic : The official status of vet AP is unstated. Very
few vets use it.
India : The official status of vet AP is unstated. Very few vets use it.
Dr. Lakshmipathi, Vet School, Tirupati has published good results with AP in bovine
infertility and in AP analgesia in cattle, sheep and dogs.
Ireland : The 1988 Guide to Professional Behaviour states that it is ethical to consult with a
nutritionist, chemist, engineer or agricultural graduate etc. These are regarded as "qualified
persons"... but .... "consultation with an unqualified person such as an acupuncturist,
osteopath, bonesetter or chiropractitioner ... would be regarded as conduct disgraceful in a
professional respect". (On conviction, a vet who so consults could be struck off the
register !!). The official status of vet AP is unstated.

Although about 1% of the profession express interest in AP, few or no vets except the author
are trained to use it. (The nearest IVAS course would be Belgium or Norway). A few use
VG26 in emergencies or use trigger point therapy or physiotherapy (laser, ultrasound etc) in
the conventional way in horses and greyhounds. A few non-vet acupuncturists
(physiotherapists, or others well trained in AP) are treating horses/dogs illegally under Irish
law.
Rogers is a member of the Irish Medical AP Society. The Vet Council turns a blind eye to his
use of AP in horses (part-time hobby). His database of AP points for various clinical
conditions is now available for PCs, which must have Windows installed, through Norwegian
software. Contact Are Thoresen for details. Rogers gets referrals of difficult or really chronic
cases from a few colleagues. The referrals tend to dry up if the success of AP is good ! He
keeps his sanity by getting out of Ireland 2-4 times a year to meet acupuncturists, continue his
study and learn new methods.
Japan : AP is accepted in Japan and the Japanese Vet AP Society is active and publishes a
journal, unfortunately in Japanese. Nationally, < 2.5% of vets use AP. Many vets use VG26 in
emergencies and in neonatal resuscitation.
The late Satoru Ishizaki (Hiroshima) published charts of AP points in dogs, had excellent
results with AP analgesia, disc disease and musculo-skeletal disorders.
Kaoru Kitazawa (Vet Surgery 2, Rakunogakuen University, Bunkyodai Midori Machi, Ebetsu,
Hokkaido 069) has published on AP analgesia in dogs. He tried many point combinations and
found BL23 (bilateral) to be the best.
Mexico : There is no national vet AP group but about 1% of vets use AP in some form. The
official status of vet AP is unstated.
Hector Sumano (see section 2) and Gerardo Lopez (Dept. Pharmacology Vet. School, Mexico
City) teach AP to interested students and colleagues. Sumano has organised AP seminars with
national and international speakers.
Netherlands : The Dutch Commission sat in 1983 to assess the validity of Alternative
Therapies in Vet Med. I have been unable to find out its conclusions. A few vets (probably <
0.2%), who studied AP in Belgium (Janssens' courses) use AP. The Dutch group has expanded
since the IVAS Congress in Noordwyk 1990. Emil Hovius and Lies Schuitemacher are
contact persons.
Norway : The official status of vet AP is unstated. Very few vets (< 0.1%) use it but the
numbers are growing.
Are Thoresen, Leikvollgt 31, Sandefjord leads the Norwegian group. He uses Pulse Diagnosis
to great effect in horses, dogs and humans. He stresses the need for complete detachment (not
caring what diagnosis may be revealed), and of having no preconceived ideas on the
condition when reading the pulse. His AP therapy is based on less than 3 needles (preferably
only one) in the most appropriate Command Point, often the Ting point. He has published on
the use of Ting Points in horses. He organised the IVAS Course in Oslo 1988-89. The 1993
IVAS Congress was held in Tromso and a course is planned in Oslo in 1994.

South Africa : The South African Vet Assoc (SAVA) has an AP group, led by Jane Fraser and
Jan Still, Vet Faculty, Medunsa 0204, S.A. AP is used by c. 3% of vets. Training courses are
planned. Still reported good results with AP in disc disease and myofascial syndromes in
dogs.
Sweden : The official status of vet AP is unstated. A few vets use it and there is increasing
interest. Ritva Krokfors, Nasby Sodergard, S-595 92 MJOLBY, SWEDEN TEL: 00-46-14257227 is one of the leaders of the Swedish Vet AP group. An IVAS Course will be held in
Skara in November 1993
Switzerland : The official status of vet AP is unstated. It is used by < 0.5% of vets.
Konrad Zerobin, Vet School, Zurich has confirmed (Zerobin and Kothbauer 1977) the effects
of AP on uterine contraction in the cow.
Schupbach (see section 2)
Olivier Glardon, Herracherweg 104, 8610 Uster has done good research in equine AP. His
Thesis was accepted by the Vet School, Berne. He confirmed that normal horses have no
tenderness in the thoraco-lumbar area and he related SHU point tenderness to diagnosed
pathology. He also reports good results with AP in dogs.
Andreas Roesti (Brunnenhof, 3752 Wimmis, Switzerland) is an artist/poet/classical
acupuncturist/wholistic vet. His paper (IVAS Congress, Tromso 1993) on the Extra meridians
Du Mai and Ren Mai was superb. I noted only three points: learn how to listen; learn how to
be empathetic/sympathetic; learn how to love (Man, Animal and Nature).
Taiwan (Republic of China) : The state recognises AP and herbal medicine as a valid vet
therapy. AP is taught as an optional extra in National Taiwan University (Taipei) and National
Chung Hsing University (Taichung). It is used by c. 10% of vets.
Jen Hsou Lin (see section 2) (Dept. Anl. Husbandry, NTU, Taipei) and H.P. Fung, Dept. Vet
Med, NCSU, Taichung lead AP teaching and research. Fung has reported very good results of
AP in bovine infertility. Lin is leader of the IVAS Pig Text.
United Kingdom : The British Veterinary AP Soc (BVAS) has c. 50 members affiliated under
the British Vet Assoc., which recognises AP as a valid therapy if used by a vet trained in the
method. However, less than c. 0.5% of vets use AP, although many vets use VG26 in
emergencies. Physiotherapy, trigger point therapy, faradism, ultrasound and laser are
commonly used in U.K. but in a conventional manner. Interest in AP training is poor, as the
last training seminar (1988) was cancelled due to low registration numbers.
John Nicol, 85 London Rd., Guildford, Surrey leads the BVAS. He has had good results in
horses and dogs.
Trixie Williams, 84 Bradenstoke, near Chippenham, Wilts has had good results with AP in her
small animal practice. She has organised training seminars also.
U.S.A. The American Vet Med association (AVMA) has accepted AP as a valid therapy if
used by vets properly trained in the method. IVAS members played a key role in producing

the documentation needed to satisfy AVMA. (AVMA had examined the claims made for a
number of "alternative therapies", including homoeopathy, chiropractic, kinesiology etc. The
other methods were rejected as of unproven value at this time). AP is used by < 0.5% of vets.
Most of the accredited, paid-up members of IVAS are in U.S.A.
Shelly Altman, 5647 Wilkinson Ave., N. Hollywood, CA 91607 is a lecturer/ teacher on IVAS
courses and Leader IVAS Small Animal (dog) Text
Marvin Cain, 7474 Greenfarms Drive, Cincinnati, Ohio 45224, founder member of IVAS,
teacher, workaholic and lion hearted, is the best known equine AP expert in the world.
Yann Ching Hwang, Vet School, Tuskegee University, Tuskegee, AL 36088 is a
teacher/researcher and Assistant editor of the IVAS Pig text. Hwang gives AP lectures to vet
students at Tuskeegee
David Jaggar, Boulder, CO, teacher, seer and a gentle man, is a founder member, ex President,
now Exec. Secretary of IVAS. He is interested in Laser applications. He reports good results
with AP in horses and dogs. David recently qualified in human chiropractic.
Alan Klide, Vet School, Spruce St., Philadelphia, PA 19348 is a teacher/ researcher (see
section 2). Klide gives AP lectures to vet students at Philadelphia
Allen Schoen, RR2 Box 11, Sherman, CT 06784 (IVAS teacher, past President IVAS 1988-89)
has wide experience of AP in dogs and horses.
Meredith Snader, Rt 4, PO Box 216, Chester Springs, Philadelphia, PA 19425 is Executive
Secretary IVAS. She is an expert in equine AP.
Earl Sutherland, Chairperson IVAS Board, POB 12009, Lexington, KY 40579-2009 is expert
in equine AP
John Turnbull, N3652 US Hwy 16 RR 2, La Crosse, WI 54601 is expert in cattle AP.
Kathy Waters, 4206 Green Briar Blvd, Boulder, CO 80303 is Editor of the IVAS Newsletter.
INTERNATIONAL ACCEPTANCE OF VET ACUPUNCTURE (AP)
While there are some exceptions, as indicated above, the general official attitude of the
international vet profession to AP is one of polite apathy/ scepticism. They accept vets who
use AP as rather eccentric colleagues. They murmur "Yes ! how interesting...." and then forget
it. They will not learn the method and, with few exceptions, will not have it included as part
of the undergraduate curriculum.
Even in those countries with an active Vet AP Association, or where the authorities accept it,
AP is a minority speciality, used by < 0.5-3.0% of vets. Belgium (10-20% of vets), Finland
and Taiwan (c. 10% of vets) make the greatest use of it. We, who know the value of the
method, must take a lot of the blame for our profession's attitude. It is up to us to change that
attitude if we want AP to be part of mainstream medicine !

Fundamentally, AP is about reflex phenomena, relationships between points, body parts and
function. The basis of AP must be a solid grasp of these material relationships. For some, AP
is much more, operating at higher, immaterial levels. It embraces a poetic philosophy of life,
almost a religion. But we must remember that few academics and teachers are poets and many
find the idea of religion to be "unscientific".
Some enthusiasts see AP as a special modality: an alternative method capable of treating
everything from acne to zoster. Others, especially those seers gifted in mental/spiritual aspects
of healing, see AP as the highest form of energetic medicine but their view is
incomprehensible to materialist science. Purists may insist on talking in classical Chinese
concepts and terminology to their western colleagues. This mentality, while valid from
personal viewpoints, delays or kills the acceptance of AP by serious scientists. Even the term
"complementary" method gives bad off vibes.
The pharmaceutical industry is not enthusiastic about wide-scale replacement of drugs
(especially analgesics, tranquillisers and hormones) by AP. Most professions (and their Parent
Organisations) are self-protective. Anyone who (or any system which) appears to challenge
the financial security or the authority-base of the organisation is usually ignored, ridiculed or
disabled for the good of the whole.
It is easy to dismiss the outsiders as cranks or charlatans. Unfortunately, there are confidence
tricksters and Diploma sellers hidden among genuine AP practitioners. Unfortunately,
untested or inadequately tested instrumentation is being marketed to AP practitioners, who,
having paid dearly for fancy toys with flashing lights or computerised controls, may feel
psychologically bound to justify their dubious investments by uncritical assessment.
Meanwhile AP and its practitioners may get a bad name.
Many academics feel threatened by the esoteric language and concepts of the purist AP
schools and by the apparent difficulty in learning it. Surgeons feel threatened by claims that
AP can treat many conditions which they regard as needing surgery. Doors close and the
troops close ranks. It is the major challenge to IVAS to get its toe in the academic door and to
rally the reluctant troops inside.
We have no real hope of introducing AP into the mainstream of Vet science until it is fully
integrated into the undergraduate curriculum, alongside of pharmacology, surgery, nutrition,
management etc. This must be the primary goal of IVAS, for it is surely not enough to have a
few hundred experts practising brilliant AP on the fringes of mainstream medicine.
The principles of vet science include : theory/experimentation, observation /measurement,
categorisation/simplification, publication and replication.
Theory/experimentation : To have maximal impact, theory must be in language
comprehensible to academics and agencies which fund research. Experiments must be well
designed, properly controlled and analyzed.
Observation/measurement in experimental or clinical trials must be recorded carefully and
accurately. We need much more evidence from controlled and clinical trials to prove to our
colleagues that AP works. Analysis of the results should be sophisticated. For example, a
recent paper by Dr. Mabel Yang (Physiology Dept., Hong Kong University) showed marked
homoeostatic effects of AP on immune response. Animals with a suppressed response (YIN)

increased the test parameters (becoming more YANG) , whereas those with a hyper response
(YANG) decreased it (becoming more YIN). (Had Dr. Yang analyzed the data in a crude way,
the effect would have been missed, as the overall effect was very little change in mean
values).
Similarly, Dr. Jukka Kuussaari's paper on aerophagia in horses (Amer. J. Acup., 11, 363-370)
had hidden effects. Of 33 horses treated by electro-AP, 6 were cured and 8 improved (failure
rate 58%). This might be dismissed as a poor result. However, on closer examination, 11
horses had NO associated gastro-intestinal signs and not one of these responded (failure rate
100%). (Had Kuussaari not recorded the clinical findings, this effect would have been
missed). Of the remaining 22 cases, all of which had gastro-intestinal signs, the aerophagia
failure rate dropped to 36% and all had their g/i signs improved or cured. Further analysis
showed that in horses with initial g/i signs, the cure and improved rates in cribbers were 25
and 25% respectively (50% failure) but in windsuckers (not cribbers) the rates were 30 and
50% respectively (20% failure).
Categorisation/simplification : Relationships between variables can be more easily
examined when they categorised, as in the above examples. For easyuse in the field, science
tries to simplify its relationships. Obfuscation and esotericism are anathema to scientists. Why
have a rigmarole about ancient ways of choosing points when a simple way may work just as
well ? For instance Luc Janssens' Cookbook points for chronic thoraco-lumbar disc disease
(tender points, local points + GB34) or Jan Still's use of GB34 alone in acute cases are easy
for the beginner to use and gave excellent results.
Publication : Two basic criteria of a top-class professional journal are :
a. a tough system of peer-refereeing and
b. selection of the best from a surplus of the good.
For instance, journals like the Vet Record (London) or the Journal of the American Vet Med
Assoc have so many articles submitted that a good article may be redrafted many times, cut to
30-50% of its original length and delayed for as long as 2 years before space can be allotted
for its publication. However, many clinical and some "research" articles published on vet AP
(even on the international level) have not satisfied these criteria yet.
AP is still a minority speciality and most practitioners seem to be allergic to ink. Therefore,
the volume of solid AP material for publication is pitifully small. This is a problem for the
IVAS Newsletter and Journal as well as for many national (and even international) AP
journals, including the human AP journals. Some have folded and some are just hanging on
precariously.
The primary purpose of the IVAS Newsletter is to be a forum for exchange of useful ideas
between vet AP colleagues and those interested in the study of AP. The IVAS Journal aims at a
higher standard of publication. At present, it does not attempt to challenge Vet Record or
JAVMA for strict scientific excellence. Its secondary purpose is to stimulate interest in vet AP
among open-minded colleagues, especially those in research and academia. If AP is to be part
of mainstream medicine, it must be taught at undergraduate level as part of the basic vet
course. We need researchers and academics to become involved. Our Newsletter and Journal

are their windows to the world of AP. Therefore, their quality must be as good as we can make
it.
Because of shortage of well documented copy, we have included occasional anecdotal copy or
longer items from newspapers or magazines. We have been criticised for this, especially by
non-American readers, whose national vet ethical codes discourage publication of articles
which might be misconstrued as forms of personal advertising.
You can help us to improve the Newsletter and Journal. If you suffer from ink allergy, try
homoeopathic desensitization, or (better still), use a cassette recorder as you do your practice
rounds ! A friendly teenager may help you to transfer the taped conversation to a
wordprocessor. If you send the disk to IVAS, the editors will help you to tidy it up, if
necessary. Encourage your expert friends to record their results (positive and negative). Let us
know how you feel about your failures. Have you any explanations for them ? (My failures
taunt me and I can not really explain them). If you see interesting abstracts/summaries which
have not appeared in the Newsletter or Journal already, send them in.
For knowledge to spread, it must be published. But if it is to spread widely and quickly, it
must be published in refereed top-quality national or international journals. The reporting of
AP must be truthful, including the partial successes, failures and relapses. Where combined
therapies are used, these must be reported also. In this way, AP can become a credible
modality. At present, much of the reporting is anecdotal, biassed and incredible.
Replication : One of the beauties of science is its approximation to an estimate of objective
truth: results attained by one worker/group should be attainable by another if the same
procedure is followed, under similar conditions and in similar types of subjects. The sloppy or
fraudulent worker will be exposed when the published work is replicated by others.
Most practitioners properly trained in AP know that it is effective in many disorders but,
before we can convince most of our scientific colleagues, we have a long march ahead, one
which may turn out to be longer and harder than that of Chiang Kai Shek or Mao Tze Tung.
The Chinese have the wisdom to incorporate the best of western science into their system.
Can we not convince our academics that it is in the best interests of the west to adopt the best
of eastern science and art ? We must convince them if we are to get AP onto the standard
curriculum of the vet schools. Today is a good day to begin. But, first, let us see AP as only a
small part of our approach to vet medicine and healing.
ACKNOWLEDGEMENTS
The history of AP was summarised from Parkinson (1974-1977), Klide and Kung (1977),
Anon (1980) and Janssens (1987). Janssens' manual (1987) and the Proceedings of the 1991
Sydney Vet Postgraduate Course are recommended highly to students of vet AP.
The current status of AP was assessed mainly from questionnaires sent to vet AP practitioners
and/or academics in 38 countries. I thank all those who replied and apologise to those whom I
did not mention in this paper.
REFERENCES

ANONYMOUS (1980) Essentials of Chinese AP (by the joint working party on AP

research and the College of Traditional Medicine). Foreign Languages Press, Beijing.
432 pp
BRUNNER, F. (1980) AP fur Tierarzte : AP der Kleintiere. WBV Biologisch Med.
Verlag, Ipweg 5, D4070 Schorndorf, West Germany. 303 pp
DEMONTOY, A. (1986) Manuel d'AP canine. Editions du Point Vet, 25 rue Bourgelat,
94700 Maisons Alfort, Paris. 176pp.
JANSSENS,L. (1975) General AP. Thesis. Vet School, Gent, Belgium.
JANSSENS,L., ALTMAN,S. and ROGERS,P.A.M. (1977) Respiratory and cardiac
arrest under general anaesthesia: treatment by AP of the nasal philtrum. Vet. Rec.,
105,273-276.
JANSSENS, L.A. (1984) Treatment of disc disease & arthrosis in dogs. Also Trigger
Points & myofascial syndromes in dogs. Proc. AP Congress, Vet School, Gent,
Belgium. 289pp & VMSAC (1983), October,1580-.
JANSSENS, L.A.A. (1987) An overview : vet AP in Europe. In : Some aspects of
small animal AP - the clinical scientific approach. (Chapter 2 of the Belgian Vet AP
Society Manual).
JANSSENS,L.A.A., ROGERS,P.A.M. and JAGGAR,D.H. (1987) Canine disc
disease : a survey of AP therapy. In Some Aspects of Small Animal AP (Janssens,
Belgian Vet AP Society), pp 9.1-9.7.
JANSSENS,L.A.A., ROGERS,P.A.M. and SCHOEN,A.M. (1987) AP analgesia : A
review of pain theories, pain abatement and technique of AP analgesia. In Some
Aspects of Small Animal AP (Janssens, Belgian Vet AP Society), pp 15.1-15.8.
JANSSENS,L., ROGERS,P.A.M. and SCHOEN,A.M. (1988) AP analgesia.: A review.
Vet. Rec., 122, 355-359.
KLIDE, A.M. and KUNG, S.H. (1977) Vet AP. University of Pennsylvania Press,
Philadelphia, U.S.A. (Chapters 7 and 8).
KOTHBAUER, O. (1961) On pain point diagnosis and neural therapy in animals.
Wiener Tierarztl. Monattschr., 53, 282-.
KOTHBAUER, O. (1966) Provocation of hyperalgetic skin zones and "pain points"
referring to the bovine uterine horns. Wiener Tierarztl. Monattschr., 53, 803-.
KOTHBAUER, O. (1974 -) Personal communication
KOTHBAUER, O. and Schaller, O. (1975) Segmental projection of the bovine uterine
cervix to the skin. Wien. Tierarztl. Monatsschr., 62, 157-.
KOTHBAUER, O. (1975) Caesarian section in a cow under APA. Wien. Tierarztl.
Monatsschr., 62, 394-. Many successful since then (personal communication 1982).
KOTHBAUER, O. & ZEROBIN, K. (1977) Tocographic verification of AP effect on
the bovine uterus during parturition and puerperium. Deut. Zeitschr. fur Akup., 20,
11-.
KOTHBAUER, O. & MENG, A. (1983) Vet AP: cattle, pigs and horses (in German)
Verlag Welsermuhl, Wels, Austria. 334pp.
LIN,J.H and ROGERS,P.A.M. (1980) AP effects on the body's defence systems: a vet
review. Vet. Bull., 50,633-640.
MILIN, J. (1957) AP in canine arthrosis. Rev. Intern. Acup., 40, (pages ??)
MILIN, J. (1964) AP in canine rheumatism. Actes CNVSPA.
MILIN, J. (1973) AP in canine gynaecology. Animal de Compagnie, 33, 293-.
MILIN, J. (1974 -) Personal communication
MARTIN, B.B. and KLIDE, A.M. (1987) Laser AP for the treatment of chronic
backpain in horses: stimulation of the AP points with a low-power laser. Vet Surgery
16, 106-110.

MOLINIER, F. (1986) Traite d'AP Vet. Publishers Maisonneuve. (A very detailed

work running to > 2000 pages in all)
MUXENEDER, R. (1984) Relaxation of uterus by AP after caesarian section in cows.
Wien. Tierarztl. Monattschr., 71, 320-.
MUXENEDER, R. (1987). Soft laser in the conservative treatment of chronic skin
lesions in the horse. Der Prakt. Tierarzt, 68, No. 1, 12 - 21.
POMERANZ, B. (1981) Neural mechanisms of AP analgesia. In : Persistent Pain
(chapter 11), pp 241-257. Academic Press, New York.
OLESON, T.D. KROENING, R.J. & BRESSLER, D. (1980) An experimental
evaluation of auricular diagnosis. Pain, 8, 217-.
PARKINSON, M. (1974 - 1977) Personal communication.
ROGERS, P.A.M. and OTTAWAY, C.W. (1974) Success claimed for AP in domestic
Animals. Irish Vet. J., 28,182-191.
ROGERS, P.A.M., WHITE, S.S and OTTAWAY, C.W. (1977) Stimulation of the AP
points in relation to analgesia and therapy of clinical disorders in animals. Vet. Annual,
17, 258-279. Wright Scitechnica, Bristol.
ROGERS, P.A.M. (1981) AP news from Europe and N. America. Acup. Res. Quart.
(Taiwan), 5,63-65.
ROGERS, P.A.M. (1981) British Vet AP: Quo vadis? Acup. Res. Quart. (Taiwan),
5,133-136.
ROGERS,P.A.M. (1983) The Taiwan Report. Acup. Res. Quart. (Taiwan), 7,45-60.
ROGERS, P.A.M. & JANSSENS, L. (1991) Veterinary Acupuncture. Proceedings of
the 1991 Postgraduate Veterinary Course. Contact Faculty of Veterinary Science,
Sydney University, NSW, Australia..
SCHOEN,A.M., JANSSENS,L. and ROGERS,P.A.M. (1986) Vet AP. Seminars in Vet.
Med. and Surgery (Small Animal), 1,224-229.
SCHUPBACH, M. (1985) Thermographic proof of points with higher temperature
after irritation of the uterus in minipigs & the influence of these points on the viscera.
Inaugural Dissertation for the degree of DVM., Vet School, Zurich. 106pp.
WESTERMAYER, E. (1978) Atlas of AP for cattle (in English & German). WBV
Biologisch Verlag, Ipweg 5, Schorndorf, Fed.Rep. Germany. 60pp.
WESTERMAYER, E. (1980) Treatment of horses by AP. Health Science Press,
Holsworthy, Devon, UK. 90pp.
WHITE, S.S. (1974-) Personal communication
WHITE, S.S., HERBERT, P.A. & HWANG, T. (1985) Electro-AP in vet medicine.
Chinese Materials Centre Publications, San Francisco. 122pp. \aphistor.pap 17/10/88 18/8/90

QUESTIONS
1. One of the following dates is correct. Circle the correct date:
IVAS was founded in U.S.A. in:
(a) 1970; (b) 1972; (c) 1974; (d) 1976; (e) 1978

2. One of the following dates is correct. Circle the nearest correct date:

The Nei Ching Su Wen (Yellow Emperor's Classic of Internal Medicine) was written circa:
(a) 900BC; (b) 300BC; (c) 000AD; (d) 300AD; (e) 900AD

3. One of the following names is correct. Circle the correct name: The first Caesarian in
cattle under acupuncture was done in the west by:
(a) Westermayer; (b) Kothbauer; (c) Greiff; (d) Rogers; (e) Kuussaari

4. One of the following names is correct. Circle the correct name:

The first experimental proof of endorphin mechanism in acupuncture analgesia was published
in 1977 by:
(a) Shealy; (b) Melzack; (c) Kaada; (d) Wall; (e) Pomeranz

5. One of the following species is correct. Circle the correct species: Schupbach (Zurich)
usedinfrared thermography to detect points for the uterus in:
(a) dogs; (b) cows; (c) sheep; (d) pigs; (e) horses

6. One of the following cities is correct. Circle the correct city:

In which veterinary school did Jan Still do his research on detection of earpoints in the dog:
(a) Munich; (b) Antwerp; (c) Brno; (d) Vienna; (e) Hanover

7. One of the following names is correct. Circle the correct name:

Work in Mexico City Vet School on AP and electrostimulation on wound and burn healing,
infertility in cows, AP analgesia in dogs, non-distemper induced epilepsy in dogs, polyarthritis
in parrots was reported by:
(a) Hector Sumano; (b) Carlos Arrupe; (c) Grum P. Spinoza; (d) Sumo Suarez; (e) Donald
Quixote

8. One of the following statements is correct. Circle the correct one:

(a) AP therapy is an alternative veterinary therapy which can completely replace conventional
vet medicine
(b) AP therapy is a reflex therapy similar to but more powerful than physiotherapy. Its use is
likely to increase in vet medicine
(c) More than 33% of European veterinary schools include AP training as an essential part of
the undergraduate curriculum
(d) The World Health Organisation (WHO) and the Food and Agriculture Organisation (FAO)
do not recognise AP as useful therapy in humans or animals
(e) The esoteric/poetic aspects of AP theory are regarded as essential to good clinical success
by most northern European Vet AP societies
1=c2=b3=b4=e5=d6=c7=a8=b

PSYCHIC METHODS OF DIAGNOSIS AND TREATMENT IN

ACUPUNCTURE AND HOMEOPATHY
INTRODUCTION
I was born in 1942 in Ballymote, Co. Sligo, in the West of Ireland. It was a small town in a
rural area, well off the main road. Few strangers called there. During World War 2, and into
the late 1950s, there was little employment in the area. This caused great poverty and
hardship. People had to make do with very little.
In those days, though there were a few local doctors and vets, medical care was primitive and
modern drugs were scarce and expensive. During my childhood, it was normal for healers and
"quacks" to treat human- and animal- diseases. Religious faith, though childlike and
unquestioning, ran deep in the psyche. That faith was interwoven with ancient myths,
superstitions and traditions. A common greeting when visiting a sick person was "God Bless
all in this house!". The common farewell, when leaving was "God is good! Sure, you will get
better if it is the will of God!".
In Ireland, hand healing is an ancient tradition, especially in the countryside. The 7th son, or
7th daughter, is attributed with special healing power: they "have the cure". Traditionally, the
"gift" is passed to one member of the family in each generation. Some "hand-healers" exhibit
a strange phenomenon: if they hold an earthworm in their hand, the worm dies within a
minute or two. If they go fishing, they need to have a friend with them to put worms on the
hook for them. These healers are usually "simple" country folk, who believe they can cure
only one or two conditions.
My maternal grandmother was a very wise and loving woman; she was one of the first
poultry-instructresses in the county and was famous for two great gifts:
1. In her youth she had a very successful cure for skin cancer. The cure, which was given to
her by her mother, involved the application of two ointments containing herbs and simple
chemicals. Over a period of 16 years, she cured many hundreds of people from all over the
country but she stopped using the cure in the early 1930s, when one of her daughters, a
medical student then, told her that the cure was unscientific and worthless.
2. All through her life, grandmother was uncannily accurate in her use of a pendulum for
sexing chicken eggs for her neighbours.
My mother graduated in science from Galway University. She was one of the founderteachers of the first secondary school in Ballymote. She set high standards for all around her.
She, and my father, worked very hard to send their six children to secondary school; three of
the six went to Third Level.
Until I left Ballymote in 1954, I lived in that simple culture, as happy as a pig in a mudbath. I
grew up with an acceptance of these old traditions, including an acceptance of the power of
prayer and of unusual ways of healing.
From 1954 to 1964, I had a classical education, 5 years in a Jesuit boarding school and 5 years
in the Vet School in Dublin. Those 10 years radically changed my attitude to my Sligo culture.

By then, I had rejected the "unscientific" and "irrational" traditions and practices of my
people. Many aspects of my (Christian) faith were largely demolished. I thought that I knew
the "real way" to live and work.
After a short time in mixed-animal practice, I became a research cadet and eventually a
researcher in the Agricultural Institute. I worked critically and "scientifically" in areas of
cattle health and nutrition. Statistics and controlled trials were the arbiters of truth in areas of
medicine and health for me.
In Spring 1972, I was confined to bed with sciatica. My doctor, a good friend, had diagnosed
two slipped disks (L4-5 and L5-S1) and a subluxation of the right sacroiliac joint. After 5
weeks of bed-rest and analgesics, I was still in agony with lumbar and sciatic pain. My doctor
advised me to go to a "bone-setter" (quack). My then-boss, a senior vet and a man with little
respect for quacks, reluctantly agreed to take me by car. The journey took more than 2 hours.
Bent over like a C, I hobbled in to the quack, who diagnosed exactly the same problems as my
doctor, but added that the sacroiliac problem was of no significance. He manipulated my
lower back; the process took only 2 minutes and I had instantaneous relief. When I walked
into the street, I was straight, and could kick with both legs above my own height. I went back
to work, almost totally pain-free, next day.
By a series of strange coincidences, one year later I met Mr. Roy Ogden; he was over 70 years
old then, and has died since. While working as a civil servant in India, Roy studied
homeopathy, radiesthesia, divination and Indian Medicine. He had a very large practice in
Dublin and also was interested in acupuncture (AP), in which I had become interested at that
time. I had arranged to meet Roy for the first time to discuss it.
I called to his house exactly on time. He greeted me, took one look at me and said
"Acupuncture is OK, but it is only a tool; it is not so important. It is the psyche, and how
one uses it, which are important. Let me show you!"
He put me sitting down about 2 metres from him and asked me to wait, but not to speak. He
produced a "rubbing pad" (see later) and began to talk to himself as he stroked the pad. He got
a reaction on "spine", "lumbar", "sacral", "right sacroiliac". After a few minutes, he told me
the exact details of my sciatic attack: 5 weeks in bed about 1 year ago, L4-L5, L5-S1 and right
sacroiliac out; that the disks were OK but the sacroiliac was still "out". I was gob-smacked:
there was no way that he could have known those details, as my first contact with him was by
phone at 12 midnight the previous night and I had said nothing about my back.
We had long conversations in the following weeks. Roy who stimulated me to study the
psychic methods of diagnosis and healing Though I did not know it at the time, he was
probably the greatest human healer whom I have known.
The ancients, mystics held that humans and animals have a psychic (sixth) sense. They also
attributed the life force to vital energies (Qi, Prana etc). Many moderns accept that as fact. In
Yin-Yang philosophy, a psychic sense (input, storing, Yin Qi) also implies a psychic
transmission force (output, dispensing, Yang Qi). These sensory and motor phenomena are
the bases of telepathy, dowsing, telekinesis, kinaesthesia, prayer-healing, spells, incantations,
symbolic healing rituals, magic (black- and white-) etc.

This paper discusses some common instruments used in dowsing (divination). It also
discusses methods of diagnostic dowsing, including autotraining, pulse (VAS, surrogate,
Chinese) diagnosis and visualisation, including Westermayer's method ("my body is patient's
body; what do I feel ?"). These methods can help to diagnose the location, nature and causes
of the problem and to choose the best ways (modalities, remedies (including homeopathic)
and AP points etc) to treat that problem. It also discusses some of the methods used in psychic
healing, including hand-healing and distant-healing (by broadcast, visualisation).
The paper concludes with the thesis that love and prayer are central to all healing. It suggests
that the great healers combine four attributes:
1. a high level of technical knowledge and skill
2. empathy with the subject and a consciously directed intention to heal
3. compassion with the subject and a spiritually directed desire to heal
4. deep wonder and humility at being part of the cosmic creative force, the source of all
healing.
SOME DEFINITIONS
A definition of holism is: "A philosophical theory according to which a fundamental feature
of nature is the existence of wholes which are more than the composite assembly of the parts
and which always tend to become more highly developed and complex". A transcendant
element is inferred, i.e. something greater than the sum of the parts. A poet's definition of
mysticism is: "Man's dialogue with God, Man-in-the-world-and-why" (Brendan Kennelly
1983).
Some people can sense, by "paranormal" means, the nature and location of human and animal
disease. Some do this in the presence of the patient. Others do it from a long distance, using
the dowsing (divining) facility or by other psychic means.
The meaning of the phrases "to dowse" or "to divine" is to establish the underlying realities of
a situation by a process of spiritual need, detached mental search and disassociated pondering.
Dowsing (divination) is a method establishing objective reality by subjective interpretation of
learned but involuntary reflex responses while in a state of detached spiritual/mental search.
The body of the dowser reacts as a biosensor to a spiritual/mental "search" by an involuntary
muscular contraction. The search can be at the examination site (local-physical dowsing) or
far away from it (distant-absent dowsing).
AP is a diagnostic and therapeutic system which operates on Holistic principles. It has two
levels, the material-physical (reflex and neuroendocrine mechanisms) and the immaterialenergetic. AP does not require paranormal concepts or methods to explain the former.
However, paranormal concepts interest those professionals who have experienced some of
these phenomena at first hand. They add an extra dimension to the study and practice of the
healing art.
Holistic Medicine is based on concepts of Qi and on balance and interaction of this Qi with
the two environments, internal and external. The internal environment involves interaction

between spiritual, psychic, emotional, neuroendocrine, visceral, somatic and immune

elements. The emotions (joy/excitement, worry/obsession, sobbing/grief, fright/fear,
anger/envy) influences specific organs (HT, SP, LU, KI, LV respectively) and vice-versa. The
external environment involves interaction with local, distant and cosmic elements, including
climatic, dietary, traumatic, infectious/parasitic etc. Specific climatic factors (the Perverse
Energies: heat/summer heat, damp, dryness, cold, wind) influence specific organs (HT, SP,
LU, KI, LV respectively) and vice-versa.
HOLISTIC CONCEPTS AND THE PARANORMAL
By definition, holistic concepts involve all possible component parts, how they interact (fit
together), how they fit into the larger plan of Nature and (in the end) an artistic-intuitive
search for aspects of the transcendant immaterial blueprint which religious people call God
or atheistic physicists see as the infinite interchange of matter and energy. Holism and holistic
concepts of health, disease and medicine contain elements of scientific medicine, art, poetry
and mysticism.
Mechanistic materialistic medicine has blind spots. It tends to label "Man-who-dialogueswith-God" as duped, irrational or mad. It tends to look on "Man-in-the-World" through halfblind eyes. It does not recognise transcendant "Whys".
Ancient Chinese medical philosophy states that "Man stands between Heaven and Earth."
This can be translated as: "The organism is the product of (embodies the characteristics of)
Heaven (spirit, mind, non-material forces) and Earth (food, physical environment, material
forces)." This can also be translated as: "The organism is influenced by spiritual, psychic arid
non-earthly forces (cosmic, solar, lunar forces) as well as forces in its immediate environment
(nutrition, climate, electro- magnetic and geophysical forces)".
There is interdependence and interaction between the organs, functions, and emotions of
the body. The Chinese regarded man as a unity of Yin-Yang and the Five Phases in bodyspirit. Psychosomatic medicine also sees man as a unity of mind (spirit) and soma. Thus,
interactions between these components of the organism influence the health (balance) of the
organism. The External influences the Internal and vice-versa. Psyche influences Soma and
Soma influences Psyche. Those who ignore this reality have a very incomplete view of factors
influencing health.
In vet medicine, it would appear that the animal psyche plays a less important role in disease
than the psyche in human medicine. Nevertheless, the animal psyche is important and can be
harnessed in many practical ways, as any experienced animal handler knows. The psyche (and
psychic energy) of the therapist can (and should) be focused to beam compassion, love and
help into the psyche of the willing patient, animal or human (Rogers 1996, Holistic Concepts
of Health and Disease).
Most countries have examples of healers who use paranormal methods of diagnosis and/or
treatment in human and animal conditions. Frequently these healers have no formal training in
medicine or diagnosis. However, the diagnostic accuracy of some healers can be incredibly
good. Also, there is evidence that hand-healing, telepathic broadcast and "radionic broadcasts"
can be an effective therapy.

The whole area of "paranormal" diagnosis and healing is difficult to assess in terms of our
scientific methods. Little or no thorough research has been done in the area. Many
confidence-tricksters make large sums of money from the public by claiming (falsely) to have
these abilities. Nevertheless, the phenomena, although rare and unpredictable, are real. Some
people are gifted with natural ability to diagnose disease and to heal in strange ways. In spite
of "scientific ridicule", telepathy, telepathic diagnosis and telepathic healing (or injury:
voodoo, black-magic) are as real as the dinner-table or bank-loan for many people.
DOWSING (DIVINATION)
Divination was, and is, regarded by many as an occult art. The word "occult" means
concealed, hidden, known-only-to-the-few (the initiates). It also means mysterious, cabalistic,
mystical and supernatural. Thus, orthodox religions are suspicious of the occult and are
divided on its ethics and morality. Some regard dowsing as a human psychic attribute, more
developed in some people than in others, a gift, which can be used for good or evil purposes
in the same way as all other human attributes: speech, thought, sexuality, creativity etc.
However, some fundamentalists regard it as a form of black magic, an evil activity with
demonic links.
All great cultures (North and South American Indians, Eskimos, Siberians, Tibetans, Chinese,
Australian and African tribes, and the Celtic and Jewish peoples) used dowsing techniques
from pre-historic times. The common uses in primitive societies were to find water, food
(game, fish) and missing persons or property. The Shaman, or Wise One, in each tribe, or
village, was attributed with "Second Sight": the Seer "knew" when one of the tribe was ill,
and, especially sensed death or disaster. Before the advent of cell-phones and other modern
means of communication, the traditions of the Polynesian, Inuit and Celtic peoples have many
stories of the tribes gathering for the funeral of a leader or friend who had died far away, and
whose death could not be known by conventional means.
However, research suggests that animals also have psychic abilities. These include telepathy,
ability to find water, food, their young and mates and to navigate at great distances etc.
Dowsing abilities are seen as visceral survival mechanisms, i.e. they are vegetative
responses, not confined to Homo sapiens. If this is so, it is not necessary to see these
phenomena as "human-spiritual". Instead they can be seen as intuitive, basic survival
instincts, which urbanisation and rationalisation have suppressed to a large extent, but which
can be trained to greater levels by those who need to use them.
There are two main types of dowsing: physical and absent dowsing. In physical-local
dowsing, a search is made for the missing object in the locality where it is expected to be
found. For example, the dowser may move the instrument slowly down the spine of the
patient, seeking the location of a suspected disc prolapse. Is this a location of the problem ?
Or one may walk over ground with Y-stick with the question: "Am I passing over a waterfissure? Am I passing over a geopathic zone?
In distant-absent dowsing the dowser uses a systematic mental question and answer
technique to obtain information about someone or something which could be on the opposite
side of the world. To help concentration, the dowser usually requires a "witness" of the object
of the search. For example, in diagnosis, the healer may use a blood-spot, a saliva sample or
clippings of hair or nails from the patient to help him/her to concentrate on ("tune in" to) the
absent patient. Other examples of distant dowsing are map-dowsing for water or missing

persons; body-chart dowsing for diagnostic purposes; visualisation to "see" and "internally
see" the patient, or to "see" what reaction an instrument (X-ray, blood test, US-scan,
pendulum etc) would give to their specific question.
DOWSING INSTRUMENTS
Most novice dowsers use some instrument to indicate the presence of a "Yes" or "No"
reaction. Common instruments used in dowsing are: the Y stick and angle-irons; the
pendulum; the rubbing pad; radionic instruments and Vega-type instruments.
a. The Y stick: Any Y or V shaped rod, stick or other flexible lever can be used. The materials
may be natural wood or whale-bone or plastic, fibreglass, metal etc. The type of material is
not important but the instrument should be flexible enough to allow a good spring action and
prevent it breaking when the hand pressure comes on. A wire coat hanger, straightened out
and then bent in two makes an ideal V stick. The handles are gripped loosely and hand
pressure is exerted until the lever is at the brink of instability in the horizontal position. This is
the "working position" for the stick. A "yes" reaction is indicated by a twisting motion from
the horizontal into the vertical (down or up), due to involuntary contraction of the flexor or
extensor muscles of the forearms. A "no" reaction is indicated by the stick staying in or near
the horizontal.
Angle-irons are made of metallic rods 2-4 mm thick. Wire coat-hangers can be used: two
lengths, c. 50 cm each, are straightened and a right-angle is made c. 10 cm from one end of
each rod. The short end of each rod is inserted into a loose-fitting sleeve of metal, wood or
plastic. A disposable plastic biro (without the ink tube and stopper) makes an ideal sleeve. The
angle-iron is free to move within its sleeve. While holding the sleeves vertically, one in each
hand, with long ends of the rods pointing forward (parallel), the dowser walks over the site to
be dowsed. The parallel-forward position is the working ("No") position. When, due to
involuntary muscle contractions, the two rods swing from a forward-parallel position to a
crossed-in, or a crossed-out position, the "Yes" dowsing reaction is indicated. Angle-irons
are slower to react than the Y stick. They are used most often for local (site-work) dowsing,
but they can be used for distant dowsing and diagnostic work also.
b. The pendulum is a weight (15-45 grams) suspended from a thread. The materials are
irrelevant: plastic, ebony, metal, perspex, wood etc. The cord can be of thread, nylon, silver,
gold or brass chain. Some dowsers use a gold wedding ring suspended from a piece of sewing
thread. The pendulum is set in motion in a line to and from the operator (Fig a). A pendulum
which receives no further impulses eventually slows down and stops. However, involuntary
muscle tremors keep the pendulum moving. Such movement can be of three types :
1. As before (Fig a)
2. Change from oscillation (Fig a) to clockwise or anticlockwise rotation (Fig b);
3. Change the angle of original oscillation (Fig a) to A1-B1 (Fig c).
The operator, through trial and error, learns which are his/her "Yes" and "No" reactions to the
mental questions or the physical search (e.g. over the body of a patient or over a field etc).
Complete the diagrams, showing angles of oscillation and clockwise/ anticlockwise rotation.

Fig (a)

Fig (c)

B1
.

.
A

A1

operator

operator

Fig (b)

|
|
|

operator

c. The rubbing pad is a thin pad or membrane, made of latex or other rubber. The pad
usually is stretched and mounted on a frame or "black box". Earlier dowsers used to rub
blocks of ebony or bakelite. The object is to detect involuntary muscle twitch by a "sticking"
action of the fingers on the rubbing pad. The operator concentrates on the object of his/her
search and begins to stroke the rubbing pad with rhythmic, firm strokes, so that the fingers are
almost (but not quite) sticking to the surface. Then, posing the question, the rubbing
continues. A "Yes" reaction is indicated by involuntary increase of muscle tension which

causes increased friction between the fingers and the rubbing pad. This causes the rubber to
crumple and slap back to the base (i.e.) the classic "Stick Reaction".
d. Radionic instruments: The topic of radionic diagnosis and therapy could take up a whole
series of seminars. Suffice it to say that it is still highly controversial, despite decades of use.
Early exponents of these instruments included Drs. Abrams, Ruth Drown (USA), George
Delawarr (UK) and David Tansley (USA). There are many types of instrument and are more
sophisticated than "Rubbing Pads", in that they are electrically- or battery- powered and a
"Diagnostic Cup" into which a "witness" of the patient (blood spot, hair sample etc), or a testhomoeopathic remedy etc can be placed.
The diagnostic aspects are similar to those already discussed under dowsing. Originally, the
operators of this technique believed that the energy emissions in disease could be detected on
specific wavelengths on special detector boxes. These boxes consisted of a series of rotatable
magnets, dials and antennae of adjustable sizes. They believed that each disease had its own
set of "rates" or antenna settings. These detector boxes (which are expensive) appear to give
very good diagnostic results in skilled hands. However, many dowsers have got equally good
results by simple dowsing. Also, it has been shown that the dials, knobs and inside wiring are
not essential for diagnostic accuracy. With wiring disconnected, an unknowing radionics
operator could work as if the circuits were fully wired-up! It is the mind and intention of the
operator which matter. If the operator believes he/she needs an expensive eye-catching
detector, then he/she needs it! If he/she believes that a bunch of keys (used as a pendulum)
will work, he/she will probably get equally effective results.
e. Instruments of the Voll-Vega type: In severe disorders of a Channel, its organ, or its
functions, many points along the Channel show abnormal sensitivity to pressure probes,
palpation, electric current or heat. This reflects disorder in the vital energy (Qi) in the
Channels. Altered point sensitivity occurs especially at the Ting points. These are the Well
Points, the most distal points, located at the nail of a toe or finger. Altered sensitivity at a Ting
point, or at other special measurement points, is the basis of the diagnostic methods of Drs.
Akabane, Reinhold Voll and others.
Akabane (Japan) used heat-sensitivity at the Ting Points to assess Qi Excess or Qi
Deficiency in one or more of the Twelve Main Channels. He held a lighted incense stick at a
fixed distance from each point and used a stopwatch to count the latency (in seconds) until the
subject reported a stinging sensation at the point. Hyper- or hypo- activity in a Channel was
determined by comparing the latency at each point with the mean for that limb and with the
latency at the same point on the opposite limb. Other workers developed this principle using
electrical resistance at AP measurement points.
Electronic diagnostic instruments which use the principle of altered point sensitivity are
sophisticated electrical resistance- or conductance- meters. They were developed by Japanese
(Nakatani, Motoyama), American, German (Voll) and other workers. The instruments are said
to be fast and reliable. Electrical conductivity and the DC potential of the points usually
increases in Qi Excess in a Channel. Conductivity decreases in Qi Deficiency. Altered point
sensitivity in disease may be unilateral (especially when the lesion is unilateral) or bilateral.
Some acupuncturists use the location of the sensitive points to assist in diagnosing the
location of the disease. For instance, in vague abdominal pains, if the points on the ST
Channel and the Earpoint "stomach" were more sensitive than other points, this would

indicate that the lesion or problem was with the stomach or its functions. It is claimed that
disease can be diagnosed in the very early stages (such as pre-clinical cancer) with these
methods. Infra-red thermography has confirmed the diagnostic claim of Voll-AkabaneRyodoraku measurements of altered sensitivity at peripheral points: organs project
information of their disease to the periphery via the autonomic nervous system. Clinical
detection of the altered sensitivity aids in diagnosis. Any method (including AP) which speeds
up the return to normal sensitivity is a good therapeutic method. Also, monitoring the speed of
return to normal sensitivity has prognostic value.
Unfortunately, there is little written in orthodox scientific refereed journals on these claims
and little research seems to have been done with these methods in animals. The instruments
are very expensive and there is inadequate proof of their value. As the probes are not springloaded on many of these instruments, constant probe-pressure can not be guaranteed. Any
involuntary changes in applied probe-pressure can change the electrical readings from the
points. This is a weakness of these instruments. Also, some of these instruments contain a
"Diagnostic Cup", as in some Radionic Instruments. A "witness" of the patient (blood spot,
hair sample etc), or a test-homoeopathic remedy etc can be placed in the cup and is said to
influence the readings, Physicists reject that claim, as they say that there are no precedents in
physics to explain this. However, these instruments appear to give excellent diagnostic help to
some practitioners. I believe that this is best explained as a form of dowsing, in which
involuntary changes in probe pressure manifest the intuitive diagnosis of the healer.
There are many other "diagnostic instruments". These include pointer rods, crystals,
pyramids, colour/shape patterns on filter paper induced by interaction of silver-, or other-,
chemical salts with the patient's urine etc. However, the Y stick, pendulum and rubbing pad
are the most common.
THE USE OF DOWSING IN DIAGNOSIS
Diagnosis is the location of the diseased systems or organs, recognition of the nature of the
illness and identification of the causes of the problem and the predisposing factors which
allow it to manifest as clinical illness. Merely putting a clinical name or tag on the disease is
not diagnosis!
Orthodox diagnosis is based on careful clinical examination, together with a knowledge of the
environment and psyche of the patient and any clinical or laboratory tests which may be
indicated.
Holistic, or psychic, methods can lead to the same conclusions as orthodox diagnosis.
However, radically different conclusions are reached occasionally because holistic-psychic
diagnosis considers many causes other than the orthodox causes, including Traditional
Chinese Medical (TCM) diagnosis, psychic attack (Fortune 19...), food allergy (Breneman
1987; Coca 1978; Mackarness 1976; Randolph 1951, 1965), geopathic and geophysical
causes ("black streams" crossing under the bed, noxious EMG fields etc).
In psychic diagnosis it is most important for the operator:
a. to "tune-in" to (feel empathy/sympathy for, and compassion with, the patient and the
cosmos and

b. to relax mentally and to become disinterested in, or detached from,the outcome.

He/she must beware of pre-conceived notions and personal diagnostic "hobby-horses".
Major system involved: Then a search is made through ALL the main systems using the
mental question "is there something seriously wrong with system X?". Thus, one searches all
the main systems (nervous (central/peripheral), endocrine, immune, skin, musculoskeletal,
visceral (cardiovascular, respiratory, digestive, urinary, reproductive etc) etc.
Location involved: If a "yes reaction" emerges, the location is searched. For example, if the
skeletal system gives "yes", one would question the location as: skull? spine?, upper limb?,
thorax?, abdomen?, lower limb?. If "yes" to spine?, one would ask: cervical?, thoracic?,
lumbar?, sacral?. If "yes" to lumbar spine: is it at : T12, L1, L2, L3, L4, L5-S1?
Nature of the disorder: Having found the location of the problems, their nature is questioned
systematically, considering possibilities of: immune disorders (autoimmunity, inflammation,
allergy, immunosuppression, infections, parasitic, cancer, etc); toxins (microbial, plant or
chemical); neuroendocrine (autonomic (poor microcirculation, smooth muscle spasm etc),
endocrine etc); degeneration, traumatic (muscle injury, prolapsed disc etc); nutritional and
metabolic disorders etc.
Other causes and predisposing factors: Further information on the causes and predisposing
factors may be evident on consideration of: genetic susceptibility, environmental factors
(climate, geophysical EMG fields), stress (spiritual, psychological, physical), etc.
Fixed, systematic routine: When using psychic methods of diagnosis, it is most important to
follow a systematic routine, to avoid omitting relevant (possible) locations, nature of disease,
causes and predisposing factors. Haphazard searching usually gives poor results and
incomplete information on the problem.
Some operators prefer to diagnose in the presence of the patient. Others may diagnose using a
photograph of the patient. Still others use merely a diagram, for example, of a horse (in
diagnosing a horse problem) and concentrate on their patient while moving the pendulum or V
rod etc over the diagram.
DIAGNOSTIC DOWSING
The main methods used in diagnostic dowsing are diagnostic autotraining, the diagnostic
pulses (VAS, surrogate, Chinese), diagnostic visualisation and Westermayer's method.
DIAGNOSTIC AUTOTRAINING
With experience and increasing self-confidence, some dowsers dispense with the usual
instruments. They believe that their spirit-mind-body can act as the diagnostic biosensor. One
can train oneself to recognise involuntary sensory or motor reactions. These include pulse
changes; visualisation; mental, visual, auditory and physical sensations in the mental state of
"My body = patient's body!", etc.

Autotraining is a form of autonomic-vegetative learning. It is a mental, somatic and visceral

process which can be induced by Pavlovian methods of reward and punishment" techniques in
animals and humans.
Biofeedback ... rats, humans, ...
Thus, some dowsers train (programme) themselves to recognise a "Yes Reaction" by
registering involuntary muscle twitches of the back, face, eyelids, neck or arm muscles, or
"feeling it" a tickle or itch in the palm or finger. They slowly move their hand, or a pointer, or
point the finger, along the body of the patient (or the map etc) being searched. They "know"
when they have found the objects of the search, as they have programmed themselves to
register an itch or tickle in the finger as it passes over the problem area.
TaiQi and QiGong are two very useful ways to train the Qi of the body and the mind
respectively. Pulse-taking, self-hypnosis and visualisation are other advanced methods of
autotraining, which will be discussed below.
DIAGNOSTIC PULSES
The VAS Pulse: ...
Surrogate Pulses: When in a detached mental state, in communion with the patient (human
or animal), Adepts and Seers can sense changes in their own pulses (or those of the owner or
handler) which reflect the Qi status of the identical Channel of the patient. The patient may
be nearby or far away.
Surrogate pulse taking must be defined as paranormal. It is similar to kinesiological
diagnostic techniques, such as the Omura O-Ring test (force needed to break the O-Ring made
between a surrogate's thumb and index finger) or more classical kinesiological muscle tests
(in which the strength of a surrogate's muscles (for example, the resistance to forcing down
the extended arm) is questioned systematically, as in dowsing). ...
Chinese pulse diagnosis, physical or psychic?: In Traditional Chinese Medicine (TCM), the
Qi status in each of the 12 Main Channels can be assessed by the qualities of the Pulses at 3
positions over each radial artery. The classic positions are indicated in the table below.
Left Radial Artery
Superficial

Deep

Pulse

Right Radial Artery

Position

Deep

Superficial

SI

HT

Distal

LU

LI

GB

LV

Middle

SP

ST

BL

KI

Proximal

PC

TH

In taking the pulse, the operator compares the quality of the pulse at each of the three
positions while applying gently and then deeper pressure to assess the superficial and deep
qualities. It is said that pulse taking can take up to half an hour.

This suggests to me that the mechanism is mainly by a type of dowsing, a comparisons of the
sensations to: "is there something wrong with the SI pulse?" HT pulse? SI pulse? HT pulse
(compare ... compare ...).
An American author (Callehr) reported his methods of pulse diagnosis and the outcome of
treatment in a large number of human psychiatric cases. The clinical results were very
impressive but the pulses were read on incorrect hands (the opposite hands to the
classical).
In Western AP the Chinese Pulse is largely ignored, mainly because of lack of expertise.
Modern texts from China, Taiwan and HongKong also ignore it, or give it very brief
discussion. Furthermore, high therapeutic success rates are reported by physicians who ignore
the Pulse system. However, in skilled hands, Pulse Diagnosis can be extraordinarily accurate
but I believe it to be a psychic rather than a physical, objectively demonstrable phenomenon.
Those who wish to study Pulse Diagnosis will find details in Wu Wei Ping, Mary Austin or
Nguyen van Nghi.
DIAGNOSTIC VISUALISATION
Some practitioners do not use physical instruments but visualise (in their "mind's eye",
behind closed eyelids) what reaction the instrument would give to their specific question.
"Unless ye become as little children": Young children can spend long periods
"daydreaming". They "See" things as they wish to see them, usually with their eyes wide
open. Most adults have lost the ability to visualise whether they open or close their eyes.
However, it is not too difficult to relearn the technique.
Relearning to visualise: An easy exercise in visualisation is to look at a matchbox, or pencil,
or pipe etc. Close your eyes and try to "See" the object on the back of your eyelids. Can you
see its shape, colour, texture? In the beginning the results are poor. Later, visualisation of
physical objects is easy. Then, one proceeds to visualise people, scenes etc. (This method can
be used very successfully in self-relaxation. You can "play" your favourite 18 holes of golf, or
"fish" your favourite river or lake very easily with this method).
Diagnostic visualisation: Having mastered these forms of visualisation, one can try to
diagnose the more difficult cases by visualising the patient. The Silva Mind Control
technique (see references) is excellent to teach these methods. There are many ways of doing
this. Three common methods of diagnostic visualisation follow:
a. Visualisation with eyes closed: Adopt a system of "normal" and "abnormal" signs for this.
For example, make a white or golden haze the "normal" signal and a red flashing light the
abnormal. "Scan" the visualised body from head to toe looking for the problem areas. Begin
the scan with a white or golden haze above the head and then move down the body. If the
"normal haze" is interrupted by a red flasher at any point, visualise deeply into the body at
that point. Imagine that your mental eyes have X-ray- or CAT-scan- ability to locate the organ
involved. Having found the organ visualise the normal haze again. This time adopt the same
code (haze = OK; red flasher = problem) while mentally asking the question: is it
inflammation, infection, cancer, trauma, etc, etc ?

b. Visualisation with eyes open: Look at the patient, or an image (photograph, diagram etc)
of the patient. Proceed as in (a) above.
c. The "Silva Mental Laboratory": The Silva Method teaches students a form of deep
relaxation or self-hypnosis. Each student constructs a Mental Work-space. The Work-space
can contain every conceivable piece of computerised diagnostic equipment which the healer
may need: X-ray, CAT scanners, ultrasound scanners, blood- and gas- analyzers, electronic
diagnostics, a state-of-the-art custom-made work-chair etc. The Work-space also has
Professional Helpers, specialist consultants and colleagues from the Mental World, who
volunteer to help (on request), as needed by the case.
The subject to be diagnosed is presented mentally to the reception area of the Work-space and
is logged-in. His/her previous files are recovered and perused. He/she is then taken to the
examination areas for a full work-up. All instruments, computers, printouts, scans etc are
activated by thought (no hands are needed for keyboard-work etc). Computerised reports, or
scans, are projected in colour to a high-resolution flat-screen which is transferable to any wall
within the Work-space. In two Silva courses, which I attended, students with little or no
knowledge of medicine were able to get 60-100% accuracy in distant psychic diagnosis at the
end of 40 hours of training! Such results seem incredible but they were real! For myself, it's a
case of "Now you see it, now you don't!". Sometimes it works but more often it is not correct.
I am still trying to get the method to work consistently for me. Meanwhile, I use more
conventional diagnostic methods!
DIAGNOSIS BY WESTERMAYER'S METHOD
I and many other veterinarians observed the diagnostic methods used by late Erwin
Westermayer (Bellamont, Germany). For me, Erwin was a truly great diagnostician, healer
and Magus. His diagnostic skills were legendary and I know of few equals. He did not have to
see the animal patient, or to have a detailed history of the case. Three of his methods are
described.
a. "My body is patient's body; what do I feel ?": This was Erwin's favourite party-piece.
He would stop his car some kilometres from the farm and get out on the side of the road. He
relaxed into a type of trance and began to move the various joints and parts of the body, from
the head to the toes. He systematically visualised himself in the animal's body and "felt" for
any subjective sign in his own body to tell him what the animal was trying to tell him:
"My right eye is the (calf's) eye; what do I feel?";
"My left ear is the (cows's) ear; what do I feel?";
"My neck is the (horse's) neck; what do I feel?";
"My right hock is the (dog's) hock; what do I feel?"
etc.
Within a minute or so, he sensed in his own body the site of pain, discomfort, or other lesion
which he saw when he later examined his patient clinically.

b. Visualisation: (See above). Erwin also used visualisation (with his back turned to the
patient), and he taught this method successfully to other vets. I saw two novices of this
technique diagnose with great accuracy physically objective lesions (splint, periostitis, curb
etc) on horses which they had not seen until they had verbalised the diagnosis to observers.
c. Autotraining: (See above). Erwin would run his hand over the animal at a distance of 2-4
cm from the skin and sense a tickle, or itch, or sensation of warmth or cold as the sign that
that part of the animal was signalling distress to him.
DOWSING AND AP
Dowsing techniques can help in diagnosing the nature and location and causes of the problem,
as discussed above. They may also be used to determine which Channels are out of balance.
For example, is there something seriously wrong with the LU, LI, ST, HT, SI, BL, KI, PC,
TH, GB, LV, CV, GV Channel?
If yes: is the left side affected? right side?
Is the Qi Excessive, Deficient, or Blocked in the affected Channel?
Is there a physical blockage (scar, injury etc) along the Channel?
For this type of diagnosis, it is useful to have a symbol of the patient (chart or diagram)
showing the 12 main Channels and the CV, GV Channels. One concentrates on each
Channel in turn, noting any "yes" reactions for further questioning.
When Qi imbalance is located, one may dowse to locate the best points for therapy. For
example, in loin and leg lameness, the pendulum may indicate the BL and GB Channels as
the best for therapy. Then, counting down the points (or going over the body, or a chart of the
body) in the region BL23 to 54, one may get positive reactions in BL23,25,32,37,40 etc. One
may also find AhShi (sensitive-, "ouch-") points with the dowsing technique.
One also may ask how many AP sessions are needed (1, 2, 3, 4 etc ?), their duration (1, 5,
10, 15, 20 etc minutes) and the interval between treatments (0.5, 1, 2, 3, 4, 5, 6, 7 etc days)
Intuitive location of the best AP points for therapy: Classic books on AP state that the
master can "feel" the points as small holes or depressions in humans. Most of our animal
patients, however, have a hair coat which would prevent this.
Having observed and having talked to skilled medical and veterinary acupuncturists
(especially those who have some experience of paranormal methods), I believe they "know"
when they have located the point. (See the section on autotraining, above). Some people find
the AhShi points intuitively, merely by running the hand across the body, but not in contact
with it. As the hand, or the finger, passes over the AhShi point, the healer feels a muscle
tremor or hot/cold/itch sensation in him/her-self. This indicates to him/her that the point is
relevant. Pressure palpation of the point confirms immediately whether the "psychic
impression" was correct or not.

Relevant AP points also can be located quickly by the reaction of a pendulum (dowsing).
Another method is to (mentally) visualise the animal and to scan the body looking for the best
points to treat, having programmed the mind, in advance, to be drawn to these points.
In classic human AP, there are about 14 Laws which are used to choose the best points for
therapy. However, the Five Phase Points are said to be very important. Their choice in each
case is based on:
a. the diagnosed Chinese Syndrome (the symptom picture, which may indicate imbalances
between the Phases and within one or more Phases) and
b. the Chinese Pulse Diagnosis.
In vet AP, even if one wished to use the concepts of the Human Chinese Pulse to diagnose the
location and nature of the problem, or to select the best points to treat, it would be impossible
to transpose directly because of anatomical differences in the arteries and also because the
Five Phase Points are located on those parts of the limbs which show the greatest anatomical
differences from Homo sapiens, with his/her five digits. Some traditional vet texts, including
Klide & Kung, report that the Chinese Pulses may be taken in animals on the carotid or other
accessible arteries but few of the vet colleagues whom I know use this system. Those who do
usually can use other Pulse methods also (their own (radial or temporal) VAS or Chinese
Pulse, the patient's, or a surrogate's.
Of course AP points can be found by conventional anatomical relationships and
hypersensitive or AhShi points can be located by physical or electrical probing!
Case history 1: Horse lame (no further details). I tried to diagnose the case using the dowsing
method in a restaurant some kilometres distant from the animal, about which I knew nothing
except that it was lame. Erwin Westermayer had already seen this animal but did not tell me
his findings.
I asked the following questions in my mind (using my thumbs as a Y stick):
a. Limb lameness? (yes).
b. Forelimb? (yes). Hindlimb? (no).
c. Left fore? (yes). Right fore? (no).
d. Scapula? (no). Shoulder joint? (no). Humerus area? (no).
Elbow area? (yes).
e. Is this a left elbow lameness? (yes).
f. Dislocation? (no). Fracture? (no). Sprain? (yes).
g. Tissues involved: muscles? (yes). Ligaments and soft tissues? (yes). Bone damage? (no).
h. Duration: less than 1 day (no). 2 days (no). 3 days (no). 4 days? (yes).

Clinical examination showed that the horse had a lameness of the left fore. On palpation of
the elbow area, the muscles were sensitive to pressure. The owner said the horse was lame for
about 5 days!
Treatment indicated : AP? (yes), other treatments? (no).
Westermayer treated this case with needles in local points, AhShi points and a few distant
points on the forearm. The result was excellent.
Case history 2: Walter Greiff had told me in 1977 that many of his non-responsive cases of
ketosis in cows were associated with crossing streams underneath the stall. (In Germany, cows
may be tied in the same stall for up to 10 months of the year). Greiff practices at Donaustrasse
39, Grenzhof, Memmingen, Schwaben, Federal Republic of Germany. He has a mixed
practice. He has confirmed that many chronic cases (especially non-responsive ketosis) in
housed cattle are associated with geopathic zones.
We visited one such farm, in which he had located the crossing-point some 12 months before.
Meanwhile, the farmer had moved the cows to a new cow house. The old house was used as a
feed/fertiliser store and there was no visible clues to the location of the problem stall.
I first walked around the house, just inside the wall, and picked up stream (A) - (B). Further
searching revealed another stream (C) - (D). It was a simple matter to find the intersection
point (E). I stood there and pointed to the spot. The farmer laughed, nodding his head
violently : Ja! Ja!
Diagram of streams A-B and C-D crossing at point E (problem cow-stall).
A
.
_____(DOOR).
|

___________________
.

C ...|..............E...............|....

.
(DOOR)
|

(DOOR)
.

|____________ (DOOR) __._______|

.
B

One should always consider the possible association between disease and physical
location (high tension cables, geopathic fields, other Electromagnetic Fields (EMFs) etc).
Dowsers in Europe, Australia, Africa and America have reported that many diseases in man

and animals are associated with strong reactive points over crossing underground
streams or rock/ore fissures. Insomnia, arthritis rheumatism, asthma and cancer have been
associated with these places. Where cattle or other animals are confined to a stall or pen
directly over these geophysical reaction points, chronic disorders can arise, such as poor
growth, chronic ketosis and infertility. Orthodox treatment is often unsuccessful in these
cases. If, however, the animals are moved to a stall/pen which is free of reactive points, the
condition usually disappears quickly. Some animals, such as dogs and cattle (Yang animals,
expenders), avoid such places if they are not forced to stay there. Others, such as cats, bees,
ants and calving cows (Yin animals, gatherers), actively seek out these points.
Many human ailments are associated with the bed, favourite armchair or work area
situated directly over these "reaction zones". Most doctors and vets are not aware of these
effects. Treatment in these cases is to move the animal to a neutral zone, if possible. Failing
this, various methods can be tried to "neutralise" the effects. One such method is to drive an
iron bar 0.3-0.6 metres long into the ground upstream of each of the problem streams
directly over each stream before it crosses under the house. Many other methods ("earthing"
to copper water pipes, metallic grids, symbols, crystals, "power stones", and even "mental
cleansing" of the area) are discussed in the Dowsing Journalks (see references).
We know that the AP points are electrically sensitive points and that they form a network on
the surface of the body. They can be seen as the interface between the external and internal
environments. Exposure of the organism to adverse climatic conditions or geophysical fields
can influence the metabolism of the body via the electrically sensitive points.
In some cultures, before a house is built, dowsers are used to check the site before the
foundations are built. If there are many geopathic reactions the site to the foundations are
moved to a more satisfactory location, or one can try to heal, or rebalance, the abnormal Earth
Energy.
DOWSING AND HOMEOPATHY
Homoeopathic practitioners can also use the dowsing techniques to assist in diagnosis. Having
diagnosed the cause, one must choose suitable homoeopathic remedies. Here again, the
dowsing techniques can help. If the symptom picture suggests 3 or 4 remedies with similar
symptom pictures, one may decide by concentrating on the patient while asking the question:
is this one (of the 3-4 remedies) the best one for my patient?
Each remedy is tested separately and the "yes reaction" is taken to indicate the best one.
Alternatively a bottle of each remedy is put in a test area near a "witness" of the patient. The
pendulum or dowsing rod is used to test compatibility or incompatibility.
TEST
|
REMEDY ..........|..........
|
HERE

WITNESS

If more than one remedy is required, the "yes" reaction may be used to check if the
combination is compatible with the patient. (Some remedies neutralize each other. This
would be indicated by a "no" reaction).
Having chosen the remedies one may then check the potency, dosage and interval between
doses of each one as follows: what is the best way to use this remedy for this patient: (a) low
potency? high potency? If low potency, mother tincture? 3X? 6X? 6C? 12C? 30C? If high
potency, 60C? 120C? 1M? 10M? CM?.
Having decided on the potency, one can check the number of doses : 5?, 10?, 15?, 20?, 25?
etc. (Note: high potency doses are usually given only once or (twice). Then decide how many
doses per day: 1?, 2?, 3? etc and how many days rest between days of medication 1?, 2?, 3?
etc.
OBJECTIVE CONFIRMATION OF PSYCHIC/INTUITIVE DIAGNOSIS
Of course the preceding sections on psychic diagnosis may seem to be superstitious, medieval
hocus-pocus (satirical Hoc est Corpus). I suspect that many self-styled "psychics and healers"
are little better than charlatans and confidence tricksters. However, some genuine healers find
these techniques to be very useful.
The validity of the psychic diagnostic technique depends mainly on confirmation by
more orthodox methods that the location, nature and cause of the problem is indeed
correct.
Having dowsed the case, do a conventional examination (anamnesis, physical + clinicalpathological) and, possibly a complementary examination (AP,
osteopathic/chiropractic/homeopathic etc).
Then, if possible discuss (with humans) or mentally discuss (with animals) the following:
What do you think is wrong in your life, in your relationships, in your body, in your spirit?
What upsets you most? What hurts you most?:
Fire (HT, SI, PC, TH) : What excites/depresses you most?
Earth (SP, ST) : What are your great worries/obsessions?
Metal (LU, LI) : What makes you weep/sob/cry?
Water (BL, KI) : What frightens you (do you fear) most?
Wood (LV, GB) : What makes you angry/jealous/envious?
If you had a "magic wand", what would you most like to change about your spirit, mind,
body, sexuality, relationships, work, life?
Double-check the interpretation from the psychic, physical and psychological/spiritual data
and try to find the main lines of agreement between them.
PSYCHIC HEALING TECHNIQUES

Psychic healers often have no training in biology and medicine. Some of these people believe
that God acts through them; others do not believe in a God, but may use some type of
meditation, or trance, or "thought projection" to help the patient. The healer may be local
(near to), or far distant from, the patient.
Some vets and doctors have these gifts to a greater or lesser degree. They may not realise that
they have the ability and they may attribute their diagnostic skills and clinical success to
"luck" or good fortune as well as good medicine.
Four common methods of psychic healing are:
a. "hand healing";
b. telepathic healing, with or without symbolic aids and visualisation;
c. "radionic broadcast therapy" and
d. symbolic transfer of homoeopathic remedies.
These methods are used by many healers who know nothing of AP; but knowledge of Qi
circulation in the Channels as the basis of health, and of the Channel circuits and their
interactions, are ideal foundations for these methods of psychic healing.
a. Hand Healing: The patient visits the healer, who "lays hands" on, or near, the affected
parts. Sometimes a simple prayer is said asking for the ailment to be cured. The success rate
varies between healers but some are very good. Common conditions treated by such healers
include ringworm, jaundice, shingles (Herpes), gastrointestinal worms, thrush (yeast- or
fungal- infection of the orifices), haemorrhage, red-water (babesiosis in cattle).
A country-woman in west Sligo had been healing ringworm in this way for years; she touched
the part and said a prayer, asking for Divine Help to heal the lesion. Her protocol was three
sessions: Sunday, Wednesday and Sunday. About 1979, one of my aunts had a radical bilateral
mastectomy, followed by severe radiation therapy for breast cancer. Following the radiation
therapy, she developed dreadful secondary infection of the area. The infection was treated by
topical antibiotic and parenteral therapy. As there was no success after weeks of therapy, I
persuaded the healer, who had never tried to cure such a case before, to treat my aunt. She
used her usual protocol. By the second Sunday, the skin infection was completely cleared up
and had remained so for more than 17 years.
Oisin ... anaemia/stunting:
Hand-healing and AP: The hand healing technique can be applied to the AP system. Healers
emit increased energy discharges from their hands during the healing session, as has been
shown by Kirlian photography. One way to influence the Qi system is to concentrate on
balancing Channel Qi while passing the hands over the Channels especially in the problem
areas. In cases where a Channel is in Excess, the healer wills Qi to move to Deficient areas.
If there is no Deficient Channel to take the Qi Excess, will (visualise) the Excess to pass to
the excreta (urine/sweat/faeces). In cases of Deficient Channel Qi, draw on any Excesses
which exist to fill the Deficiency. If there are no Excesses, will (visualise) some Qi to come
from a number of other Channels (especially the reservoirs: the GV and CV Channels) to fill

the Deficiency. (Also advise on tonic diets for extra Qi and remember ST36 and BL43
(lateral to BL14) in chronic debilitating diseases). Remember the Luo (passage) points (KI04,
SP04; HT05, LV05, TH05; LI06, PC06; LU07, SI07; GB37; ST40; BL58) when
redistributing Qi among the Channels, whether using classic needling or psychic transfer.
QiGong: Modern Chinese Communists do not believe in a soul (a personal energy or memory
independent of the body) that survives death. However, recent unconfirmed reports from
China indicate that research in QiGong is producing exciting results. Mental and physical
focusing/control of body Qi is possible. It can be learned and used for many purposes,
including diagnosis and healing. Acupuncturists who are Masters of QiGong can often
"sense" the location of disturbed Qi in the patient and, without touching the patient, can treat
the disorder by directing their own Qi to the correct AP points.
b. Telepathic healing: With or without the conscious knowledge of the patient, by psychic
means, some people can help animals or humans to heal themselves. Such healers may be
with, or far distant from, the patient: they simply pray for (or visualise or concentratemeditate on) the patient and "project Qi, or Prana, or healing energy" to the diseased area,
Chakra or AP points. The session may last 0.5-5 minutes, or more, and is repeated as often as
is necessary.
There are many variations of this technique. To help concentration on the patient, the healer
uses the "witness" (focus of concentration) which best suits the healer's temperament. To
overcome the imbalance of life Qi, and restore it to normal, the healer "wills" (visualises)
healing energy to permeate the energy body of the patient.
In this technique the focus of concentration in absent healing may be a photograph of the
patient, a blood-spot or sample of hair, nails or saliva of the patient. Some healers merely
write the patient's name on a piece of paper and concentrate on that. Those who use the AP
system may visualise the patient's Channel system and "remove" the red flashing areas,
replacing them with a golden or white haze, if these are the healer's norms for healthy Qi (see
the dowsing methods of diagnosis).
Visualisation: Another type of approach is to visualise the patient at his/her worst, with all
symptoms and lesions exaggerated. Then "scrub out" this image from your mind's eye and
replace it with a positive one in which the patient is bouncing with energy and vitality.
Those of you who have read of Yoga will know of the concept of Prana, Kundalini and the
Chakras. (These concepts are quite similar to the Chinese concepts of Qi and the Channels).
One type of telepathic healing visualises the patient with the crown Chakra (on top of the
head) open. The healer then imagines streams of energy coming from the Cosmic Source of
Energy (or the God Force) beaming down toward the patient, penetrating the crown Chakra
and flowing all through the patient's energy system until it is ablaze with light. Then the
crown Chakra is "closed" and sealed shut, retaining the healing energy.
Symbols, diagrams and the "Sorcerer's Doll": Another focus of concentration is to use
two-dimensional symbols or diagrams, such as standard AP charts. Alternatively, one may use
three-dimensional dolls, such as those depicting the human and equine AP points. One may
(mentally) visualise needles or bursts of Qi (as golden (Yang) or white (Yin) energy)
penetrating the AP points, or the imbalanced Channels, most relevant to the patient's
condition. In very serious cases, where one may wish to apply longer stimulation, one may

physically insert needles into the correct AP points (or those located by the dowsing) in the
doll, willing the Qi to be similarly manipulated in the absent patient.
Such practices may upset the religious feelings of some listeners, as they are very similar to
voodoo rituals. If voodoo is seen as Black, the healing ritual must be seen as White, as the
intention is positive and good. All human gifts and energies (speech, sexuality, creativity etc)
can be used for good or evil. Conscience and intention are very important in the human
morality of thoughts, words and deeds.
The Silva Treatment Suites: See Diagnosis by Visualisation, section (c), the "Silva Mental
Laboratory". The Silva Work-space also contains every conceivable piece of computerised
treatment equipment which the healer may need: electronic therapy machines, acupuncture,
laser and ultrasound suite, physiotherapy and massage suite, sauna, hot and cold pools,
relaxation rooms, blood- and gas- exchangers, surgical suite, gamma-ray probes etc. The
Treatment Suites also have Counsellors and Professional Helpers, specialist consultants and
colleagues from the Mental World, who volunteer to help (on request), as needed by the case.
The subject to treated is presented mentally to the relevant suites for comprehensive
treatment. Personally, I use more conventional treatment methods, but I occasionally go to my
Work-space to help friends who are far away.
Techniques of telepathic healing are almost as varied as the healers who use these techniques.
The main thing is to have compassion for and sympathy with your patients and to wish them
everything they need to regain health. Love is the key!
NORWEGIAN VET ...
c. "Radionic broadcast therapy". Radionic practitioners believe that their instruments can
broadcast healing waveforms. One well known company (Delawarr Laboratories, Oxford,
UK) recommend that the dials on their broadcast instrument are set to the inverse of the
diagnostic rate. For example, if the values on four diagnostic dials were 60, 10, 80, 20 for
disease X, to broadcast the healing energy, the values on these dials would be set at 40, 90, 20,
80 respectively. (Note : 60 + 40 = 100; 10 + 90 = 100, etc).
This type of healing is an extension of telepathic healing. In both cases we see a ritual of
concentrating on the patient ("tuning in" to the patient), followed by the positive intention to
help by correcting the energy, imbalance in the body and energy body.
d. Symbolic transfer of homoeopathic remedies: This is a method which can be used very
simply or in more sophisticated ways.
Having chosen the correct homoeopathic remedy, one may put it in a symbol ready for
"beaming down" to the patient. A circle or equilateral triangle is often used. These shapes
have esoteric and religious significance stretching back thousands of years. The medicine is
put into the centre of the symbol on top of (or beside) the patient's name, which is written
inside the symbol:
.
.

. Tom .
.Arnica6.
...........

Occasionally a symbol of the medicine (for example, its name or a geometric shape designed
to represent the essence of the medicine) is used instead of the medicine. The healer then
"wills" the essence of the remedy to travel to the patient. A variant of this technique is to put
the medicine (or its symbol) into the well of a radionic broadcast instrument and to broadcast
the essence to the patient, as if it were a radio-wave.
One healing symbol which I use is shown below. It consists of an equilateral triangle, apex up,
in a circle. The circle is surrounded by another ovoid shape, topped by the great Omega and
bottomed by the great Alpha its end. The patient's name or initial is placed in the centre. The
significance which I place on this symbol is as follows. Triangle: the Trinity (Creator,
Saviour, Spirit). Circle: continuity, infinity, birth and death and rebirth. The triangle is sharp
and angled, a YANG (male) symbol. The circle is soft and round (YIN, female) and contains
the YANG. The alpha and omega are symbols of the Godhead also, the beginning and end of
all things. They are joined and surround the rest of the symbols.
The meaning is : "May my Patient in his/her short journey from God to God be flooded and
surrounded by the infinite energy of our Great God. May God protect him/her".
If this idea interests you, make up your symbol. It won't do any harm and it could do a lot of
good! On the other hand, if you show it to the wrong people, you may wind up in the nearest
asylum for the mentally disturbed!
INTEGRATION OF THE PARANORMAL INTO AP
The seers of the East and West have claimed that all living things have Qi, an Aura, or
Energy Field. This aura reflects the mental and physical state of the organism. It responds to
the internal environment of the organism and also to its external environment (terrestrial and
extra-terrestrial forces). It is the interface between the external and internal environments.
The AP points are the areas where the Energy Field is strongest. In disease, the energy pattern
at the AP points changes. These changes can be sensed (by paranormal sight or touch) by
psychics. With some experience, the nature and location of disease can be diagnosed by the
changes in the Energy Field. (By telepathic means, trance, clairvoyance or other paranormal
means, these changes can be sensed at great distances by trained psychics).
Healing can be stimulated by altering the Energy Field of the patient so that normal patterns
of energy are re-established. Transfer of energy from the healer to the patient causes this to
occur.
Those who are trained in the AP method can concentrate more specifically on sensing and
altering the Energy Field at those AP points which are most affected.

FURTHER TRAINING
Some of you may have had paranormal experiences or may suspect that you have some
psychic healing power. If so, I strongly urge you to read up the techniques of dowsing,
radiesthesia, self-hypnosis and telepathic healing. I have touched only briefly on some of the
psychic technology. You must study the methods in much more depth. There are many
American and European books on these topics. One of the best of these is the Silva Method
of Mind Control (see references). Similar mental control can be learned by the techniques of
Yoga and QiGong.
Please remember that some of these books are of very poor quality. However, the idea is to
read widely on the methods and to find one which suits your temperament and abilities.
It is most helpful if you contact medical or veterinary colleagues who use psychic methods.
One such group is the Scientific and Medical Network (see Useful Contacts, under
References). This is a group of doctors, scientists, artists, writers and vets whose common
bond is that they believe in (and use) spiritual energies in their work and play. They hold
regular seminars and training sessions and they publish a fascinating Newsletter which covers
science, medicine, physics, metaphysics and religious concepts.
You could also join a local dowsing group and subscribe to the dowser's journals. The
American Society of Dowsers (ASD) and the British Society of Dowsers (BSD) (see Useful
Contacts, under References) publish journals which covers many facets of the diagnostic and
healing techniques.
Dream-trance/hypnosis: In occult traditions, thought (dream, conception, will) precedes
action (foundation, construction, reality). The Spirit(s) breathe(s) the dream/idea, which may
strike a number of people at the same time. Nothing is more powerful than an idea which has
reached its time. If enough people want something to be (to happen), it will, at least for them.
The dream precedes the blueprint, which precedes the Taj Mahal. Directed or controlled
visualisation (daydream) is a powerful tool.
Truth versus fantasy: Truth/reality is primarily opposite in trend to dream/fantasy but the
seeds of one lie in the other and the opposites of each lie in each. One can lead to the other.
Dreams or fantasy can have a basis in truth/reality and can develop into it, as in precognitive
dreams or medical diagnosis/healing using the inner (sixth) sense. Truth/reality can have a
basis in dream/ fantasy and can develop into it, as in human endeavour in the First World to
solve the problems of the Third World. One fingerless hand claps, as in most aspects of
nature.
My truth/reality may be your fantasy/nightmare. Our interpretation of the world is imperfect
and subjective. It depends on our senses, our training and, to some extent, on intuition/instinct
to fill in missing pieces of the image. Reason can be defective, a fact well known to those who
work with psychiatric patients.
If truth is certainty and our world uncertain, our world is fantasy. The main certainty for us is
death, the main uncertainty what then?
Hallucinations and delusions may be signs of serious mental illness or of exposure to alcohol
or psychotropic drugs! Those who attempt to use psychic methods or diagnosis and

healing must constantly guard against self-delusion. Let the success of the method in
clinical practice decide whether or not the method is justified as a technique in its own right or
as a supplement to conventional techniques. It is the clinical outcome of the case which
matters most. The aim of the healer is to help the patient to regain health. The healer must
decide whether this requires an orthodox or an unorthodox approach (or combination of
approaches).
I ask you to keep an open mind on these questions. If some of you recognise these abilities in
yourselves, please read as much as you can of the literature on the paranormal. You will find
that your clinical success will improve when you combine these techniques with scientific
medicine. I am no expert in these methods but I have studied different approaches to these
techniques since 1973 and I am still trying to train myself to them: I am trying to rediscover
my birthright, the culture of my childhood.
CONCLUSIONS
I have discussed the main methods of diagnosis and therapy in relation to psychic healing. In
dowsing, the techniques used are many and varied. What works for one operator may not
work for another. The important thing is to have confidence in your own method and to get
plenty of practice with it.
If you believe that the patient must be present to get good diagnostic results with dowsing, it
will be necessary for the patient to be present! If you believe that a witness is needed for
distant dowsing, you will need a witness!
Your belief in yourself, self confidence and a sense of detachment (relaxation) are of the
utmost importance in dowsing, as they are in your professional, social and personal life.
Above all, any subjective diagnostic or therapeutic impressions should be confirmed by
objective evidence, especially the clinical response to treatment.
Psychic methods of diagnosis and healing should complement conventional methods. In the
first attempts at these methods, the novice may expect to find serious conflicts between the
psychic and orthodox methods. This should not be allowed to discourage further attempts. In
cases of such conflict, the operator should rely more on the orthodox conclusions. Later, as
he/she gains more self-confidence and experience, the psychic conclusions may become more
important aids.
Before one attempts psychic diagnosis, healing, or projection to a human patient's psyche or
energy field, one should get permission from the patient, or from the guardian; when
attempting to work with an animal in this way, permission should be given by the owner,
handler, or trainer.
Despite genuine attempts to learn the techniques, many of us may never develop significant
psychic abilities in this life. This, per se, should not cause us to be sceptical of, or to deride
others who have these abilities! These skills exist to a high degree in some people and we will
never know if they exist in us unless we try to find them.
I gave much thought as to whether or not I should discuss these topics with a scientifically
trained audience of vet colleagues. There is a danger that such discussion may undermine my
entire credibility as a qualified lecturer! Some of you may have been scandalised by these

topics. If so, I apologise to you and I ask your patience. Please, forget this section and try the
more conventional techniques. Let me assure you that the orthodox (physical) techniques
of AP are adequate for most conditions responsive to AP! Orthodox physical concepts can
explain AP satisfactorily, without the necessity of invoking the "paranormal".
The central thesis of this paper is that love and prayer are central to all healing. The great
healers known to me combine four attributes:
1. a high level of technical knowledge and skill
2. empathy with the subject and a consciously directed intention to heal
3. compassion with the subject and a spiritually directed desire to heal
4. deep wonder and humility at being part of the cosmic creative force, the source of all
healing.
Whether we like it or not, there is a growing consciousness of these topics in the West. It is
time that scientists discuss the "paranormal" even if its validity is not proven to the high
degree of predictability set by "scientific protocol". Therefore, I thank your Committee for the
courageous decision to include these topics in a serious veterinary seminar! To those of us
who have first-hand experience of psychic methods, they merely add another dimension to a
fascinating tapestry that is total reality.
REFERENCES

Bell AH (1965) Practical Dowsing: A symposium (G. Bell & Sons, London).
Breneman, J.C. (1978) The basics of food allergy. Charles C. Thomas, Springfield,
Illinois.
Burr HS (1972) Blueprint for immortality: the electric patterns of life. Neville
Spearman Ltd., London (or) Burr HS (1973) The Fields of Life: our links with the
universe. Ballantyne Books Inc., New York.
Coca,A.F. (1978). The pulse test: easy allergen detection. Arco Books, c/o Thorson's
Books, Wellingborough, Northants, England.
Fortune, Dionne (19...) Psychic Self-Defence. ...
Graves,Tom (1976) Dowsing techniques and applications (Penguin Books,
Middlesex, UK).
Hitching, Francis (1977) Pendulum: the PSI connection (Fontana/Collins, Glasgow).
Karagulla, Shafica (1973) Breakthrough to creativity (De Vorss, Santa Monica,
California 90404).
Koestler, Arthur (1973) The act of Creation (Picador/Pan Books).
Koestler, Arthur (1974) The roots of coincidence (Picador/Pan Books).
Kethbridge TC (1974) ESP: beyond space and time (Sidgwick & Jackson, London).
Mackarness,R. (1976) Not all in the mind. Pan Books, London.
Maury, Marguerite (1953) How to dowse (G. Bell & Sons, London).
Mermet, Abbe (1975) Principles & practice of radiesthesia (Watkins, London).
Oyle, Irving (1975) The healing mind. (Celestial Arts, Millbrae, California).
Ostrander S & Schroeder L (1977) Psychic discoveries behind the iron curtain.
Abacus Books (Sphere Books), London.

Parker, Michael W. (1974) Healing and the wholeness of man (Regency Press,
London & New York).
Randolph,T.G. (1951) Food allergy. Charles C. Thomas, Springfield, Illinois, U.S.A.
Randolph,T.G. (1965) Ecologic orientation in medicine: comprehensive
environmental control in diagnosis and therapy. Annals of Allergy, 23, 7-22.
Russell, Edward (1971) Design for Destiny (Neville Spearman, London).
Russell, Edward W (1973) Report on radionics: science of the future. Neville
Spearman Ltd., London.
Shealy, Norman & Freese, Arthur (1975) Occult medicine can save your life (Dial
Press, New York).
Silva, Jose & Miele, Gary (1980) Silva Mind Control Method. (Silva Mind Control,
Box 1149, 1110 Cedar Avenue, Laredo, Texas 78040, USA). Silva Mind Control
Methods are taught in some European countries, as well as in the USA. The basic
course is 40 hours, usually taking 4 days. For details of the courses in your area.
Contact the Organisation under Silva's address, given above.
Stelter, Alfred (1976) PSI Healing (Bantam Books).
Underwood, Guy (1972) Patterns of the past (Abacus Books, London).
Watson, Lyall (1974) Supernature (Coronet Books, London).
Watson, Lyall (1979) Lifetide. Hodder and Stoughton, London.

USEFUL CONTACTS
American Society of Dowsers; Email: ASD@dowsers.org; WWW (Internet):
http://newhampshire.com/dowsers.org
British Society of Dowsers, Secretary: M.D. Rust, Sycamore Cottage, Tamley Lane,
Hastingleigh, Asford, Kent TN25, 5HW, UK; Tel/Fax: +44-1233-750253; Email:
bsd@fern.demon.co.uk; No WWW Page yet).
Email Special Interest Groups (SIGs): CAM&VM ...; Holistic ...
INDHN (International Nondenominational Distant Healing Network): contact the author by
Email at progers@grange.teagasc.ie
Internet (WWW) Sites: Search under AltMed, AltVetMed, Magi, Holistic, Dowsing,
Divining ...
Scientific and Medical Network, c/o: David Lorimer, Lesser Halings, Tilehouse Lane,
Denham, Uxbridge, Msex UB9 5DG, UK. Tel/Fax: +44-1985-835818
Email: Scientific and Medical Network @smnet.demon.co.uk, or,
100114.1637@compuserve.com
WWW (Internet): http://www.cis.plym.ac.uk/scimednet/1.htm...
QUESTIONS
1. One of the following statements is not correct. Indicate the incorrect statement:

a. Acupuncture (AP) operates on two levels, the material-physical (reflex and

neuroendocrine mechanisms) and the immaterial-energetic.
b. AP does not require paranormal concepts or methods to explain the material-physical
mechanisms
c. Many professionals have experienced paranormal phenomena at first hand
d. The diagnostic accuracy of some (medically untrained) healers can be excellent
e. There is no acceptable evidence that hand-healing or telepathic healing can be effective
therapy
2. One of the following statements is not correct. Indicate the incorrect statement:
a. Dowsing (divination) is a method establishing objective reality by subjective interpretation
of learned but involuntary reflex responses while in a state of detached spiritual/mental
search.
b. Orthodox religions are divided on the ethics and morality of dowsing.
c. Divination is a strictly-human activity, unknown other animal species
d. Dowsing techniques stretch back to pre-history in all great cultures.
e. Most novice dowsers use some instrument to indicate the presence of a "Yes" or "No"
reaction. With experience and increasing self-confidence, some dowsers dispense with these
instruments.
3. One of the following statements is not correct. Indicate the incorrect statement:
a. Dowsers can dispense with inanimate instruments if they train themselves to recognise
involuntary muscle twitches of the back, face, eyelids, neck or arm muscles, or to "feel" a
tickle or itch in the palm or finger, as it moves over the area of the body (or map etc) being
searched.
b. "Physical" dowsing is much more accurate than "absent" dowsing.
c. Three main instruments are used in dowsing: the Y stick, the pendulum and the rubbing
pad.
d. The material used to make the Y stick, or pendulum, is irrelevant if the dowser believes it to
be so
e. Each dowser must establish his/her "Yes", "No" and "Don't know" reaction with the
instrument being used.

4. One of the following statements is not correct. Indicate the incorrect statement:
a. Some dowsers use a "mental Y stick, or other instrument", i.e. they visualise what reaction
the instrument would give to their specific question.
b. In diagnosis, some healers run their hands over the patient (without touching him/her).
They "know" when they have found their object, as they have programmed themselves to
register an itch or tickle in the finger as it passes over the problem area.
c. Psychic diagnosis can lead to the same conclusions as orthodox diagnosis.
d. In psychic diagnosis, the practitioner should have a good suspicion as to the cause before
attempting to dowse for it.
e. Effective diagnostic dowsing uses a systematic search of all the systems and subsystems of
the body
5. One of the following statements is not correct. Indicate the incorrect statement:
a. In diagnostic dowsing, having found the location of the problems, their nature is
questioned systematically, considering possibilities of: inflammation, poor microcirculation,
degeneration, cancer, prolapsed disc etc etc.
b. Causes and predisposing factors should be queried under: genetic susceptibility, trauma,
allergy, stress, environmental factors (climate, geophysical EMG fields), infections, microbial,
plant or chemical toxins, metabolic disorders etc.
c. When using psychic methods of diagnosis, it is most important to follow a systematic
routine, to avoid omitting relevant (possible) locations, nature of disease, causes and
predisposing factors. Haphazard searching gives poor results and incomplete information.
d. The validity of the psychic diagnosis does not depend on confirmation by more orthodox
methods.
e. Dowsing can be used to determine which AP Channels are out of balance, which side is
affected, is the Qi Excessive, Deficient, or Blocked, etc.
6. One of the following statements is not correct. Indicate the incorrect statement:
a. Silva Mind Control is a dangerous cult, which practising Christians should avoid
b. In diagnostic dowsing, the possible association between physical location (high tension
cables, geophysical electromagnetic points etc) and disease should be considered.
c. Many human ailments are associated with the bed, favourite armchair or work area situated
directly over these "pathological zones".

d. Reputable homoeopaths should not use dowsing to select remedies, or potencies, or to

check for incompatibilities between remedies
e. Some vets find the AhShi points intuitively, without touching the animal, except to confirm
that they are correct.
7. One of the following statements is not correct. Indicate the incorrect statement:
a. Surrogate Pulse taking and the Omura-O-Ring test can be useful in diagnosis
b. Some university-trained professionals get excellent clinical results with "Hand healing",
telepathic healing, "radionic broadcast therapy", or symbolic transfer of homoeopathic
remedies.
c. Regular use of the "sorcerer's doll" brings "bad luck" to the house of the practitioner.
d. Intention to heal, knowledge, skill, self-belief, compassion and love are the keys to
excellent clinical success
e. Symbols have power
1=e2=c3=b4=d5=d6=a7=c

ACUPUNCTURE : AN ANTI-ENDOGENOUS OPIATE MECHANISM ?

(Letter to IVAS Newsletter and American J. Acupuncture)
Injection of naloxone, nalmefene or diprenorphine was successful in treating crib biting
(aerophagia assisted by gripping an object between the incisor teeth) and hyperkinesis in
horses. Yawning, sedation and penile relaxation occurred 10-30 minutes treatment, coinciding
with disappearance of crib biting. Then the horses became bright and alert and did not crib for
20 minutes after naloxone, or up to 4 hours after nalmefene or diprenorphine (1). Naltrexone
and nalmefene significantly reduced the time spent self-licking, self-chewing or scratching in
dogs but the effect wore off after 60 - 90 minutes (2). Nalmefene reduced self mutilation in a
stallion and the effect was dose-related but lasted only 4 hours or so (3). Thus, opiate
antagonists have clear but short-term therapeutic effect in stereotypic disorder. The outcome
of long-term opiate antagonist therapy requires further research.

The endogenous opiate system is involved in stereotypies but whether as cause or effect is not
clear (2). It is suggested that stereotypic behaviour, such as aerophagia, crib biting,
hyperkinesis, self mutilation etc activates the brain's pleasure centres and other opiate centres
in nervous tissues. Repetitive self-gratification may become an intractable vice, a state
analogous to long-term opiate dependency. Many drugs act as opiate antagonists. They
include naloxone, naltrexone, nalmefene and diprenorphine. Opiate antagonists displace
opiates from their receptor sites, abolishing the pleasurable effect of the opiates or their
inductive behaviour. This may be why opiate antagonists can suppress or reduce stereotypic
disorders (1,2,3).

Yin-Yang theory proposes that everything has its opposite. Endogenous opiate mechanisms of
acupuncture (AP) have been confirmed, hence one might suspect that anti-endogenous opiate
mechanisms also exist. The high success of AP in reversing narcotic apnoea (4) and in
detoxifying narcotic addicts (6, 10) is strong evidence of this.

AP therapy was very successful in treating aerophagia in horses which also had
gastrointestinal disturbance but gave poor results in those which had normal gastrointestinal
function (5). Thus, AP may activate an anti-opiate mechanism rather than the opiate
mechanism suggested by Kuussaari (5). In contrast to anti-opiate drug therapy (1, 2, 3), the
results to three AP sessions were longlasting. AP has reflex effects (autonomic, antiinflammatory etc) on irritated target organs (7, 8, 9). These reflex effects may explain the
longlasting results of AP.

Prolonged electro-stimulation at Earpoint Lung or the mastoid processes is highly successful

in alcoholic and narcotic detoxification. This suggests that these points should be researched

in relation to treating other stereotypic disorders, such as self-gratifying vices and selfmutilation in humans and animals.

Signed :
........................
Philip A.M. Rogers MRCVS
1 Esker Lawns, Lucan,
Dublin, Ireland.

........................
Jukka Kuussaari DVM
24560 Toija,
Finland.

................................
Nicholas Dodman BVMS, MRCVS, DVA
Department of Surgery,
School of Veterinary Medicine,
Tufts University,
200 Westboro Rd.,
North Grafton,
MA 01536, U.S.A.

REFERENCES

1. Dodman, N.H., Shuster, L, Court, M.H. and Dixon, R. (1988) Investigation into the use of
narcotic antagonists in the treatment of a stereotypic behaviour pattern (crib-biting) in the
horse. Amer. J. Vet. Res., 48, 311-.
2. Dodman, N.H., Shuster, L, White, S.D., Court, M.H., Parker, L. and Dixon, R. (1988) Use
of narcotic antagonists to modify stereotypic self-licking, self-chewing and scratching
behaviour in dogs. J. Amer. Vet. Med. Assoc., 193, 815-.
3. Dodman, N.H., Shuster, L, Court, M.H. and Patel, J. (1988) Use of a narcotic antagonist
(nalmefene) to suppress self-mutilative behaviour in a stallion. J. Amer. Vet. Med. Assoc.,
192, 1585-.
4. Janssens, L., Altman, S. and Rogers, P.A.M. (1979) Respiratory and cardiac arrest under
general anaesthesia : treatment by AP of nasal philtrum. Vet. Rec., 105, 273-.
5. Kuussaari, J. (1983) AP treatment of aerophagia in horses. Amer. J. Acup., 11, 363-.
6. Lau, M.P. (1976) AP and addiction - an overview. Addictive Diseases : an International J.,
2, 449-.
7. Lin, J.H. and Rogers, P.A.M. (1980) AP effects on the body's defence systems. A veterinary
review. Vet. Bulletin 50, 633-.
8. Rogers, P.A.M., White, S.S. and Ottaway, C.W. (1977) Stimulation of the acupoints in
relation to analgesia and therapy of clinical disorders in animals. Vet. Annual (Wright
Scitechnica, Bristol) 17, 258-279.
9. Rogers, P.A.M. and Bossy, J. (1981) Activation of the defence systems of the body in
animals and man by acupuncture and moxibustion. Acup. Res. Quarterly (Taiwan) 5, 47-54.
10. Smith, M.O. (1988) AP treatment for Crack : clinical survey of 1500 patients treated.
Amer. J. Acup., 16, 241-.

THERAPEUTIC EFFECTS OF ACUPUNCTURE IN CALF RESPIRATORY

DISEASE
Tchi-chou Nam, Chung-ho Chang, Yong-ho Park, Kang-moon Seo

College of Veterinary Medicine, Seoul National University Seodun-dong,

Kwonson-Gu, Kyung Gi-Do, 441-744, South Korea
Fax: +82-331-293-6403
ABSTRACT
Traditionally, acupuncture (AP) points used to treat respiratory disease include SanTai,
FeiYu, An-fu and SuQi. Clinical, bacteriological, virological and immunological effects of
AP were studied in calves with respiratory disease, which were allocated to one of 5 groups
for treatment by: 1=Medicine alone; 2=Medicine + AP at SuQi; 3=Medicine + AP at (SanTai
+ FeiYu + AnFu); 4=AP at SuQi alone; 5=AP at (SanTai + FeiYu + AnFu) alone. In the AP
groups, needles were inserted into the points to a depth of 3 cm for 20 minutes daily for three
days.
Clinical recovery rates (Excellent to Good) were respectively: 1=59%; 2=83%; 3=73%;
4=83% and 5=63%. Virus isolation rate was significantly decreased in calves with viral
respiratory diseases after AP. Otherwise, antibody response of calves given AP, especially at
SuQi, was increased significantly. The percentages of leucocyte subpopulation expressing
MHC class II antigen, CD2, CD4, sIgM and N12 antigens were significantly higher in the
calves with respiratory disease treated with AP.
AP therapy reduced the clinical signs in calves with respiratory disease and promoted their
immune responses. Therapy which combines medicine with AP could be put to practical use
in field outbreaks of respiratory disease in calves.
KEYWORDS
Acupuncture, Bronchopneumonia, Immune response, Leucocyte subpopulation, Respiratory
disease, Virus isolation rate.
INTRODUCTION
Infectious respiratory disease is a serious threat to the profitability of animal husbandry,
especially in intensive units. The main infectious agents involved are viral (especially IBR,
RSV, PI3, BVD) and bacterial (especially Pasteurella). Calf pneumonia results in great
economic loss. The prevalence of respiratory disease in calves increases as herd size
increases. Therefore, respiratory diseases are attributable to multiple factors, which include
management and environment, etc. The major clinical signs of bovine influenza include fever,
cough and nasal discharge. Fever, cough and dyspnea are common in bronchitis. When
bronchitis develops to pneumonia, lung rales (rassel-sounds) are easily found and the
condition is more serious1.

In Western countries, bovine respiratory disease often arises in spite of the use of currently
available vaccines. Therapy of clinical cases often uses medication with antibiotic- and/or
antiinflammatory- drugs (such as corticosteroids), bronchodilators and antitussives. Except to
control secondary bacterial infection, antibiotic therapy seldom helps in viral diseases. Steroid
therapy is problematical; it can aggravate the clinical signs and increase the mortality rate. To
avoid the use of steroids, non-steroidal antiinflammatory drugs (NSAIDs)5 and
antiprostaglandins have been recommended6. Antiprostaglandins effectively decreased
respiratory rates, lowered body temperature and stopped cough in calf pneumonia6.
The prevalence of calf respiratory disease, especially pneumonia, has been investigated
recently in Korea. The prevalence rate ranged from 13-64% and many calves died.
Respiratory disease was more prevalent during the suckling and growing period, especially in
calves less than one month old. Mortality rate was highest at that age. Although various
approaches have been tried to reduce the occurrence of bovine respiratory disease, the disease
is still troublesome.
In Eastern countries, herbal medicine (especially Traditional Chinese Medicine (TCM)) and
AP have been used for centuries to treat respiratory disease7,15,16. For example, AP is used to
reduce fever, to increase phagocytosis and local immunity in the lung, bronchi and trachea, to
dilate the bronchi, to enhance mucolysis and expectoration in cough, to enhance circulation
and to increase the supply of vital nutrients7,16. As it can support the internal organs and
increase their defensive reactions, AP therapy can reduce the dose and the frequency of
medication7. AP combined with western therapy was effective in treating respiratory diseases7.
In 21 calves with bronchitis, TCM gave excellent and good results in 62% and 33%; 5% were
not cured3. AP significantly decreased tracheal resistance of 9/12 patients with bronchial
asthma at 10 minutes, 1 hour and 2 hours after AP treatment2. Over 70% of bronchial asthma
patients were significantly improved at 10 weeks after AP treatment8. AP in rats had some
preventive effects on damage to tracheal epithelial cells and enhanced mucosal secretion12. In
mice, AP stimulation (especially, by filiform needle (hao chen) and by hot needling) had
positive effects on the immunosuppressive response caused by cold stimulation. The most
effective point to improve the immunosuppressive response caused by cold stimulation in
mice was Hou-san-li (ST36)13,14.
As antimicrobial agents are not very effective (especially in viral diseases) and consumers
demand food free of chemical residues, we decided to study the efficacy of AP to treat calves
with clinical respiratory disease. Our aim was to develop the most effective therapy for
respiratory disease in calves and ultimately to improve their productivity. Different authors
used different AP points to treat respiratory disease in calves: TaiMai and AnFu (Klide and
Kung4); FeiYu and BiYu (Kurosawa & Sakai11); ShanKen, BiYu, TaiMai, FeiNei, SanTai,
SuQi and FeiYu (Yang and Lee9); SuQi, AnFu and FeiYu (Woo10).
Using 89 calves with clinical respiratory disease, we compared the cure rate of medicine
alone, medicine combined with AP (at a point complex (SuQi), or at a combination of three
points (SanTai + AnFu + FeiYu)) and AP alone (at the same points). We also examined some
aspects of the immune responses of treated calves.
MATERIALS AND METHODS
Patients and treatments: Calves with respiratory disease (influenza, bronchitis, pneumonia
and bronchopneumonia) were submitted to the trial from local rearing farms. The respiratory

diseases were not differentiated. Clinical cases (n=89) were selected and were allocated to one
of five treatment groups, as follows:

Group
1
2
3
4
5
TOTAL

Number of calves treated

Treatment
Spring Summer Overall
Medicine only
5
12
17
Medicine + AP at SuQi
10
8
18
Medicine + AP at (SanTai + FeiYu + AnFu)
5
10
15
AP at SuQi only
15
8
23
AP at (SanTai + FeiYu + AnFu)
7
9
16
42
47
89

The medicine used was mainly injection of antibiotic (enrofloxacin), analgesic-antipyretics

and antitussives, as required.
In groups 2 to 5, round sharp AP needles were inserted into the selected points to a depth of 3
cm, and remained in situ for 20 minutes. The angular direction of needling was forwards and
downwards between the vertebral spines of the three midline points (AnFu, SanTai and main
SuQi point) and inwards and downwards into the muscles at the other points (FeiYu and
secondary SuQi points).
Sampling: Blood and sputum were obtained aseptically from the patient on the day before
treatment, and on day 1, 3 and 10 posttreatment. The samples were transferred to National
Veterinary Research Institute (Anyang, Korea) in order to investigate the infectious agents and
to pursue the changes of host cellular immune response after AP application.
Evaluation of therapeutic effects: Clinical recovery was evaluated by four different grades
as follows:
Excellent: positive effects +++
Good : positive effects ++
Fair : positive effects +
Poor : no, or negative, effects
Virus isolation and viral seroconversion rate: Cells were propagated in a -Minimum
Essential Medium (a -MEM, GIBCO) supplemented with 7% fetal calf serum (FCS). Buffy
coat from the blood and nasal secretion were cultured with a monolayer of Mardin Darby
bovine kidney (RK-13) at 37oC and the cytopathic effects were observed. Bovine viral
diarrhoea virus (BVDV) showed cytopathic effect in only RK-13 cells but Infectious bovine
rhinotracheitis virus (IBRD) and Parainfluenza virus-3 (PI3) showed cytopathic effect in both
MDBK and RK-13 cells. The infectious cells were fixed with cold acetone after washing with
phosphate-buffered saline and identified by the direct fluorescent antibody technique with
FITC conjugated anti-bovine polyclonal antibody.
Leucocyte subpopulations: Peripheral blood was collected in acid citrate dextrose (ACD).
Mononuclear leucocytes were separated from other blood components by centrifugation on

Lymphopaque (density: 1.086g/ml, sigma). Purified mononucleated leucocytes were reacted

with a panel of monoclonal antibodies (MoAbs) specific to bovine leucocyte differentiation
antigens. Fluorescein isothiocyanate (FITC)-conjugated goat anti-mouse IgG+M antibody
(Caltag Lab., San Francisco) was used as a secondary antibody followed by reaction with
MoAbs and separated cells. After fixing the cells on 96-well plates using 2% formaldehyde,
proportions of leucocyte subpopulations were determined by using flow cytometry (Becton
Dickinson, FACScan) and Consort 32 programs.
RESULTS
Therapeutic effects in calf respiratory disease: Table 1 summarises the clinical recovery
rates (Excellent to Good) within 3 days for each treatment.
Table 1.
Treatment group, clinical recovery rate (and % recovered) in
calves with respiratory disease
Treated in
Group = Treatment
Overall

Spring

Summer

1 = Medicine only
10/17 (59)

3/ 5 (60)

7/12 (58)

2 = Medicine + AP at SuQi
15/18 (83)

9/10 (90)

6/ 8 (75)

3 = Medicine + AP at (SanTai + FeiYu + AnFu)

11/15 (73)

4/ 5 (80)

7/10 (70)

13/15 (87)

6/ 8 (75)

5/ 7 (71)

5/ 9 (55)

34/42 (81)

31/47 (66)

4 = AP at SuQi only
19/23 (83)
5 = AP at (SanTai + FeiYu + AnFu) only
10/16 (63)
Total
65/89 (73)

Table 1 shows that the curative effects of treatments 2 to 5 seemed to be 10-16% points better
in spring than in summer but further research is needed to confirm this finding. Both
combinations of medicine with AP (Groups 2 and 3, 83 and 73% respectively, overall 79%)
gave higher recovery rates than medicine alone (59%). AP alone (Groups 4 and 5, 83 and 63%
respectively, overall 74%) gave intermediate results. However, Groups 2 and 4 (Medicine +
AP at SuQi and AP at SuQi alone) gave the best clinical results (83 and 83%).
Virus isolation and viral seroconversion rate: In calves treated by AP at SuQi, virus
isolation fell from 77% before treatment to 54% on day 3 and 57% on day 10 after AP. The
combination of medicine + SuQi showed similar results to those of AP alone (Table 2).
AP at SuQi gave 73% antibody production against BVD but gave lower antibody production
(13%, and 27%) against IBR and PI3. However, the combination of medicine + AP at SuQi
gave a lower antibody production than that of AP alone (Table 3).

Percentage of leucocyte subpopulation expressing specific antigen: Compared with

pretreatment values, calves treated with AP, or medicine combined with AP, had:
a. significantly more leucocytes expressing MHC class II antigens (which have central roles
in host defense mechanisms);
b. significantly more Bo (Bovine) CD2 and BoCD4 antigens and
c. a higher percentage of expression of B lymphocyte-specific antigen, surface IgM (sIgM),
and N (nonT/nonB cells)-12 antigens (Table 4).
DISCUSSION
In our study of calves with respiratory disease, AP alone, or AP combined with medicine gave
better clinical results than those of medicine alone. The improvement correlated with a
decreased viral isolation rate, an increased number of negative samples and an increase in
viral seroconversion rate. The therapeutic effects of AP may be due to the enhancement of
host immunity by activation of lymphocytes involved in central host defense mechanisms.
The clinical recovery rate (Excellent to Good) of calves with respiratory disease in Group 1
(medicine alone) was 59%. Recovery rates were higher in Group 2 (medicine + AP at SuQi,
83%) and Group 4 (AP at SuQi alone, 83%). Recovery rates were intermediate in Group 3
(medicine + AP at (SanTai + FeiYu + AnFu), 73%) and Group 5 (AP at (SanTai + FeiYu +
AnFu) alone, 63%).
AP alone decreased the rate of virus isolation in calves with respiratory disease and increased
the number of negative samples. These effects were stronger for AP at SuQi than for AP at
(SanTai + FeiYu + AnFu). We concluded that the changes of the rate of virus isolation and
the number of negative samples may be the theoretical basis for the better therapeutic effects
of SuQi relative to (SanTai + FeiYu + AnFu).
Although the overall clinical recovery rate to medicine + AP (79%) was slightly better than
for AP alone (74%), the rate of virus isolation and the number of negative samples between
the two groups were not correlated with the clinical results. Further study is needed to
elucidate these results.
Viral seroconversion rate was low in calves treated by medicine + AP, whereas it was
remarkably high in those treated by AP at SuQi. Compared with pre-treatment values, the
percentage of leucocyte subpopulations expressing MHC class II antigens (which have central
roles in host defence mechanism), CD2, CD4, B cells and N cells, were significantly higher in
calves with respiratory disease treated with AP alone, or with medicine + AP. This may be the
scientific basis for the therapeutic effects of AP alone or medicine + AP on SuQi in
respiratory diseases in calves. Even though clinical recovery rates to the combined use of
medicine + AP were somewhat better than those of AP alone, the isolation rate of virus and
immune response showed no difference between those groups. This remains to be elucidated.
CONCLUSIONS
This trial used 89 calves with clinical respiratory disease to compare the therapeutic effects of
medicine alone (injection of enrofloxacin, analgesic-antipyretics and antitussives),

combinations of medicine + AP, and AP alone. AP was used for 3 days at one of two sets of
points: SuQi alone, or a combination of (SanTai + AnFu + FeiYu).
Clinical recovery rates were poor (59%) in calves treated by medicine alone. Rates were best
to combinations of medicine + AP (83-73%). AP alone gave intermediate rates (83-63%). AP
alone at SuQi gave better recovery rates (83%) than at (SanTai + AnFu + FeiYu) (63%).
Therapeutic effects of AP were related to enhanced host immune responses, by activating
lymphocytes which express MHC (Major Histocompatibility Complex) class II, CD2 and
CD4 antigens.
ACKNOWLEDGEMENTS
This paper was presented at the XIX World Buiatrics Congress, Edinburgh, 8-12 July, 1996.
We thank Mr. Philip A.M. Rogers MRCVS, Dublin, Ireland for help in the post-Congress
redrafting of the paper.
REFERENCES
1. Blood,D.C. & Radostits,O.M.: Veterinary Medicine 7th ed. Bailliere Tindall Toronto 1989,
pp 367-372.
2. Berger,D. & Nolte,D.: Acupuncture in Bronchial Asthma. Comparative Medicine East and
West 1977, 5: 265-269.
3. Da,Z.Z.: Treatment of Calf Bronchitis with TCM. J. Trad. Chin. Vet. Med. 1992, 4: 34-35.
4. Klide,A.M. & Kung,S.H.: Veterinary acupuncture. University of Pennsylvania Press 1977,
pp 96-106.
5. Snow,D.H.: Pharmacological Basis of Large Animal Medicine. Eds J.A.Bogan, P.Lees,
A.T.Yoxall. Blackwell Scientific Publication 1983, pp 391-427.
6. Selman,I.E.: Effects of Anti-prostaglandin Therapy in Experimental Parainfluenza type 3
Pneumonia in Weaned Conventional Calves. Vet. Rec. 1984, 109: 101-105.
7. Schwartz,C.: Acupuncture for Chronic Respiratory Conditions. In: Veterinary Acupuncture:
Ancient Art to Modern Medicine (Ed: A.Schoen), American Veterinary Publications, 5782
Thornwood Drive, Goleta, CA93317, USA 1994, pp213-222.
8. Zwolfer,W., Keznickl-Hillebrand,W., Spacek,A., Cartellieri,M. & Grubofer,G.: Beneficial
Effect of Acupuncture on Adult Patients with Bronchial Asthma. Am. J Chin. Med. 1993, 21:
113-117.
9. Yang,G.D. & Li,S.J.: Handbook of Veterinary Acupuncture, China Agriculture Press,
Beijing 1985, pp 179-204.
10. Beijing Agricultural University, Chinese Veterinary Medicine, China Agriculture Press,
Beijing 1986, pp 383-386.
11. Kurosawa,R. & Sakai,T.: Veterinary Surgery, Yang Hung Dang, Tokyo 1981, 569 pp.

12. Kim,Y.S. & Choe,Y.T.: Effect of Aqua-acupuncture of Sileris Radix Extract Solution on
the Epithelium of the Trachea in Rats. Kyung Hee University, O. Med. J. 1984, 7: 335-344.
13. Song,Y.H. & Choe,Y.T.: Effects of On-chim, Laser acupuncture and acupuncture on the
Depression of the Immune Response Induced by Cold stress in Mice. Kyung Hee University.
O. Med. J. 1992, 15: 69-89.
14. Choo,T.C. & Choe,Y.T.: Effect of On-chim on Depression of Immune Response Induced
by Exposed to Cold Stress in Mice. Kyung Hee University, O. Med. J. 1992, 15: 297-312.
15. Lin,J.H., Rogers,P.A.M. & Yamada,H.: The Scientific Basis of Chinese Herbal Medicine.
In: Alternative Veterinary Medicine. Eds.: A.Schoen & S.Wynn, Mosby Book Publishers,
USA 1996. In Press.
16. Rogers,P.A.M.: Immunologic Effects of Acupuncture. In: Veterinary Acupuncture:
Ancient Art to Modern Medicine (Ed: A.Schoen), American Veterinary Publications, 5782
Thornwood Drive, Goleta, CA93317, USA 1994: pp243-267.
Table 2. Rate of virus isolation in calves with respiratory disease treated by AP at SuQi
alone, or with medicine + AP at SuQi.
Days of treatment
Virus

AP on SuQi alone Medicine + AP at SuQi

Day 1

Day 3

Day 10

Day 1

Day 3

Day 10

n (%)

n (%)

n (%)

n (%)

n (%)

n (%)

Negative

4 (24)

6 (46)

6 (43)

3 (30)

4 (40)

2 (20)

BVD + IBR

4 (24)

2 (15)

2 (14)

1 (10)

2 (20)

0 ( 0)

BVD + IBR + PI3

2 (12)

1 ( 8)

1 ( 7)

1 (10)

1 (10)

3 (30)

IBR

1 ( 6)

2 (15)

2 (14)

3 (30)

3 (30)

3 (30)

IBR + PI3

2 (12)

1 ( 8)

0 ( 0)

1 (10)

0 ( 0)

0 ( 0)

PI3

1 ( 6)

0 ( 0)

0 ( 0)

1 (10)

0 ( 0)

0 ( 0)

PI3 + BVD

2 (12)

1 ( 8)

0 ( 0)

0 ( 0)

0 ( 0)

1 (10)

BVD

1 ( 6)

0 ( 0)

3 (21)

0 ( 0)

0 ( 0)

1 (10)

Table 3. Effects on antibody production in calves with respiratory disease treated by AP

at SuQi alone, or with medicine + AP at SuQi.

AP on SuQi alone

Medicine + AP at SuQi

Seroconversion

Nonconversion

Seroconversion

Nonconversion

Virus

n (%)

n (%)

n (%)

n (%)

BVD

11 (73)

4 (27)

2 (20)

8 ( 80)

IBR

2 (13)

13 (86)

0 ( 0)

10 (100)

PI-3

4 (27)

11 (73)

1 (10)

9 ( 90)

Table 4. Mean percentage and standard deviation (X%+sd) of leucocyte subpopulations

expressing specific antigens in blood from calves with respiratory disease treated by AP
at SuQi alone, or with medicine + AP at SuQi.
AP on SuQi alone

Monoclonal
Antigens

antibodies

Before
AP
(n=10)
X%+sd

MHC
class I
MHC
class II

Medicine + AP at SuQi

Day 3

Day 10

(n=10)

(n=10)

X%+sd

X%+sd

Before
AP
(n=10)
X%+sd

Day 3

Day 10

(n=10)

(n=10)

X%+sd

X%+sd

H58A

85.9+8.3

95.8+4.2

93.0+5.9

81.5+4.2

92.5+3.2

92.4+2.1

H42A

28.5+4.7

39.9+3.7

38.2+3.9

27.4+2.7

34.1+2.7

36.3+2.2

BAQ95A

49.3+3.6

53.8+6.2

59.4+5.7

52.3+4.6

53.7+3.8

56.0+3.7

CACT138A

19.7+3.4

35.5+3.6

22.6+3.7

20.7+3.7

30.2+4.7

20.6+4.1

CACT80C

10.7+4.2

10.7+3.7

23.9+3.9

18.5+3.9

18.6+3.1

27.6+3.2

PIG45A

20.1+4.3

34.0+2.9

32.3+6.7

10.7+3.7

30.0+2.3

30.3+4.0

CACT61A

28.3+3.7

26.4+3.9

31.0+4.9

23.1+4.1

32.2+2.1

31.2+3.8

BoCD 2
BoCD 4
BoCD 8
sIgM
NI2

TREATMENT OF BACKPAIN IN THE HORSE AND DOG BY

ACUPUNCTUREPart 1
Philip A.M. Rogers MRCVS
e-mail : progers@grange.teagasc.ie
Nordic Acupuncture Congress, Oslo, Norway, September 1987
ABSTRACT
Backpain may be primary, secondary, or as part of a generalised disorder. Depending on the
cause, nature and duration, 70-90% of cases in horses and dogs respond to acupuncture (AP)
therapy. In practice, it is difficult to make a specific diagnosis of the cause of backpain,
especially in horses, due to the difficulty of routine X-ray and myelography. The general
practitioner may be satisfied with clinical remission. In hospitalised dogs, AP is successful in
treating post-operative pain and complications. It can be successful also in backpain which
has not responded to surgery.
AP therapy is by stimulation of relevant reflex points in the skin and muscles. Points of
tenderness to palpation are important. They are equivalent to human Trigger Points (TPs) or
AHSHI points. Stimulation is given to the TPs, paravertebral (SHU) points, and points related
to specific areas, organs or functions, e.g. local and distant points on meridians through
affected areas.
AP points are located in dogs by transposition from human AP. Those in horses are located in
the same way, with some adjustment for 18 ribs, 6 lumbar vertebrae and digital anatomy, or
by reference to traditional horse AP texts. The choice of points to treat backpain in horses and
dogs is similar to that outlined in humans (Paper 1). In animals, the position of PAIHUI is in
the lumbo-sacral space, not on the head, as in humans. The combination of TPs, PAIHUI,
BL23, 26, 30, 54, 60, GB30, 34, covers most backpain below the ribs, including radiating
sciatic pain. The combination of TPs, BL13, 16, 21, TH15, SI 9 covers most thoracic
backpain. The combination of TPs, GB20, 21, TH15, CO17, ST38 (or GB34) covers most
neck pain. Other useful points are: PAIHUI (all problems below the ribs); BL11 (joints);
BL23 (bones); BL16 (spinal column); GB34 (muscles).
Simple needling (for 20 minutes every 1-3 days in acute cases or every 3-7 days in chronic
cases) is the classical method. Electro-needling is also used. Point injection is effective and
faster.
Most responsive cases improve after 1-3 sessions but chronic cases may need 1-10+ sessions.
Other methods of point selection (Earpoints, Hoofpoints etc) and of stimul-ation (Dermojet,
staples, implants, magnets, LASER, ultrasound etc) must be regarded as experimental at this
time.
INTRODUCTION
Backpain may be primary (paravertebral muscle pain, thoracolumbar disc disease, vertebral,
sacroiliac or arthrotic), secondary (referred from irritation of thoracic or abdominal organs),

or as part of a generalised disorder (nutritional muscular dystrophy in deficiency of Vit E-Se;

myositis in azoturia).
Animals used for competitive sports (racing, jumping, polo etc) or for active work (draught
animals, hunting dogs etc) need to be physically fit. For top performance, they rely heavily on
the musculo-skeletal system. In particular, they need full flexion and extension of the
paravertebral musc-les for maximum stride and speed and to enable them to run around
corners.
Owners request acupuncture (AP) for two main reasons: (a) the animal is visibly lame or
some other signs of pain or stiffness (aggression, reluctance to be saddled, mounted or
handled over the back; rigidity of the back; running wide on bends etc) are present or (b) the
competitive performance has fallen off gradually or suddenly. In both cases, other forms of
therapy usually have been tried without much success before AP is considered.
This paper deals with the clinical assessment and AP therapy of backpain in horses and dogs.
It includes some examples of limb lameness, where this is associated with irritation of the
vertebral nerves. Most of the data are from named experts but some of my own cases are
included.
THE BASICS OF ANIMAL ACUPUNCTURE
Irritation of the thoracic or abdominal organs can refer pain to related skin and muscle
segments, especially in the paravertebral area. This can establish Trigger Points (TPs), as
detailed by Travell and Simons (1984) and in the TP Therapy Symposium (1981). Long after
the visceral pain has gone, the TPs can remain active. Unless TPs in the thoraco-sacral
muscles are 'removed' by AP or other physiotherapy, the function of the back muscles is
impaired and performance is impaired. In human AP, the AHSHI point is defined as a point,
usually in muscle, which is tender on palpation. AHSHI means Ouch! or Ah Yes! There are
two kinds of AHSHI points: those from which palpation elicits only local tenderness and
those which radiate pain to the problem area (the area in which the patient complains of pain).
The latter type is the true TP of western medicine. In animals, however, it is not possible to
distinguish between real TPs and AHSHI points which are just tender locally. In practice, this
distinction is unnecessary- the tender point is the most important point in AP therapy and
AHSHI points are taken to be TPs.
REFERRED PAIN: Hindlimb lameness is often due to pain referred from thoraco-lumbar or
lumbo-sacral nerves, as in sciatica in humans. It may arise also in pain referred from
abdominal viscera, such as in a painful kidney, ovary, uterus or colon. Forelimb lameness may
arise in pain referred from cervical or upper thoracic nerves or from pain in thoracic organs
(lung, pericardium, heart). Thus, neck- and back-pain often manifest as lameness in the foreor hind- limb.
In human AP, the paravertebral SHU (reflex points for all major thoracic and abdominal
organs) are located on the inner line of the bladder (BL) meridian as follows:
Lung (LU), Pericardium (HC), Heart (HE), Governor Vessel (VG), Diaphragm = BL13 to 17,
in area T3 to T7 respectively; Liver (LI), Gallbladder (GB), Spleen-pancreas (SP), Stomach
(ST) =BL18 to 21, in area T9 to T12 respectively; Triple Heater (TH), Kidney(KI),
CHIHAISHU, COLON (CO), KUANYUANSHU = BL22 to 26, in area L1 to L5

respectively; Small intestine (SI), Bladder (BL), CHUNGLUSHU, PAIHUANSHU = BL27 to

30, in area S1 to S4 respectively. These points have diagnostic value (when tender). They help
to identify the affected organ. They also have therapeutic value in treating the affectedorgan
and local problems near the points. However, local muscle strain or trauma can also cause
SHU point tenderness. Thus, SHU point tenderness need not always indicate disorders of the
related organs. The outer line of paravertebral BL points (BL36 to 49) have similar functions
to the related points on the inner line.
AP points are located in dogs by transposition from human AP. Janssens (1984) has prepared
an atlas of the points in dogs. The points in horses are located in the same way, with some
adjustment for 18 ribs, 6 lumbar vertebrae and digital anatomy, or by reference to traditional
horse AP texts. Fuller details of animal AP (points, methods of therapy) are given elsewhere
(Rogers 1987a, b).
ASSESSMENT OF HORSES AND DOGS BEFORE TREATMENT
A complete history is taken, together with any findings of previous investigations. In the
clinical examination, attention is paid to any lesions or signs related to all major systems or
functions. One tries to identify the primary problem(s) and the location(s) of pain.
It is essential to probe or palpate the muscles from head to tail, to locate any TPs. Particular
attention is paid to the paravertebral muscles and the large muscles of the neck and limbs. The
joints and tendons are also palpated. Animals with signs of pain, stiffness or lameness are
seldom free of TPs. Their detection is indicated by an attempt to bite, kick, or avoid the
palpation or by yielding to the pressure, or by vocalising.
TPs may occur almost anywhere in muscle. Scars may also act as TPs. TPs in the
paravertebral area correspond with SHU points. For example, virus infection of the
respiratory tract in horses can increase the fragility of capillaries and small bloodvessels. An
affected horse may rupture small vessels in the lung or upper respiratory tract at full gallop,
especially in a long race. Such horses are called Bleeders. The condition is a common cause of
poor racing performance and often shows up as a sudden loss of speed on the run home. The
condition may last for months or years. Most bleeders are tender to palpation of the reflex
areas of the lung (BL13 and the area behind the posterior edge of the scapula). They may be
tender also on the Diaphragm and Liver points (BL17, 18), which are related to haemorrhage
and prothrombin (Fig. 15). As the saddle sits over those areas, such horses may resent being
saddled, or may be troublesome when mounted. Horses with kidney or ovary problems may
be touchy in the area L1 to L3 (BL22-24). The key reflex point for the ovary and kidney is
BL23.
In mares and fillies, sporadic lameness (hindquarter, hunched or rigid back and, occasionally,
forelimb lameness) which may be severe can arise due to referred pain from ovarian or uterine
irritation. Check for TPs related to the ovary and uterus (see section 1.5 below).
Be careful to check for DIAGONAL relationships. Cain stresses that forelimb lameness is
often accompanied by tenderness at contralateral lumbo-sacral or hind-limb points. Also,
hindlimb lameness is sometimes associated with TPs on the contralateral side of the neck.

Be careful to check the paravertebral SHU points in relation to the location of limb pathology,
for instance BL25 (lumbar 4-5, large intestine SHU) in medial forelimb lameness and BL21
(behind last rib, stomach SHU) in antero-lateral hindlimb lameness etc.
In all local problems (neck, shoulder, elbow, back, thoraco-lumbar, lumbo- sacral, hip, stifle,
laminitis etc), the TPs must be found. They are recorded and clipped (in horses) as they are
located. This helps rapid reassessment of the case on later visits. It also makes it easy for the
handler to locate them for heavy massage or other physiotherapy (ultraound, LASER etc)
between AP sessions.
CHOICE OF POINTS IN AP THERAPY
Rogers 1987 lists the methods of choosing points for the treatment of human backpain.
Similar points and reasoning are used in animals. The points depend on the organs and parts
involved. The most common combination of points is: all TPs, plus 1-2 LOCAL points (near
the affected organ or part), plus 1-2 DISTANT points on meridians passing through, near or
related to the affected parts. If an organ is thought to be involved, its SHU point is used,
whether tender or not. To this can be added the MU (abdominal alarm) point.
In low-backpain patients, GB30, 34 and BL54, 60 are useful distant points. In animals, the
lumbo-sacral space is called PAIHUI. (In humans, PAIHUI (VG20) is on the top of the head).
The combination of TPs, PAIHUI, BL23, 26, 30, 54, 60, GB30, 34, covers most backpain
below the ribs, including radiating sciatic pain. The combination of TPs, BL13, 16, 21, TH15,
SI 9 covers most thoracic backpain. The combination of TPs, GB20, 21, TH15, CO17, ST38
(or GB34) covers most neck pain.
Other useful points are:
PAIHUI (all problems below the ribs); BL11 (joints); BL16 (spinal column); CO 4 (forelimb
& general effects); BL21, ST36 (hindlimb, appetite and general effects); ST44 (hindlimb); TH
5 (forelimb); GB34 (hindlimb, muscles, tendons, neck, shoulder and elbow); BL23 (lumbosacral and hindlimb; adrenal point, stress conditions; ovary/kidney/Vitamin D/parathyroid/bone point and general effects).
However, many point combinations are possible. Examples of these are given below and the
locations are shown in attached figures.
METHODS USED IN AP THERAPY
Simple needling: In horses, special AP needles or hypodermic needles 19-26 gauge, 2-6
inches long are used. In dogs, human AP needles or hypodermic needles 26-30 gauge, 0.5-2
inches long are used. Sterile needles are inserted into the points. Cleansing of the skin before
insertion of the needle is a cosmetic exercise unless the skin is wet or visibly dirty. The
needles are left in situ for 20 minutes. Twirling and pecking of the needle is done every few
minutes. Cases are treated at intervals of 1 - 2 days in acute or 3 - 7 days in chronic cases.
Acute cases may require 1 to 3+ sessions to recovery. Chronic cases may need 1 to 10+
sessions.

Electroneedling: Needles are inserted as usual. Output leads from special electrostimulators
are used to deliver electrical stimuli to the needles. Session length and intervals between
sessions are as for simple needling. An advantage claimed for electro-AP is that it requires
fewer sessions. This, however, is doubtful. Strong, painful needle manipulation is as good as
electro-AP, but electro-AP leaves the operator free to talk, take notes etc. In cases of paralysis
and in severe pain, electro-AP may be better than simple needling. White suggests electro-AP
treatment every 12-24 hours in acute cases with severe pain or paralysis. Electro-AP is also
the usual method used to obtain AP analgesia for surgery in animals.
Point injection: This is an effective, rapid and safe method in horses and dogs. It is very
useful in busy practice. In horses, 1-5 ml is injected at each point; in dogs, .5-1.5 ml. The
solution may be .5-1.0% procaine in saline, saline alone, saline-B12, Impletol, homoeopathic
solutions etc. Choice of solution depends on practitioner preference- all methods are used.
Point injection also allows the use of drug-therapy, when needed. The Dermojet (highpressure skin injector) is also used.
Massage: It shortens recovery time if animal handlers are shown the techniques of massage.
TPs and other important AP points can be marked or clipped. Massage for 2 minutes/point
every 1-2 days between AP sessions is very useful. In the horse, I demonstrate massage by
fist-pounding to the horse's tolerance. In the dog, I demonstrate deep massage with the thumbs
(for spinal areas) or other methods for limb muscles.
Ultrasound: Standard equipment may be used. Different probes are available for diifferent
parts- body surface, orifices etc. A contact jelly is essential. Output is .25-1.0 watts. Time 1560 seconds/point. The method is painless and non-invasive but is not as well documented as
the needling or injection methods.
LASER: Low power laser (1-5 mW) and higher power (5-10 mW) has been used in horses
and dogs instead of needling. Three types are common: He-Ne (632 nm wavelength), infrared
(902 nm) and diode lacers (not true laser light). Laser is painless and non-invasive but its
penetration is shallow. It is not possible to assess laser effectiveness at this time.
Some users report excellent results (for instance Martin and Klide 1987) in backpain in the
horse but others say the laser is not as good as needling. All agree that laser is excellent for
local (superficial) problems, such as septic wounds, tendonitis, granulomas, ulcers, eye
problems etc. It may be useful in Earpoint AP. However, at this time, Earpoint AP is also not
as well documented as classical AP and TP therapy.
Implants: Skin staples, implant of sutures, platinum-, gold- or surgical beads or wire can be
used to stimulate the AP points. Klide has used implants effectively to control epilepsy in
dogs. Cain has used them to control nervousness in fillies. Others have used them in backpain
and other conditions. They are very effective (implants around the acetabulum) in treating hip
dysplasia in dogs. However, the method needs more documentation before acceptance as a
routine procedure.
EXAMPLES OF AP THERAPY IN HORSES
1.1.1. Soreback (thoracic, lumbar and sacral area)
(Kothbauer; Kuussaari; Klide; Grady-Young; Johnson; White)

Search the back and paravertebral muscles for TPs. If the tail twitches during riding, this
indicates pain at BL23 (kidney SHU). Use all TPs. Add PAIHUI and points from BL18 (ICS
15) to BL26 (L 5 to L 6) and BL28, 30 (foramina S 2, 4) or points from BL17 (ICS 14) to
BL25 (L 4 to L 5) and BL27, 29 (foramina S 1, 3). Use the more anterior points if the pain is
more anterior. Consider also VG12; BL31, 34, 49 and the point at the meeting of the scapula
and the anterior edge of the scapular cartilage (TH15, TCVM POCHIEN).
Treatment: injection, simple needling, electro-AP (20 seconds/needle) or LASER. Treat 1-2
times/week (usually every 5 days) for 2 - 10 times. In acute cases, with severe pain or
paralysis, treat every 12 - 24 hours. Relapse within 6 months after successful treatment may
be 5-50%.
A set formula, used with 87% success by Klide, is:
PAIHUI, BL19 (or 43), 22, 23, 24, 25, 26, 50 (simple needling or injection of 1 ml
saline/point). Treat weekly, 7-12 times (Klide 1984, 1987). Point lasering gave a lower
success rate (73%) (Martin and Klide 1987) but the difference between AP and Laser may not
be significant.
Ly (1977) reported that all 5 horses treated for lumbosacral pain and sciatica recovered. They
were treated at PAIHUI, WEIKEN, BL points on the lumbosacral area, GB30 and points
along the course of the sciatic nerve. Electro-AP was used, twice/week for 10 sessions. The
horses were rested for 3 months before being slowly returned to work.
1.1.2. Saddle-sore: (Grady-Young; Johnson)
Pain in the area of the saddle, is treated similarly. Tenderness near BL18 (liver SHU) may be
associated with muddy colour of the eye mucosa -the liver controls the eye in TCVM.
Treatment: all TPs plus BL points, especially BL21, 23, 25.
: inject procaine-B12 (9 ml 1% procaine + 1ml B12 - 3000 units/ml at each point), using 19 g
needle, depth 1.5'
(or): needle or electro-AP 20 minutes; 2/week; 2 - 4 times.
1.1.3. Shoulder lameness: (Kuussaari; White)
Few cases relapse after successful treatment.
The main points (Klide and Kung system) are: FL 2, 4, 12, 13, 7 with any TPs located in the
neck or scapular-shoulder muscles. These points correspond with points: BL11; GB21; TH14;
CO15; SI 9; LU 1 in humans -all of which are key points for shoulder lameness in people.
Treatment is: Electro-AP (10 - 20 seconds per point) or simple needling (20 - 30 minutes), 2 6 times (mean 3) at intervals of 3 - 7 days mean 4). White suggests 20 minutes electro-AP
every day in acute cases.
1.1.5. Hip and thigh lameness:

The points most effective on the hip and thigh are:

: all TPs in the lumbo-sacral, hip-thigh and posterior thigh ms.
: local points (GB29, 30, 31, 32; BL50, 51, 52; ST31, 32, 33, 34)
: region points (PAIHUI; BL23, 49)
: additional points from GB34, 39
Treat by simple AP, electro-AP or point injection every 3 - 7 days for 1 to 3 times in recent
cases and 3 to 8 times in chronic cases.
1.1.6. Stifle lameness: (Jeffries)
Point injection is excellent in 1 to 2 sessions. Walk the horse for 2 days before return to the
track. Jeffries uses an American product for injection (Sarapin, containing Vitamin B12 and
C). Three ml is injected below the patella, medial and lateral to the patellar tendon at the point
HSIYEN (Knee Eyes = ST35) and the point postero-medial to the patellar tendon; ST36 (12
ml); KI10 (5 ml); BL54 (4 ml, 2' deep).
1.5. REPRODUCTIVE PROBLEMS:
The most important points for reproductive disorders and for the genital organs are in the
lumbo-sacral area. A simple guide is to imagine the female organs (ovary to vulva) as a
straight tube, with the ovaries related to AP points in the area T 18 to L 3 (points such as
BL21, 22, 23, BL45, 46, 47; TIANPING; VG 5, 4) and the vulva/anus/perinaeum related to
the area S 3 to the tailhead (points such as BL29, 30, 33, 34, 35, 49; VG 1, 2). The other
organs (tubes, uterine horn, uterine body, cervix, vagina) are related to intermediate points.
Kothbauer recommends BL22, 23, 47; VG4 for the ovary and BL27, 28, 31; PAIHUI; VC 6
for the uterus. Johnson reports excellent results with these points in cases of uterine atony,
metritis, embryonic reabsorption etc.
If one had to remember just 3 points for reproductive/genital disorders, they should be:
PAIHUI; BL26 (between transverse wings of L 5 - L 6); BL28 (lateral to sacral foramen 2).
There are other points (Fig. 18).
The abdominal meridians include ST, SP, BL, KI, GB, LI, VC, VG. Local points (points
nearest the target organs) on ANY of these meridians influence the organs. Although most
importance is attached to the VG and BL points (lumbo-sacral area), GB 26 to 28 in the
paralumbar fossa and under the external angle of the ilium are sometimes tender in mares with
ovarian problems, especially cysts. Points over the iliac wing (between the tuber coxae and
the iliac crest) may also be tender in uterine disorders.
In disorders of the reproductive system and genitalia, (as in all other clinical uses of AP),
TREAT THE TPs (AHSHI POINTS). A few points (whether tender or not) for the affected
organ may be added and VC 2, 3, 4; BL49; LI 2 may be considered as additional points. SP 6
is regarded as a point with special action on the inguinal area, genitalia and reproductive
function of males and females.

Westermayer suggests treatment for 20 - 30 minutes for 2 to 4 times (mean of 3), at intervals
of 5 days.
1.5.2. Cystic ovary: (Jeffries; Grady-Young; Johnson)
Luteal cysts often are associated with metritis or pyometra. They may be expressed manually
(per rectum) in many cases (Grady-Young).Follicular cysts are usually associated with
nymphomania.
Points in the area L 2 to S 1 (BL22 - 27, 46, 47; VG 4) and in the paralumbar fossa and under
the tuber coxae (GB26, 27, 28) are examined for TPs. All TPs are used. Other points are
chosen from:
BL22 to 29; SP 6, 15; LI14; GB25; ST36; PAIHUI; YANCHI
Jeffries and Johnson also inject 10 ml of 2% procaine solution into the broad ligament on each
side of the cervix, using a special 50-60 cm needle. This method was successfully used in
cows by Kothbauer and Greiff for many years. It is called paracervical injection or neural
therapy.
Treatment: simple AP; injection of NaOH solution (concentration of 10 to the power of minus
9) + Vitamin B12 and Ascorbic acid; LASER. The choice is individual preference.
Jeffries: injection method plus paracervical injection, 2 times. Success is 5-15% better in
luteal cysts than in follicular cysts.
Grady-Young: LASER (20 minutes total to do all points) 3 to 5 times at interval of 3-4 days.
Skip 3 oestrus periods before breeding.
Johnson: needle + moxa (20 minutes) on 10 cm, 20 guage needles. Inject BL54 and LASER
SP 6; ST36 and (sometimes) BL11.
EXAMPLES FROM MY FILES
Case 1. Sciatica. Severe left hind lameness in mare following injection of a copper compound
i/m over the sciatic nerve area. Duration > 6 mths.
17/6 Sacro-trochanteric sweat track and area of hair regrowth noted, running in posteroventral direction from suspect injection site. Five TPs located and clipped along the track. TPs
in left and rightneck. Electro-AP, 20 minutes, at rump TPs, plus BL23, 25, GB30, 34,
PAIHUI. Simple AP at neck TPs (probably not important) plus BL11. Handler to massage all
TPs.
22/6 Little change. Treated as before.
29/6 Marked improvement. All TPs gone. Mare sound. Treated as before.
Riding to begin in early July.

18/7 All TPs still gone. Hair more normal along original track. Mare riding sound. Working
up to full race training.
20/8 Came 4th in high-class race. Still sound.
Case 2. Ovarian backpain. 18/5 Severe left lumbar pain and left hind lameness in filly.
Humped back and lumbar m. spasm clearly visible. Duration > 10 months. She had ovulated 2
days before and left ovary area was very sore on rectal examination by colleague. History of
not showing clear signs of oestrus. TPs in left lumbar area and under external angle of ilium
(ovary areas). Electro-AP, 20 minutes on all TPs, plus BL23, PAIHUI and uterus point
(midway between external angle of ilium and iliac crest).
21/5 Some improvement but TPs still tender. New TP on right rump near uterus point.
Treatment as before, plus GB34 (both).
25/5 definite improvement on walk but hunched up on turning. All left TPs gone but right one
still tender. Treated as before.
30/5 Normal on walk, trot and on turning. Right TP still tender and new TPs found on left and
right neck and over last right rib. Treated all TPs including original ones, plus PAIHUI.
4/6 Normal walk and turn. TPs gone except right neck. All TPs treated, plus PAIHUI, BL23
(both).
9/6 Sound. All TPs gone. Walking exercise to be increased. No treatment except massage by
handler.
16/6 Going well in walk and canter on soft ground.
19/6 (32 days after initial exam, 34 days after painful ovulation): Was sent for jog on hard
surface. Came back crippled, worse than ever. Left lumbar TPs very tender.
c. 22/6 colleague found left ovary area very sore on rectal exam. (This case is classed as a
failure. Despite initial success, she relapsed. She was sent to the Veterinary College for
specialist examination and treatment. They found nothing and suggested resting her for 6-8
months.)
Case 3. Stiff back. Gelding, had won races earlier. Back rigidity and stiffness had prevented
him from racing for the past 2 years.
4/4 TPs over the last few ribs on both sides. Rhinitis (mild). Electro-AP 20 minutes, at TPs
plus PAIHUI, BL23, GB30 (both).
10/4 Not possible to assess improvement, as he had not been ridden since. TPs still tender.
Treated as before, plus BL13 (both) for the rhinitis.
16/4 Rhinitis gone. Vast improvement in back flexibility and stride was noted by riders who
did NOT KNOW he had been treated. Put back on full training schedule. No treatment.
26/4 Owner reported him fully sound and going very well. One year later, he was still sound.

EXAMPLES OF AP THERAPY IN DOGS

MYOFASCIAL LAMENESS:
TPs are frequently found in dogs in the paravertebral, neck, shoulder, triceps and thigh
muscles.
Janssens (1984) reported TP therapy for myofascial lameness in 21 dogs. Mean duration of
lameness before therapy was 24 weeks. TP therapy was successful in 70% of cases, in a mean
time of 17 days (2.5 sessions). The relapse rate was 33% but response to treatment of relapse
cases was similar to that in new cases. He described TPs in the Triceps, Peroneus longus,
Gluteus medius, Iliocostarum lumborum, and the thigh Adductor ms.
ARTHROPATHY
Joint trauma, rheumatism and arthritic pain can be helped by AP. Much of the pain and
stiffness in arthropathy is due to muscle spasm (guarding) and TPs in the muscles above or
below the affected joint.Arthropathy can affect the vertebrae also and is treated as in disc
disease (see below).
Janssens (1986) reported AP therapy in 61 dogs with arthritis. The mean duration before
treatment was 36 weeks. AP was most successful in pain of the shoulder and stifle (80 and
72% respectively), less so in hip pain (55%) and was least successful in pain of the elbow,
carpus and tarsus (33%). Recovery time averaged 24 days (5.2 sessions). Relapses occurred in
48%. Retreatment had the same success in them as in new cases. Schoen (1984) reported good
or excellent results in 63% of 24 dogs treated by AP for arthrosis.
CERVICAL (CDD) AND THORACOLUMBAR (TLDD) DISC DISEASE
As in arthrosis, much of the pain in disc disease is due to spasm and guarding of the muscles
near the lesion. Irritation of the vertebral nerve root and oedema of the spinal cord add to the
pain signals.
In treating disc disease, it is important to assess the degree of nerve damage. If one uses a 4grade system (1 = pain only; 2 = pain+paresis; 3 = pain+paralysis; 4 = paralysis and loss of
deep pain sensation), the prognosis in grade 1 and 2 is excellent, in grade 3 is very good and
in grade 4 is poor. Grade 4 cases need a lot of care (nursing, turning, catheterisation, manual
emptying of rectum in faecal retention etc) and many owners are unwilling to give it.
The approach to AP treatment in disc disease is to localise the affected area by finger
palpation and other methods (including X-ray). One or two points are used bilaterally above
and below the problem disc(s), with TPs and distant points.
For TLDD, distant points include GB30, 34, BL54, 60. For CDD, they include CO11, SI 3,
GB34. The local points in CDD include GB20, TH15. Treatment is every 5-7 days but in
acute pain every 2-4 days.) Additional therapy (conventional, playpen rest etc) is used as
needed.

Ly (1977) reported that 79% of 19 dogs with paresis recovered following electro-AP and point
injection (.5 ml/point) with B12 solution. He treated every 2-3 days for 8-10 sessions and
most cases improved within the first 5 sessions.
Janssens (1983) reported results of AP therapy in 78 chronic TLDD cases. The average
duration of signs before AP was 21, 23, 31 and 18 days in Grades 1 to 4 respectively.
Recovery rates to were 97% in Grade 1 in a mean of 13 days (2 sessions); 95% in Grade 2 in a
mean of 24 days (3.4 sessions); 85% in Grade 3 in a mean of 32 days (4.8 sessions); 33% in
Grade 4 in a mean of 76 days (9 sessions).
In another study (Still 1987), 63 dogs with acute TLDD (mean duration 4.4 days) were treated
with AP every 1-3 days. In contrast to chronic cases, 100% of acute cases of Grade 1+2 had
pain control within 4 sessions; 63-71% within 24 hours. Full cure (all signs gone) was seen in
83%. In Grades 3+4, 62% had pain control within 4 sessions; 39% within 24 hours. However,
full recovery (all signs) in Grades 3+4 occurred in only 11%, with improvement in another
46% (43% remained unchanged in sensory-motor function). Essential improvement of motor
and other sensory functions occurred within 24-36 hours after the first treatment in Grade 2
and within 3-21 days (mean 10.9) after first treatment in Grades 3+4. Occasional autonomic
upsets (constipation, diarrhoea, urinary retention) resolved within 1-3 days of first treatment
in Grades 1+2 and 7-14 days in Grades 3+4.
These recovery rates and times compared very well with published values for conventional
methods, including surgery.
In CDD, Janssens (1984) reported 80% recovery in Grade 1 in a mean of 11 days (2.8
sessions). In Grades 2 and 3, 67% recovered in a mean of 21 days (3.5 sessions). There were
no Grade 4 cases in the seris.
Relapses in cured TLDD and CDD cases occur in 20-40% but response to treatment in relapse
cases is similar to that in new cases.
POSTOPERATIVE PAIN
Janssens (personal communication) reported that AP has controlled pain in dogs which did not
respond to surgery for disc disease. He has also used AP successfully to control pain and other
complications arising after abdominal and other surgery.
EXAMPLE FROM MY FILES
Case 1. Cramp. Greyhound with history of race cramp, 5 months duration. He had won as a
pup. Examination showed TPs near BL23 (kidney) and near the femoral artery on the upper,
inner thighs. Three sessions of electro-AP at weekly intervals (TPs, GB20, 34) gave marked
improvement. All TPs disappeared and normal urination (he had been a 'dribbler') was
restored. The dog was beaten by a nose in his next race (I lost my bet!) but he won the
following race and was exported at a good price.
CONCLUSIONS

In practice, it is difficult to make a specific diagnosis of the cause of backpain, especially in

horses, due to the difficulty of routine X-ray and myelography. The general practitioner may
be satisfied with clinical remission.
Palpation of the muscles, to locate TPs is an essential part of the clinical examination.
Point selection for local problems includes some from TPs, local points, distant points for the
region, points with special or generalised action and (most of all) the paravertebral SHU
point(s) for affected organ(s) or function(s). This includes the use of SHU points in superficial
problems which may not have direct organic involvement. For instance, BL13 and 25 (SHU
points for the LU and CO meridians) would be indicated as part of a prescription to help
resolve pain of an inside-forelimb splint (in the meridian area of LU and CO). Similarly,
BL23, 28 (SHU of KI and BL) would be indicated in capped hock (meridian area of KI and
BL). One or two distant points on a meridian passing through the problem area, or a chain of
points along an affected nerve are also helpful.
Certain key points are: ST36, BL21 stomach and appetite; BL13, 38 lung; BL18, VG 9 liver;
GB34, TH15 muscles; BL23, PAIHUI adrenal, uro-genital, hindquarter; TH15, GB21
forequarter; GB20, 21 neck; BL25, PAIHUI hindgut; BL11, 23 bones, joints; CO11, VG14,
ST36 immunostimulation.
Simple needling for 20 minutes, electroneedling or point injection are the main methods used
in horses and dogs.
A clinical success rate of 70-90% can be attained in 1-3 sessions at 1-3 day intervals (recent or
acute cases), or in 1-10 sessions at 3-7 day intervals in longstanding or chronic cases.
However, beginners should study the principles of AP before attempting to use it. They should
advise the use of other physiotherapies (massage, ultrasound, LASER etc) on the points
(between sessions) to ensure high success rates.
There are other methods of point selection (earpoints, hoof points etc) and of point stimulation
(magnets, staples, implants, Dermojet, LASER etc) but these methods must be regarded as
experimental until adequate documentation and comparative clinical trials are available.
ACKNOWLEDGEMENTS
Basic texts on animal acupuncture are scarce. The authors of texts on the horse kindly
presented me with copies and explained their methods to me. They are:
Colleagues Alan Klide, Philadelphia; Oswald Kothbauer, Austria; Jen Hsou Lin, Taiwan;
Erwin Westermayer, Germany; Sheila White, Australia.
The following gave details of their approach to equine AP, either in formal or informal
meetings, discussions or correspondence:
Marvin Cain, Cincinnati; Yann Ching Hwang, Alabama; Dick Jeffries, Ohio;
Ralph Johnson, Minnesota; Jukka Kuussaari, Finland; Grady Young, Georgia.

Colleagues Shelly Altman, Los Angeles; Luc Janssens, Belgium; Jacques Milin, France; Jan
Still, Belgium have been most helpful in my study of small-animal AP.
To them and to many others unnamed, who have taught me to listen to the body (my own as
well as the patient's), I give my sincere thanks.
I also thank Dr. Pekka Pontinen, Tampere, Finland and the organisers of the Nordic
Acupuncture Congress for financing my trip to the Congress.
REFERENCES
JANSSENS, L.A.A. (1983) AP treatment of canine thoraco-lumbar disc protrus-ions: a review
of 78 cases. Vet. Med. Small Anim. Clinician, October, 1580-1585.
JANSSENS, L.A.A. (1984) Atlas of the AP points and meridians in the dog. Oudestraat 37,
Wilryk, Belgium.
JANSSENS, L.A.A. (1984) Treatment of canine cervical disc disease by AP: a review of 32
cases. Veterinary AP Training Seminar, Veterinary School, Gent, Belgium. 289 pp.
JANSSENS, L.A.A. (1984) Myofascial pain syndromes in dogs: TP therapy of 21 cases.
Veterinary AP Training Seminar, Veterinary School, Gent, Belgium. 289 pp.
JANSSENS, L.A.A. (1986) Observations on AP therapy of chronic osteo-arthri-tis in dogs: a
review of 61 cases. J. Small Anim. Pract.27, 825-837.
KLIDE, A. & KUNG, S. (1977) Veterinary AP. University of Pennsylvania Press
Philadelphia, PA, USA. 297pp.
KLIDE, A.M. (1984) AP treatment of chronic backpain in the horse. AP and
Electrotherapeutics Research. Int. J. 9, 57-70.
KLIDE, A.M. (1987) Use of AP for the treatment of chronic backpain in horses: stimulation
of AP points with saline solution injections. J. of the American Veterinary Medical
Association 190, 1177-1080.
KOTHBAUER, O. & MENG, A. (1983) Veterinary AP: cattle, pigs and horses (in German)
Verlag Welsermuhl, Wels, Austria. 334pp.
LIN, J.H. and ROGERS, P.A.M. (1980) Acupuncture effects on the body's defense systems. A
veterinary review. Vet. Bulletin 50, 633-640.
LIN, J.H. (1985) AP in the ox, pig, horse, goat & dog. (in Chinese). Write c/o Dept. Animal
Husbandry, National Taiwan University, TAIPEI, TAIWAN, R.O.C.
LY, J.P. (1977) Veterinary AP. Proc. 54th Ann. Conf. Austral. Vet. Assoc., pp 69-71.
MARTIN, B.B. and KLIDE, A.M. (1987) Laser AP for the treatment of chronic backpain in
horses: stimulation of the AP points with a low-power laser. Veterinary Surgery 16, 106-110.

ROGERS, P.A.M. and OTTAWAY, C.W. (1974) Success claimed for acupuncture in domestic
animals. A veterinary news item. Irish Vet. J., 28, 182-191.
ROGERS, P.A.M. WHITE, S.S. and OTTAWAY, C.W. (1977) Stimulation of the AP points in
relation to analgesia and therapy of clinical disord-ers in animals. Vet. Annual (Wright
Scitechnica, Bristol) 17, 258-279.
ROGERS, P.A.M. (1979) Acupuncture in equine practice: a brief review. Irish Vet. J., 33, 1925.
ROGERS, P.A.M. (1981) Serious complications of AP ... or AP abuses ? Amer. J. Acup., 9,
347-350.
ROGERS, P.A.M. and BOSSY, J. (1981) Activation of the defence systems of the body in
animals and man by acupuncture and moxibustion. Acup. Res. Quarterly (Taiwan) 5, 47-54.
ROGERS, P.A.M. (1984) Choice of points for particular conditions. Proc. Veterinary AP
Seminar, Veterinary School, Gent, Belgium and Proc. 10th IVAS Congress, Austin, Texas.
ROGERS, P.A.M. (1987) The choice of AP points for the treatment of human backpain.
Nordic Acupuncture Congress, Oslo, Norway, September 1987.
ROGERS, P.A.M. (1987a) Clinical AP in the horse: points and methods used in therapy. 13th
Annual Congress of the International Veterinary AP Association, Antwerp. September 9-12.
ROGERS, P.A.M. (1987b) AP in small-animal practice. Ibid.
RUBIN, M. (1976) Manuel d'AP pratique moderne. Maloine Publishers, Paris. 85 pp.
SCHOEN, A.M. (1984) AP therapy in chronic arthropathy in dogs. A review of 24 cases.
Veterinary AP Training Seminar, Veterinary School, Gent, Belgium. 289 pp.
STILL, J. (1987) AP treatment of thoracolumbar disc disease in dogs: a review of 63 cases.
Paper in preparation.
TRAVELL, J.G. & SIMONS, D.G. (1984) Myofascial pain & dysfunction: the TP manual.
Part 1. Williams & Wilkins, London & Baltimore, 713pp.
TRIGGER POINT THERAPY: Symposium on myofascial TPs (1981) Arch. Rehabilitation
Med., March, 97-117; Dorrigo et al (1979) Pain, 6, 183-; Kajdos (1974) Amer. J. Acup., 2,
113-.; Kellgren (1939-42) Clinical Sci., 4, 35-; Khoe (1979) Amer. J. Acup., 7, 15-; Lewit
(1979) Pain, 6, 83-.; Melzack et al (1977) Pain, 3, 3-.; Macdonald (1983) Annals of Royal
Coll. Surg. Eng., 65, 44-,; Rogers, C. (1982) Amer. J. Acup., 10, 201-.
WESTERMAYER, E. (1980) Treatment of horses by AP. Health Science Press, Holsworthy,
Devon, UK. 90pp.
WESTERMAYER, E. (1978) Atlas of AP for cattle. WBV Biologisch Verlag, Ipweg 5,
Schorndorf, Germany. 60 pp.

WHITE, S.S., HERBERT, P.A. & HWANG, T. (1985) Electro-AP in veterinary medicine.
Chinese Materials Centre Publications, San Francisco. 122pp.

AMALGAMATED DATA:
TOP 10 POINTS FOR MAJOR BODY FUNCTIONS, ORGANS &
PARTS
COPYRIGHT
Philip A.M. Rogers MRCVS These prescriptions are publis-hed as a micro-compu-ter
software package. They may not be published or used for commercial purposes wi-thout
written permission from the author !! However, colleagues are most welcome to use them for
their own clinical or research purposes.
Point convention used in the computer outputs :
The Meridian Points are coded as follows: LU=Lung; LI=Large Intestine; ST=Stomach;
SP=Spleen-Pancreas; HT=heart; SI=Small Intestine; BL=Bladder; KI=Kidney; PC=Pericardium, Heart Constrictor, Circulation-Sex; TH=Tri-Heater; GB=GallBladd-er; LV=Liver;
CV=Conception Vessel (Ren Mo) ; GV=Governor Vessel (Du Mo). In this system, the second
branch of the Bladder meridian has BL41 (Fu Fen) at the scapular area and BL40 (Wei
Chung) at the popliteal crease, as in most modern Chinese texts. The Stomach meridian has
ST01 (Cheng Chi) infraorbital and ST08 (Tou Wei) on the meeting of the vertical and the
horizontal hairline on the forehead.
Meridian Code

LU LI ST SP HT SI BL KI PC TH GB LV CV GV

no. of points

11 20 45 21

9 19 67 27

9 23 44 14 24 28

The New, Strange & Hand Points are ordered as in the 'Newest Illustrations of the AP points'
(Med. & Health Publishers, Hongkong, 1973) :
NZ=New Head & Neck; NY=New Abdomen; NX=New Loin & Back; NA=New Upper
Limb; NL=New Lower Limb; Z =Strange Head & Neck; Y =Strange Thorax & Abdomen; X
=Strange Loin & Back; A =Strange Upper Limb; L =Strange Lower Limb; H =Hand points.
New Points
Point code

NZ NY NX NA NL

no. of points

35

6 18 15 36

Strange Points
Z

31 19 35 44 42 18

Category OT (Other) codes :

01=AHSHI; 02=Tian Ying; 03=Segmental nerve; 04=Haemorrhoid point; 05=Local points for
region; 06=Distant points for region; 07=points on meridian through area; 08=Periosteal AP;
09=Periincisional pts.; 10=Chieh Kou (Cut ends)
Trigger Points (categories TP, TQ, TR):

Trigger Points are located as in 'Myofascial Pain and Dysfunction' by Travell & Simons
(Williams & Wilkins, Baltimore & London, 1983). Their coding is summarised in the index of
point locations, which is appended.
Point code

OT TP TQ TR

no. of points

10 99 99

The total number of points (Meridian, New, Strange etc plus Trigger Points) in the database is
871.
The 12 basic laws of selecting points are :
(1) Treat the main contradiction, adding 1-2 points for the more serious symptoms.
(2) Points according to the innervation or in same dermatome as the problem area or function.
(The paravertebral and Hua To Chia Chi (X 35) points are especially important).
(3) AHSHI (tender) points (trigger, myalgic, fibrositic, motor, REPP points).
(4) Local points or points locally on nearest meridians.
(5) Distant points on meridians controlling problem area.
(6) Combination of local & distant points or Yin and Yang points (e.g. The YUAN (Sou-rce)
point of the problem part/organ/meridian and the LUO (Passage) point of its linked meridian).
(7) Points 'Fore & Aft', 'Above & Below', 'Left & Right' - bracketing the problem area.
(8) Points well known for their symptomatic effects.
(9) Back & Abdomen combination - SHU (BL Reflex) and MU (Front Alarm) or points near
the SHU and MU.
(10) The XI (Cleft) point of affected organ/meridian in acute diseases.
(11) Scar therapy - improving electrical conductivity of scars and soft tis-sue injury by
needling, injection, laser, physiotherapy etc.
(12) The Tian Ying point - under the ulcer base, into the cyst etc.
!! Always seek the tender (trigger) points !!
Final selection of points from this index :
(1) High scores with multiple authors indicate the most important points. If the first point
listed has a score <.40, this indicates poor agreement between authors and may indicate a
prescription of doubtful value.
(2) The first 4 to 6 points in each prescription list are the most frequen-tly cited points.
Additional points may be added from those remaining, if other symptoms indicate a need for
them.
(3) Prescriptions with less than 2 authors or with little variation in point scores may be of
doubtful value !!
(4) When needling, always provoke 'needle sensation'. Expect poor results if poor needle
sensation is reported !!
(5) The number of needles per session should normally be less than 12 (use as few as
possible).
(6) Alternate prescriptions if in doubt or if result is not satisfactory af-ter 1-2 sessions.
(7) Research workers seeking 'non-active' points for 'placebo' or 'contr-ol' groups of subjects
should not use any point listed in these prescriptio-ns. As 'active' points, they should consider
points in the Top Ten of each list.

(8) The most common prescription for local or organ problems is : local points + AHSHI
points + distant points.
!! Always seek the tender (Trigger) points !!
AMALGAMATED DATA: TOP 10 POINTS FOR MAJOR BODY FUNCTIONS, ORGANS
& PARTS The Point Index for body organs, parts and functions is laid out in a regional
sequence as follows:
01xxxx Emergencies and First Aid
02xxxx Head, its organs and functions
03xxxx Neck, thyroid
04xxxx Thoracic limb
05xxxx Thorax, its organs and functions
06xxxx Abdomen, its organs and functions
07xxxx Pelvic limb
08xxxx Skin and hair
09xxxx General, immunity
When searching for, say the sacral area, search under 06xxxx (Abdomen)
When searching for, say the heart area, search under 05xxxx (Thorax )
The main headings of the index are :
010100 EMERGENCIES
010200 FIRST AID
020100 PSYCHE AND MENTAL DISORDERS
020200 ADDICTIONS
020300 BRAIN, ITS FUNCTIONS & PARTS, MENINGES, POLIO, CONVULSI-ONS,
020323 MEMORY: LOSS OF;AMNESIA;FORGETFUL
020349 BRAIN, MENINGES
020350 CVA, POLIO, PARALYSIS, HEMIPLEGIA
020351 CONVULSIONS, EPILEPSY, TETANUS, TREMOR
020353 SPINAL CORD
020400 HEAD, FOREHEAD, VERTEX, OCCIPUT, TEMPLE, HEADACHES,
020433 FOREHEAD, FRONTAL SINUSES
020434 VERTEX
020435 OCCIPUT
020436 TEMPLE
020500 FACE, CHEEK
020600 EYE, EYELID, VISION ETC
020700 NOSE, NOSTRIL, NASAL SINUSES, OLEFACTION
020800 THROAT, PHARYNX, LARYNX, TONSIL, VOICE
020900 EAR, HEARING, MENIERES DISEASE, EUSTACIAN TUBE, MASTOID ETC
021000 LIP, ORAL MUSCLES
021014 MOUTH
021100 TOOTH, GUM
021124 TOOTH, UPPER
021125 TOOTH, LOWER
021200 TONGUE, SPEECH

021222 SALIVA, SALIVARY GLANDS ETC

021300 MAXILLA
021313 CHIN
021315 MANDIBLE
021316 TEMPORO-MANDIBULAR JOINT, MASSETER
021317 MAXILLA, MANDIBLE
030000 NECK AND CERVICAL SPINE
030129 THYROID, PARATHYROID
040000 THORACIC LIMB, ITS ORGANS AND FUNCTIONS
040200 SHOULDER, SCAPULA, CLAVICLE
040300 AXILLA
040400 ARM, HUMERUS
040500 ELBOW
040600 FOREARM, RADIUS, ULNA
040700 WRIST, CARPUS
040800 HAND, PALM
040900 FINGER
050000 THORAX AND BACK, ITS ORGANS AND FUNCTIONS
050001 THORAX, CHEST, RIBS, STERNUM
050002 THORACIC SPINE, BACK AREA
050200 HEART, PERICARDIUM
050228 CIRCULATION, BLOOD PRESSURE
050229 ARTERIES, VEINS, ARTERIOSCLEROSIS, ISCHAEMIA
050300 OEDEMA, FLUID RETENTION, ASCITES
050400 BLOOD, BODY DEFENCES, HAEMORRHAGE, THYMUS ETC
050500 RESPIRATORY SYSTEM (TRACHEA, BRONCHI, LUNG, COUGH, ETC
050541 PLEURA
050543 TRACHEA
050544 BRONCHI, LUNG, PNEUMONIA, ASTHMA
050545 COUGH GENERAL
050600 OESOPHAGUS
050700 DIAPHRAGM
060000 ABDOMEN AND BACK, ITS ORGANS AND FUNCTIONS
060141 ABDOMEN UPPER, EPIGASTRIC, HYPOCHONDRIAC AREA
060142 ABDOMEN MIDDLE, PERIUMBILICAL AREA
060143 ABDOMEN LOWER
060200 DORSO-LUMBAR SPINE AND AREA
060228 COCCYGEAL AREA
060231 LOWBACK (LUMBO-SACRAL, RENAL, SACRO-ILIAC), LUMBAR, SACRAL)
060232 WAIST, FLANK AREA
060300 LIVER (INFLAMMATION, CALCULI, JAUNDICE, ACETONAEMIA ETC)
060323 GALLBLADDER, BILEDUCTS (INFLAMMATION, CALCULI, OBSTRUCTION)
060400 SPLEEN
060410 PANCREAS, DIABETES MELLITUS, HYPO- & HYPER- GLYCAEMIA
060500 GASTROINTESTINAL TRACT
060503 INDIGESTION, INAPPETANCE, NAUSEA, VOMITING
060542 PAIN, COLIC, SPASM IN ABDOMEN OR ITS ORGANS, PERITONITIS
060543 DIARRHOEA, DYSENTERY, CONSTIPATION
060600 STOMACH AND DUODENUM

060700 SMALL INTESTINE, APPENDIX, CAECUM, COLON, RECTUM

060752 ANUS, TENESMUS, PROLAPSE, PILES
060753 INGUINAL AREA, GROIN
060754 PERINAEUM
060755 MALE & FEMALE EXTERNAL GENITALIA AND PUBIC AREA
060800 UROGENITAL (GENERAL CONDITIONS)
060900 URINARY TRACT AND FUNCTIONS
061000 GENITALIA FEMALE AND REPRODUCTION
061100 PREGNANCY: CONDITIONS OF
061101 PREGNANCY: FORBIDDEN/ABORTION Points
061125 PARTURITION
061126 POST-PARTUM CONDITIONS
061200 MAMMARY FEMALE
061300 MENSTRUAL CYCLE, CONTRACEPTION
061316 MENOPAUSE: GENERAL Points FOR FLUSHES & MENOPAUSAL PROBLEMS
061400 REPRODUCTION MALE (IMPOTENCE, SPERMATORRHOEA ETC )
061500 GENITALIA MALE
070000 PELVIC LIMB , ITS ORGANS AND FUNCTIONS
070200 BUTTOCK
070239 HIP
070240 THIGH, FEMUR
070300 KNEE, POPLITEAL
070315 PATELLA
070400 LEG, CALF
070417 TIBIA, FIBULA
070429 ACHILLES AREA, HEEL
070500 ANKLE, TARSUS
070503 TARSAL-METATARSAL
070600 METATARSAL, FOOT
070608 TOE
080000 SKIN
080124 HAIR,SKIN : ALOPECIA;BALDNESS;HAIRLOSS;OPPILATION
090100 FEVERS
090101 CHILLS
090200 SWEATING PROBLEMS
090300 INFECTIONS: MALARIA,TB,CHOLERA,TYPHOID,TYPHUS,HERPES,ETC
090400 IMMUNITY
090410 TONIC EFFECTS
090419 GANGRENE, ISCHAEMIA OF EXTREMITIES
090420 LYMPHADENOPATHY
090500 BONES, JOINTS (GENERAL)
090600 MUSCLE, TENDON, SOFT TISSUES (GENERAL)
090700 ANALGESIA, PAIN CONTROL (GENERAL)
010100 EMERGENCIES /
39 References / 168 Points / Rating .964
GV26

KI01

ST36

PC06

A 01

LI04

PC09

GV20

LU11

LI11

.851

.824

.521

.500

.497

.441

.391

.362

.338

.319

010200 FIRST AID /

32 References / 145 Points / Rating .959
GV20

ST36

PC06

GB20

LV03

GV26

Z 03

LI04

Z 09

LU11

.570

.564

.521

.414

.322

.306

.293

.290

.283

.221

020100 PSYCHE AND MENTAL DISORDERS /

46 References / 344 Points / Rating .967
HT07

SP06

PC06

ST36

GB20

LI04

GV20

LV03

BL15

CV12

.867

.780

.771

.692

.634

.620

.539

.521

.515

.515

020200 ADDICTIONS /
18 References / 71 Points / Rating .950
ST36

SP06

LI04

BL13

PC06

CV12

BL21

CV06

LV03

GB08

.637

.579

.409

.327

.292

.292

.275

.269

.234

.211

020300 BRAIN, ITS FUNCTIONS & PARTS, MENINGES, POLIO, CONVULSI-ONS, MEMORY,
TETANUS, CVA ETC / 53 References / 477 Points / Rating

.953

LI04

LI11

ST36

GB34

ST06

LI15

GB20

GB30

ST04

GV14

.800

.741

.703

.663

.634

.610

.608

.604

.594

.578

020323 MEMORY: LOSS OF;AMNESIA;FORGETFUL /

15 References / 45 Points / Rating .940
HT07

GV11

BL15

BL43

HT03

GV20

HT09

NL04

ST36

PC06

.553

.383

.340

.319

.270

.270

.241

.213

.199

.199

020349 BRAIN, MENINGES /

19 References / 100 Points / Rating .937
LI04

GV15

GB20

ST36

GV12

LI11

GB34

BL64

KI01

GV14

.444

.427

.427

.371

.360

.303

.264

.258

.213

.213

020350 CVA, POLIO, PARALYSIS, HEMIPLEGIA /

44 References / 401 Points / Rating .964
LI04

LI11

ST36

GB34

ST06

GB30

ST04

LI15

TH05

GB39

.858

.792

.767

.743

.731

.719

.684

.656

.618

.616

020351 CONVULSIONS, EPILEPSY, TETANUS, TREMOR /

35 References / 272 Points / Rating .960
GV14

ST36

LI04

GV26

KI01

GV20

LV03

LI11

GB20

PC06

.723

.693

.690

.670

.664

.661

.658

.607

.604

.589

020353 SPINAL CORD /

10 References / 27 Points / Rating .910
BL11

GV14

GV04

BL60

GV15

KI07

BL10

GV20

ST36

KI08

.440

.440

.429

.330

.297

.253

.220

.220

.209

.187

020400 HEAD, FOREHEAD, VERTEX, OCCIPUT, TEMPLE, HEADACHES, SINUSITIS ETC /

52 References /

286 Points / Rating

.965

LI04

GB20

Z 09

GV20

LU07

Z 03

BL10

LI20

BL02

BL60

.902

.845

.725

.657

.635

.610

.556

.540

.500

.494

020433 FOREHEAD, FRONTAL SINUSES /

34 References / 74 Points / Rating .971
LI04

Z 03

GB14

BL02

GV23

Z 09

GB20

LU07

ST44

GV24

.800

.594

.491

.430

.403

.355

.297

.273

.206

.203

020434 VERTEX /
27 References / 51 Points / Rating .948
GV20

GB20

LV03

KI01

LI04

BL07

GV19

BL60

GB11

SI03

.832

.574

.492

.387

.340

.223

.215

.188

.156

.148

020435 OCCIPUT /

35 References / 80 Points / Rating .957

GB20

BL10

SI03

BL60

GV15

BL65

LI04

LU07

GV20

OT05

.854

.606

.409

.310

.260

.254

.254

.236

.227

.173

020436 TEMPLE /
23 References / 57 Points / Rating .961
Z 09

GB20

GB08

GB41

LI04

TH03

TH05

TH23

GB07

LU07

.579

.471

.448

.430

.344

.308

.213

.213

.208

.181

020500 FACE, CHEEK /

49 References / 198 Points / Rating .963
LI04

ST06

ST04

ST07

ST02

LI20

BL02

GB14

TH17

ST03

.860

.860

.780

.780

.595

.581

.547

.532

.513

.487

020600 EYE, EYELID, VISION ETC /

43 References / 292 Points / Rating .958
BL01

LI04

GB20

ST01

Z 09

BL02

ST02

GB14

TH23

BL18

.835

.811

.735

.648

.595

.590

.583

.566

.558

.512

020700 NOSE, NOSTRIL, NASAL SINUSES, OLEFACTION /

43 References / 204 Points / Rating .963
LI04

LI20

GB20

GV23

LI11

GV14

Z 03

BL07

LI19

ST02

.930

.867

.684

.577

.512

.495

.457

.437

.367

.350

020800 THROAT, PHARYNX, LARYNX, TONSIL, VOICE /

43 References / 208 Points / Rating .960
LI04

LU11

CV22

LI11

ST44

LU10

CV23

PC06

LI18

SI17

.952

.634

.598

.586

.545

.484

.409

.395

.378

.378

020900 EAR, HEARING, MENIERES DISEASE, EUSTACIAN TUBE, MASTOID ETC /

45 References /

276 Points / Rating

.964

TH17

GB02

SI19

TH21

TH05

GB20

LI04

TH03

ST36

GV20

.843

.733

.721

.721

.680

.671

.659

.624

.583

.539

021000 LIP, ORAL MUSCLES /

22 References / 57 Points / Rating .955
ST04

ST03

LI04

ST06

CV24

GV26

ST07

ST44

LI20

LI03

.638

.519

.510

.419

.329

.267

.233

.186

.181

.171

021014 MOUTH

28 References / 104 Points / Rating .950

LI04

LI11

ST04

ST06

PC08

GV12

GV27

LI07

Z 20

ST44

.680

.492

.455

.421

.346

.301

.289

.282

.256

.241

021100 TOOTH, GUM /

44 References / 170 Points / Rating .959
LI04

ST06

ST07

ST44

ST05

CV24

SI18

LI03

LI11

ST03

.891

.874

.822

.616

.410

.386

.299

.296

.296

.296

021124 TOOTH, UPPER /

10 References / 24 Points / Rating .950
LI04

ST07

ST06

ST44

SI18

LI20

ST02

ST36

GV26

SI05

.589

.589

.411

.411

.389

.316

.316

.211

.211

.200

021125 TOOTH, LOWER /

17 References / 35 Points / Rating .959
ST06

LI04

ST05

LI03

ST07

ST44

ST36

CV24

TH08

LI11

.699

.515

.472

.411

.288

.233

.184

.184

.153

.104

ST06

GB20

Z 21

021200 TONGUE, SPEECH /

38 References / 179 Points / Rating .961
CV23

GV15

LI04

HT05

TH17

LI11

TH05

.732

.641

.600

.501

.397

.392

.389

.345

.310

.247

021222 SALIVA, SALIVARY GLANDS ETC /

11 References / 34 Points / Rating .964
ST40

SP04

LV03

LI04

SI05

LI10

ST43

BL59

GB07

GB38

.283

.283

.283

.274

.255

.245

.189

.189

.189

.189

021300 MAXILLA /
25 References / 65 Points / Rating .960
LI04

ST02

ST07

ST03

ST06

LI20

ST04

SI18

GV26

ST44

.679

.675

.525

.508

.479

.450

.329

.317

.313

.279

021313 CHIN /
4 References / 12 Points / Rating .925
CV24

ST04

ST05

CV22

GV27

SI10

SI07

GB05

GB21

GV22

.730

.541

.541

.541

.541

.459

.270

.270

.270

.270

021315 MANDIBLE /
39 References / 110 Points / Rating .962
ST06

ST07

LI04

CV24

ST05

ST04

ST36

LV03

TH17

ST44

.773

.669

.640

.392

.381

.365

.315

.267

.248

.232

021316 TEMPORO-MANDIBULAR JOINT, MASSETER /

37 References / 76 Points / Rating .962
LI04

ST07

ST06

GB02

ST05

SI19

TH17

LV03

GV26

TH21

.705

.702

.654

.346

.323

.267

.261

.197

.194

.191

ST05

LI20

ST44

021317 MAXILLA, MANDIBLE /

33 References / 100 Points / Rating .967
ST06

ST07

LI04

ST02

ST04

ST03

CV24

.755

.755

.721

.508

.458

.442

.398

.386

.367

.332

030000 NECK AND CERVICAL SPINE /

49 References / 254 Points / Rating .963
GB20

GV14

LI04

BL10

SI03

LI11

OT01

GB21

GB39

SI15

.676

.540

.530

.489

.485

.468

.434

.413

.409

.381

030129 THYROID, PARATHYROID /

28 References / 110 Points / Rating .964
CV22

LI11

LI04

ST09

PC06

GB20

LI18

BL10

CV23

GV14

.567

.426

.422

.419

.385

.304

.289

.237

.237

.233

040000 THORACIC LIMB, ITS ORGANS AND FUNCTIONS /

48 References / 291 Points / Rating .983
LI11

LI15

TH05

LI04

SI03

TH04

HT03

PC07

LI10

OT05

.978

.879

.842

.792

.688

.669

.608

.606

.604

.604

040200 SHOULDER, SCAPULA, CLAVICLE /

45 References / 181 Points / Rating .960
LI15

LI11

TH14

SI11

SI09

LI04

OT01

SI10

OT05

BL11

.873

.713

.625

.507

.491

.470

.449

.417

.403

.396

040300 AXILLA /
17 References / 40 Points / Rating .959
HT01

GB40

GB42

GB22

SI09

PC01

GB38

PC05

LI15

TH12

.460

.411

.405

.362

.344

.344

.276

.184

.160

.160

040400 ARM, HUMERUS /

33 References / 167 Points / Rating .961
LI11

LI15

LI04

SI09

SI11

TH06

LI10

TH08

LI14

PC03

.874

.659

.451

.429

.394

.391

.391

.360

.353

.328

040500 ELBOW /
42 References / 126 Points / Rating .967
LI11

TH05

LI04

HT03

LU05

LI10

OT01

LI12

TH10

SI07

.852

.520

.453

.453

.404

.404

.335

.313

.310

.239

040600 FOREARM, RADIUS, ULNA /

27 References / 106 Points / Rating .948
LI11

HT03

LI10

LI04

PC06

HT07

PC03

TH05

SI08

TH09

.707

.676

.672

.563

.559

.434

.434

.422

.367

.363

040700 WRIST, CARPUS /

36 References / 97 Points / Rating .967
TH04

TH05

LI04

PC07

LI05

LU07

SI04

PC06

LI11

OT01

.690

.500

.422

.391

.330

.307

.273

.250

.247

.247

040800 HAND, PALM /

32 References / 101 Points / Rating .953
LI04

LI11

A 22

SI03

PC07

LI03

PC08

SI04

TH03

PC06

.564

.380

.380

.338

.302

.292

.289

.213

.213

.193

040900 FINGER /
38 References / 130 Points / Rating .958
LI04

A 22

SI03

LI03

TH05

SI04

SI07

PC07

PC06

TH04

.555

.536

.503

.409

.401

.371

.368

.365

.354

.349

050000 THORAX AND BACK, ITS ORGANS AND FUNCTIONS /

53 References /

431 Points / Rating

PC06

BL13

BL17

ST36

LI11

LI04

GV14

GB34

GB20

HT07

.812

.808

.808

.755

.741

.733

.722

.696

.688

.682

050001 THORAX, CHEST, RIBS, STERNUM /

.962

44 References / 231 Points / Rating .975

GB34

PC06

TH06

BL18

CV17

BL17

LV13

BL14

LV14

BL15

.746

.730

.615

.515

.492

.401

.401

.375

.361

.347

050002 THORACIC SPINE, BACK AREA /

38 References / 203 Points / Rating .958
GV14

BL40

OT01

GV12

OT05

GV13

X 35

GV09

BL60

OT06

.505

.473

.407

.404

.401

.398

.349

.338

.330

.269

050200 HEART, PERICARDIUM /

39 References / 242 Points / Rating .964
PC06

HT07

BL15

HT05

PC05

ST36

BL14

PC07

PC04

CV17

.843

.766

.633

.556

.492

.457

.452

.449

.439

.439

050228 CIRCULATION, BLOOD PRESSURE /

36 References / 142 Points / Rating .958
LI11

ST36

LV03

GB20

ST09

PC06

SP06

KI01

CV12

HT07

.690

.687

.545

.539

.406

.400

.342

.328

.313

.299

050229 ARTERIES, VEINS, ARTERIOSCLEROSIS, ISCHAEMIA /

14 References /

123 Points / Rating

.914

ST36

GB20

BL10

CV06

SP06

GV20

GB21

LV03

GV14

OT05

.797

.719

.570

.523

.500

.500

.492

.453

.438

.438

050300 OEDEMA, FLUID RETENTION, ASCITES /

25 References / 114 Points / Rating .952
SP09

CV09

KI07

BL23

ST36

BL20

ST25

SP06

CV05

CV08

.647

.597

.559

.517

.475

.445

.441

.437

.349

.315

050400 BLOOD, BODY DEFENCES, HAEMORRHAGE, THYMUS ETC /

29 References / 111 Points / Rating .959

BL17

ST36

BL20

LI04

LI11

CV04

GV14

SP06

CV06

SP10

.752

.680

.464

.410

.410

.392

.374

.335

.306

.284

050500 RESPIRATORY SYSTEM (TRACHEA, BRONCHI, LUNG, COUGH, PNEUMONIA, ASTHMA

ETC / 48 References / 345 Points / Rating .963
BL13

GV14

CV22

LI04

LU05

LU07

CV17

ST40

BL12

PC06

.831

.797

.'36

.725

.710

.686

.667

.641

.602

.587

050541 PLEURA /
15 References / 144 Points / Rating .913
BL42

BL47

BL43

KI23

ST12

KI22

BL13

BL11

GB22

GB44

.628

.628

.620

.620

.555

.555

.533

.482

.482

.482

050543 TRACHEA /
21 References / 49 Points / Rating .938
CV22

ST40

LI04

BL13

LU02

GV14

BL11

LU07

CV17

PC06

.670

.401

.386

.365

.244

.234

.223

.183

.183

.152

050544 BRONCHI, LUNG, PNEUMONIA, ASTHMA /

44 References / 251 Points / Rating .966
BL13

CV22

CV17

GV14

LU05

BL12

PC06

LI04

LU07

ST36

.816

.753

.725

.602

.562

.544

.532

.494

.466

.452

050545 COUGH GENERAL /

41 References / 198 Points / Rating .961
BL13

LU05

LU07

ST40

CV22

LU10

GV12

BL12

CV17

GV14

.627

.622

.599

.586

.548

.343

.343

.338

.338

.327

CV12

CV22

BL20

050600 OESOPHAGUS /
20 References / 96 Points / Rating .935
PC06

BL17

ST36

LI04

CV17

LI10

BL10

.604

.487

.412

.401

.390

.337

.337

.337

.326

.294

050700 DIAPHRAGM /
34 References / 86 Points / Rating .962
BL17

PC06

CV12

ST36

CV15

CV17

LV14

GB24

ST13

CV22

.728

.569

.419

.355

.355

.324

.318

.291

.263

.245

060000 ABDOMEN AND BACK, ITS ORGANS AND FUNCTIONS /

53 References / 489 Points / Rating .966
ST36

SP06

CV12

CV04

BL23

PC06

GB34

CV03

CV06

ST25

.969

.961

.924

.922

.908

.885

.850

.850

.830

.826

060141 ABDOMEN UPPER, EPIGASTRIC, HYPOCHONDRIAC AREA /

28 References / 115 Points / Rating .979
ST36

PC06

CV12

BL21

BL51

GB34

BL23

LV13

LV01

BL18

.639

.569

.526

.420

.288

.182

.168

.168

.164

.164

060142 ABDOMEN MIDDLE, PERIUMBILICAL AREA /

18 References / 65 Points / Rating .989
SP14

ST36

ST25

CV06

CV08

CV07

BL23

BL25

GB34

CV04

.388

.382

.331

.281

.225

.169

.112

.112

.112

.112

060143 ABDOMEN LOWER /

38 References / 132 Points / Rating .961
ST36

L 13

SP06

ST25

CV04

LI11

ST37

CV03

SP13

CV06

.710

.542

.499

.493

.438

.340

.241

.238

.236

.236

060200 DORSO-LUMBAR SPINE AND AREA /

31 References / 150 Points / Rating .968
BL40

BL23

X 35

BL60

OT01

BL37

GB30

GV14

OT05

OT06

.523

.447

.397

.363

.230

.230

.230

.230

.227

.197

060228 COCCYGEAL AREA /

9 References / 34 Points / Rating .911
BL34

BL40

SI06

BL30

OT01

BL37

X 35

OT05

OT06

BL35

.683

.610

.488

.488

.488

.366

.366

.366

.366

.317

060231 LOWBACK (LUMBO-SACRAL, RENAL, SACRO-ILIAC), LUMBAR, SACRAL SPINE /

49 References / 250 Points / Rating .963
BL23

BL40

GB30

BL60

GB34

BL25

BL37

GV04

BL57

BL31

.879

.862

.761

.701

.678

.672

.617

.553

.515

.506

060232 WAIST, FLANK AREA /

13 References / 76 Points / Rating .962
GB34

GB40

BL40

GB30

GB41

ST36

BL23

GB39

LV02

LV13

.944

.480

.448

.448

.320

.312

.280

.232

.232

.232

060300 LIVER (INFLAMMATION, CALCULI, JAUNDICE, ACETONAEMIA ETC) /

35 References / 158 Points / Rating

.951

BL18

LV03

BL19

GV09

BL20

ST36

LV13

GB34

BL48

SP06

.793

.748

.736

.640

.598

.550

.483

.471

.399

.378

060323 GALLBLADDER, BILEDUCTS (INFLAMMATION, CALCULI, OBSTRUCT-ION ETC) /

34 References / 102 Points / Rating

.956

BL19

ST36

GB34

L 23

PC06

GV09

GB24

LV03

BL18

GB40

.717

.689

.671

.548

.474

.471

.412

.400

.363

.348

060400 SPLEEN /
25 References / 65 Points / Rating .948
BL20

ST36

LV13

BL51

SP06

CV12

PC06

X 16

LV03

BL22

.603

.553

.397

.287

.241

.241

.228

.211

.207

.190

060410 PANCREAS, DIABETES MELLITUS, HYPO- & HYPER- GLYCAEMIA /

28 References /

91 Points / Rating

.950

KI02

CV12

BL23

ST36

SP06

CV04

BL20

BL18

BL17

X 12

.429

.417

.414

.398

.391

.391

.387

.383

.316

.301

060500 GASTROINTESTINAL TRACT /

49 References / 343 Points / Rating .963
ST36

ST25

PC06

CV12

CV06

SP06

CV04

BL21

TH06

BL20

.945

.875

.835

.811

.718

.697

.672

.604

.597

.572

060503 INDIGESTION, INAPPETANCE, NAUSEA, VOMITING /

44 References / 287 Points / Rating .959
ST36

PC06

CV12

ST25

SP06

CV06

BL21

BL20

SP04

LI04

.986

.872

.860

.666

.595

.590

.581

.569

.438

.422

060542 PAIN, COLIC, SPASM IN ABDOMEN OR ITS ORGANS, PERITONITIS /

52 References / 344 Points / Rating

.965

ST36

CV12

SP06

PC06

CV04

ST25

CV06

BL23

BL21

CV03

.849

.843

.829

.729

.671

.655

.633

.629

.588

.554

060543 DIARRHOEA, DYSENTERY, CONSTIPATION /

43 References / 215 Points / Rating .963
ST25

ST36

CV04

CV12

SP06

TH06

CV06

BL25

CV08

SP09

.930

.867

.722

.657

.635

.611

.609

.529

.490

.454

060600 STOMACH AND DUODENUM /

46 References / 250 Points / Rating .961
ST36

CV12

PC06

ST25

BL21

CV13

CV06

BL20

SP04

SP06

.941

.912

.747

.692

.690

.491

.473

.455

.428

.412

060700 SMALL INTESTINE, APPENDIX, CAECUM, COLON, RECTUM /

39 References / 213 Points / Rating

.959

ST36

ST25

BL25

CV04

L 13

CV12

BL27

PC06

SP15

ST37

.832

.791

.644

.580

.556

.532

.511

.444

.441

.436

060752 ANUS, TENESMUS, PROLAPSE, PILES /

38 References / 132 Points / Rating .961
GV01

BL57

GV20

BL32

SP06

BL25

BL31

BL33

BL30

BL34

.847

.770

.718

.496

.474

.455

.419

.419

.389

.370

060753 INGUINAL AREA, GROIN /

21 References / 91 Points / Rating .943
LV01

SP11

SP12

SP13

ST30

KI11

LV03

LV04

LV06

SP06

.480

.384

.348

.298

.293

.288

.278

.253

.253

.232

060754 PERINAEUM /
19 References / 68 Points / Rating .932
BL32

GV01

BL31

BL30

BL33

BL34

LV01

LV10

SP06

ST36

.316

.299

.271

.260

.226

.226

.226

.226

.215

.209

060755 MALE & FEMALE EXTERNAL GENITALIA AND PUBIC AREA /

23 References / 86 Points / Rating

.948

CV04

CV03

SP06

LV08

CV07

LV04

LV12

CV01

LV02

LV01

.683

.606

.431

.353

.344

.312

.303

.275

.257

.252

060800 UROGENITAL (GENERAL CONDITIONS) /

50 References / 290 Points / Rating .964
SP06

CV04

BL23

CV03

CV06

BL28

KI03

BL32

ST36

SP09

.979

.880

.863

.757

.676

.660

.637

.620

.566

.564

060900 URINARY TRACT AND FUNCTIONS /

47 References / 235 Points / Rating .964

SP06

BL23

BL28

CV03

CV04

CV06

KI03

SP09

CV02

BL32

.925

.808

.702

.702

.700

.611

.570

.536

.459

.426

061000 GENITALIA FEMALE AND REPRODUCTION /

41 References / 232 Points / Rating .959
SP06

CV04

GV04

CV06

SP10

CV03

GB26

BL32

LV03

ST36

.863

.781

.585

.580

.565

.555

.517

.509

.506

.491

061100 PREGNANCY: CONDITIONS OF /

25 References / 81 Points / Rating .952
BL67

ST36

PC06

LV03

SP04

SP06

BL18

CV17

CV12

KI21

.542

.475

.445

.273

.235

.223

.197

.197

.193

.189

061101 PREGNANCY: FORBIDDEN/ABORTION Points /

23 References / 71 Points / Rating .957
SP06

LI04

BL67

BL60

LV03

BL32

ST36

CV04

CV03

BL31

.745

.623

.623

.436

.427

.305

.259

.259

.241

.218

061125 PARTURITION /
26 References / 47 Points / Rating .958
SP06

LI04

BL67

BL60

BL32

LV03

BL31

ST36

SP09

BL62

.735

.655

.558

.382

.353

.349

.313

.241

.197

.157

061126 POST-PARTUM CONDITIONS /

27 References / 120 Points / Rating .963
SP06

GV20

CV04

Y 16

CV02

LV01

CV03

CV07

Y 18

CV06

.635

.485

.481

.462

.442

.415

.392

.331

.308

.304

LI04

LV03

GB21

061200 MAMMARY FEMALE /

27 References / 101 Points / Rating .978
CV17

SI01

ST18

GB41

ST36

ST16

SP18

.777

.625

.621

.371

.333

.284

.284

.261

.223

.212

061300 MENSTRUAL CYCLE, CONTRACEPTION /

45 References / 210 Points / Rating .962
SP06

CV04

CV03

CV06

SP10

ST36

BL23

LV03

BL32

BL33

.917

.824

.776

.674

.651

.515

.510

.467

.464

.464

061316 MENOPAUSE: GENERAL Points FOR FLUSHES & MENOPAUSAL PROBLEMS /

7 References / 11 Points / Rating

.914

ST36

SP06

CV04

LI04

PC06

GB21

CV03

SP10

LV14

CV05

.609

.609

.609

.313

.156

.156

.156

.141

.141

.141

061400 REPRODUCTION MALE (IMPOTENCE, SPERMATORRHOEA ETC ) /

42 References / 180 Points / Rating

.964

SP06

CV04

BL23

CV03

CV06

BL32

GV04

BL33

BL31

ST36

.953

.877

.859

.728

.662

.590

.565

.558

.543

.531

061500 GENITALIA MALE /

25 References / 137 Points / Rating .956
SP06

CV03

CV04

ST29

BL32

BL33

BL34

LV01

BL31

LV04

.854

.753

.707

.611

.565

.485

.481

.473

.444

.431

070000 PELVIC LIMB , ITS ORGANS AND FUNCTIONS /

52 References / 330 Points / Rating

.965

GB34

ST36

GB30

SP06

BL60

BL40

BL57

GB39

GB31

KI03

.940

.884

.841

.809

.793

.773

.751

.735

.691

.687

070200 BUTTOCK /
18 References / 80 Points / Rating .956
GB30

BL36

OT01

ST36

BL23

BL54

BL37

OT05

BL40

BL60

.564

.407

.401

.285

.285

.285

.285

.233

.174

.174

070239 HIP /
37 References / 100 Points / Rating .968
GB30

GB34

GB29

GB31

BL40

BL60

OT01

GB39

ST36

LV08

.888

.595

.408

.380

.352

.304

.279

.274

.193

.176

070240 THIGH, FEMUR /

27 References / 124 Points / Rating .963
GB30

GB31

GB34

LV08

ST36

BL23

LV11

BL40

BL37

SP06

.773

.585

.519

.512

.458

.400

.362

.335

.304

.300

070300 KNEE, POPLITEAL /

44 References / 146 Points / Rating .968
GB34

BL40

L 16

ST35

SP09

ST36

ST34

LV08

OT01

GB31

.864

.608

.596

.568

.479

.390

.383

.380

.272

.251

070315 PATELLA /
4 References / 21 Points / Rating .975
SP09

SP10

GB33

OT01

OT05

BL40

LV08

BL11

ST30

SP05

.769

.769

.769

.769

.744

.513

.513

.487

.256

.256

070400 LEG, CALF /

47 References / 208 Points / Rating .962
BL57

GB34

ST36

SP06

BL40

GB30

BL60

GB39

ST32

LV03

.701

.657

.555

.553

.509

.480

.363

.314

.292

.237

070417 TIBIA, FIBULA /

17 References / 63 Points / Rating .965
ST36

GB35

GB34

GB37

BL40

LV03

GB36

GB30

BL62

LV02

.543

.402

.366

.360

.348

.305

.287

.244

.226

.226

070429 ACHILLES AREA, HEEL /

17 References / 58 Points / Rating .971

BL60

KI03

BL57

BL61

KI04

SP06

OT01

ST36

ST41

BL40

.606

.594

.545

.352

.352

.303

.303

.182

.182

.182

070500 ANKLE, TARSUS /

40 References / 112 Points / Rating .973
BL60

ST41

KI03

GB39

GB40

SP06

BL57

OT01

ST36

SP05

.769

.725

.555

.506

.427

.360

.355

.280

.254

.252

070503 TARSAL-METATARSAL /
15 References / 38 Points / Rating .967
GB41

OT01

ST41

OT05

BL59

KI06

GB40

BL60

SP05

KI03

.483

.483

.414

.414

.338

.269

.269

.262

.207

.200

070600 METATARSAL, FOOT /

36 References / 138 Points / Rating .956
BL60

KI03

LV03

SP06

BL57

ST41

GB39

OT01

ST42

GB41

.608

.570

.462

.448

.395

.363

.337

.317

.308

.308

070608 TOE /
34 References / 118 Points / Rating .965
L 08

SP04

SP06

LV03

OT05

ST36

GB34

OT01

BL60

SP05

.454

.378

.360

.351

.299

.268

.241

.241

.207

."01

080000 SKIN /
38 References / 223 Points / Rating .963
LI11

LI04

SP10

SP06

ST36

BL40

GV14

OT05

BL13

GB20

.836

.710

.689

.522

.503

.495

.380

.374

.325

.273

080124 HAIR,SKIN : ALOPECIA;BALDNESS;HAIRLOSS;OPPILATION /

9 References /

66 Points / Rating

.956

BL16

BL40

GB20

OT05

LI04

BL10

CV12

ST36

BL43

CV04

.547

.419

.349

.349

.233

.233

.233

.221

.221

.221

090100 FEVERS /
37 References / 195 Points / Rating .959
GV14

LI11

LI04

PC05

BL40

GV13

A 01

PC09

LI01

LU10

.932

.907

.786

.468

.437

.431

.420

.408

.403

.389

090101 CHILLS /
17 References / 100 Points / Rating .929
GV14

ST36

LI04

GV16

BL40

HT06

GB25

LI11

TH04

BL12

.791

.551

.544

.481

.418

.354

.241

.234

.222

.215

090200 SWEATING PROBLEMS /

26 References / 94 Points / Rating .954
KI07

LI04

HT06

SI03

SP02

LV02

LU08

LU10

LU11

GV14

.815

.536

.460

.383

.278

.270

.185

.185

.181

.149

090300 INFECTIONS: MALARIA,TB,CHOLERA,TYPHOID,TYPHUS,HERPES,RU-BELLA,

VARI-CELLA ETC / 34 References / 195 Points / Rating

.965

GV14

ST36

PC05

LI04

SI03

LI11

GV13

PC06

SP06

CV12

.726

.680

.616

.576

.543

.530

.497

.460

.375

.345

090400 IMMUNITY /
12 References / 19 Points / Rating .933
ST36

LI04

GV14

SP06

LI11

CV04

BL18

BL19

BL23

CV06

.598

.580

.580

.321

.313

.250

.179

.179

.179

.179

LI04

SP06

LI11

090410 TONIC EFFECTS /

28 References / 156 Points / Rating .957
ST36

CV06

CV04

BL43

BL20

PC06

BL23

.821

.451

.448

.444

.246

.243

.228

.216

.209

.198

090419 GANGRENE, ISCHAEMIA OF EXTREMITIES /

11 References / 33 Points / Rating .973
OT02

OT05

A 22

L 08

LI11

HT03

GB34

SP09

SP06

BL43

.467

.458

.374

.374

.364

.364

.364

.280

.178

.178

090420 LYMPHADENOPATHY /
12 References / 32 Points / Rating .917
ST36

HT03

BL60

SP06

GB39

OT02

ST31

PC01

LI01

LI13

.264

.236

.236

.182

.182

.182

.173

.173

.155

.155

090500 BONES, JOINTS (GENERAL) /

34 References / 214 Points / Rating .959
OT05

OT06

ST36

LI04

OT01

GB34

LI11

TH05

BL11

BL23

.669

.491

.479

.463

.457

.423

.417

.325

.322

.298

090600 MUSCLE, TENDON, SOFT TISSUES (GENERAL)

28 References / 133 Points / Rating .946
OT05

OT01

GB34

ST36

OT06

LI04

LV03

LI11

SP06

OT03

.600

.540

.491

.438

.389

.385

.321

.317

.287

.275

090700 ANALGESIA, PAIN CONTROL (GENERAL) /

23 References / 78 Points / Rating .957
LI04

ST36

LI11

TH05

OT05

SP06

LV03

GB34

A 22

GB38

.482

.436

.355

.341

.341

.314

.273

.264

.227

.209

ACU-POINT INJECTION IN GASTRIC ULCER AND DIARRHOEA IN

FOALS
Conventional treatment of diarrhoea and gastric ulceration in foals was summarised in the
August 1991 issue of the Irish Veterinary News (p 24). Readers may be interested in another
modality to treat these conditions. Acupuncture-point injection may be combined with
conventional therapy, or may be used alone if conventional methods fail to relieve the
condition in a few days.
Acu-points used in digestive upsets include all paravertebral pressure-sensitive points. In
foals, these points, usually 5-10 cm from the dorsal midline, are found by pressure-palpation,
using a round-ended 10 ml plastic test-tube as a pressure-probe. To locate these points, the
probe is slid systematically over the area. The probe is moved slowly in 2 or 3 long lines (say
5 and 10 cm, or 4, 8 and 12 cm) parallel to the dorsal midline. Firm constant probe pressure is
maintained on the skin and underlying muscles. Then the probe is moved in a zig-zag crosshatch over the path of the long lines. In this way, the entire paravertebral area from thoracic
13 to sacral 4 is searched. Point hypersensitivity is indicated by the foal yielding to pressure at
the point(s), but not yielding to the same pressure at points nearby. One or more of the organ
reflex points (BL20,21,25,27, see below) is usually sensitive in gastro-intestinal disorders.
In all cases, VG 3; ST36; HC 6 are added in addition to the paravertebral hypersensitive
points. The locations of these classic points are:
VG 3 (Master point) : single point, in the lumbo-sacral space
ST36 (Master point) : bilateral point, lateral to tibial crest, about 7 cm below the patella
HC 6 (Master point) : bilateral point, on the medial face of the forearm, behind the radius, 7
cm above the carpus
Finally (depending on the organs involved), 1-2 of the following organ-reflex points are
added: BL20 (Spleen reflex), BL21 (Stomach reflex), BL25 (Large intestine reflex) and BL27
(Small intestine reflex). Their locations are:
BL20 : bilateral point, in the last intercostal space, 7 cm from the midline
BL21: bilateral point, just behind the last rib, 7 cm from the midline
BL25: bilateral point, just behind the transverse process of lumbar 5, 7 cm from the midline
BL27: bilateral point, just behind the transverse process of lumbar 5, 7 cm from the midline
Acu-points can be stimulated in different ways. The most convenient is to inject each selected
point with 1-2 ml of 0.5% lignocaine of xylocaine in sterile saline, using a 25 mm 21-23
gauge needle. One may treat 7-8 points bilaterally (14 to 16 points in all) in one session.
Treatment is given 1-5 times (mean of 3), at intervals of 3-7 days. Good restraint is needed
when injecting HC 6 and ST36.

The response in foals with gastric ulcer can be dramatic within 3 days but the response in
diarrhoea can be disappointing, especially in older foals and adult horses.