VOL.35 / NO. 4 November 2012
THEA PUBLICATION OF THEPOINT INTERNATIONAL VETERINARY ACUPUNCTURE SOCIETY
Dr. Marvin Cain visited the IVAS US Basic Course in Veterinary Acupuncture on November 14, 2012. What a great honor for our students to meet one of the first teachers of acupuncture in the US and receive a few pearls of wisdom. THE POINT A PUBLICATION OF THE INTERNATIONAL VETERINARY ACUPUNCTURE SOCIETY VOL.35 / NO. 4 November 2012 Table of Contents From the Desk of the Executive Director...... 3
News from our Affiliates...... 4
2013 AAVA/IVAS JOINT CONGRESS...... 5
Congress Schedule...... 8
Congress Registration Form...... 11
Acupuncture Used to Treat Coxofemoral Osteoarthritis in a Shepherd Mix Dog...... 13
Acupuncture Was Used To Treat Intervertebral Disc Disease in a Dachshund...... 18
Vestibular Syndrome in a Golden Retriever Dog Treated with Conventional Medicine and Acupuncture...... 24
Laser Acupuncture in Infectious Diseases and Wound Infections Including MRSA Infections...... 29
Hind End Weakness and Decreasing Energy in a 10 year old Dog Successfully Treated with Ba Wei Di Huang Wan Including MRSA Infections...... 35
Abstracts on Recent Research from Phil Rogers...... 39
Horse Special Acupoints: Where Acupuncture Doesn’t Work...... 47
Herbs for Ruminants...... 51
Yin and what it Means in a Quantum Holographic World...... 58
Market Place...... 67
2 THE POINT A PUBLICATION OF THE INTERNATIONAL VETERINARY ACUPUNCTURE SOCIETY VOL.35 / NO. 4 November 2012 From the Desk of the Executive Director Happy New Year! year IVAS is working with the American Academy of Veterinary Acupuncture to put on this jointly I hope all of our IVAS members had a peaceful and sponsored conference. There is further information relaxing holiday season and are now ready to get busy contained in this publication and you may register again. We are working on updating your member online at www.ivas.org or by telephone, fax or benefits over the coming year. snail mail.
1. We have energized our International Continuing If you have suggestions for how IVAS may be more Education Committee to include representation beneficial to you, please feel free to contact me. from all IVAS’ affiliates. During 2013 we will be working to offer easier ways for you to obtain I hope 2013 will be a successful and prosperous year your acupuncture continuing education hours. In for all of you. 2012, IVAS purchased a Learning Management System called Moodle. This will allow us to offer CE programs via web-based learning that our members worldwide will be able to take advantage of.
2. There is a good possibility that we will be offering an acupuncture study trip to South Korea during the summer of 2013. Dr. Choi at the University of Minnesota is coordinating the effort now. We hope to have the timing in place with the schedule in the very near future. Much like the study trip to China in 2011, this trip will be limited to the number of attendees. More information soon!
3. Over the next month we will be working to further update the website with a fresh new look, and developing it to be even easier to use.
4. Don’t forget the 2013 Congress is being held in New Orleans from May 16 to 19. We have put together a wonderful program of speakers and wet labs. I am speaking with LSU and the Louisiana VMA for co-sponsorship. With co-sponsorship from the LVMA, this will satisfy CE hours you need for your state and provincial licensing. This
BOARD OF DIRECTORS *President, House of Delegates: Kristine Elbaek, DVM, CSA, CIA (Denmark) IVAS *President: Uwe Petermann, DVM (Germany) [email protected] 1730 S. College Ave., Barbara Fougere, BSc, BVMS (Australia) [email protected] Suite 301 [email protected] Kevin May, DVM (USA) *Executive Director: Fort Collins, CO 80525 USA [email protected] *President-Elect: Vikki Weber, MBA (USA) Phone: +970-266-0666 Linda S. Hamilton, B.Sc., DVM (Canada) [email protected] Maurice F. Casey, III, DVM (USA) [email protected] Fax: +970-266-0777 Chair, Int’l Education Comm: [email protected] *Treasurer: Michelle Schraeder, DVM, MEd (USA) Email: [email protected] Robert Norman Schwyzer, DVM (USA) Richard Schafer, DVM (USA) [email protected] Website: www.ivas.org [email protected] [email protected] Linda C Boggie, DVM (Netherlands) Published by the International *Past President: [email protected] Kim Samuelsen, DVM (Denmark) Veterinary Acupuncture Society. Frances E. (Lea) Baker, DVM (USA) [email protected] [email protected] Ferdinand Niessen, Tierarzt (Germany) Reproduction in whole or in part without [email protected] *member of Executive Committee permission of IVAS is prohibited. ©2012 All rights reserved.
3 THE POINT A PUBLICATION OF THE INTERNATIONAL VETERINARY ACUPUNCTURE SOCIETY VOL.35 / NO. 4 November 2012 News from our Affiliates AAVA - Winter 2012 up past CE hours. Simply begin now to make your The AAVA has spent a great deal of energy on our certification current. membership campaign in the fall of 2012. Our goal 3. If you earn extra CE hours in a given year: You was to gain enough members to apply to the American cannot roll over extra hours into the next two year Veterinary Medical Association as a member of the time period. House of Delegates. Thanks to the efforts of a very 4. If you have NO CE for the coming fiscal year but active membership committee as well as new members have paid or wish to pay for membership for the from the AATCVM, we reached our goal. Our coming year: You are given a 90 day grace period application has been submitted and we should know to acquire the necessary CE hours to keep your the result in 5-6 months. certification current. Beyond that time frame your active member status will become associate We have completed elections and can announce our member until you provide IVAS with proof of new President; Dr. Ken Ninomiya, and Vice President; attendance at an IVAS approved event. Leslie Phillips. An open board spot will be filled by Dr. Ron Carsten. Obtain CE Approval or Rejection for a CE Event To verify if a course, workshop, or seminar has We continue to work on our Strategic Plan via our already been approved or rejected, please check under very energized committees. the IVAS Event Calendar on the website. If you have any questions regarding the CE listings please contact us at +970-266-0666 or at [email protected]. Sincerely, Susan G. Wynn, DVM, CVA, CVCH, AHG If a course, workshop, or seminar you are searching AAVA President has NOT been previously submitted to IVAS for approval, please contact IVAS with the following Upcoming CE Events information for submittal to our CE Committee: 2 Day Intensive Seminar by Dr. Linda Boggie Bi and Wei Syndrome – Focusing on Musculoskeletal • Obtain the daily schedule breakdown containing and Neurologic Patterns the following: hours of lectures, lecture titles, and February 16 & 17, 2013 lecturers. Toronto, ON • Fax, email, or mail the schedule to IVAS as much in advance of the course, workshop, or seminar as COMS 2013 Veterinary Workshop possible for IVAS CE approval or rejection. The Use of Ishizaka, Mishizaka and Huatuojiaji Points in the Treatment of Back Pain, Myofascial Pain IVAS will forward the information to the Continuing and Specific Protocols for Neurological and Other Education Committee Chair, Kristin Edwards VMD. Conditions in the Horse and Dog, with Dr. Kevin May, We anticipate having a response within two weeks DVM from the time we receive the information. Feel free March 14-15, 2013 to contact us if you haven't heard from us after two Vancouver, BC weeks.
Remember to check the Calendar for CE Events.
CE Guidelines to fulfill the Standing CE Recommendation for Certified Active Members: 1. All CE requirements are based on the IVAS member annual dues billing cycle (fiscal year) beginning July 1st. 2. If you are behind on your CE: One does not catch
4 THE POINT A PUBLICATION OF THE INTERNATIONAL VETERINARY ACUPUNCTURE SOCIETY VOL.35 / NO. 4 November 2012 Discover Veterinary Acupuncture at the Hotel Monteleone New Orleans Congress Information and Registration
2013 AAVA/IVAS JOINT CONGRESS May 16 - 19, 2013
Hotel Monteleone New Orleans, Louisiana, USA
5 THE POINT A PUBLICATION OF THE INTERNATIONAL VETERINARY ACUPUNCTURE SOCIETY VOL.35 / NO. 4 November 2012
Welcome We would like to invite you to attend the 2013 and science of Veterinary Acupuncture and Traditional AAVA/IVAS Joint Congress. This international Chinese Medicine, to further the professional conference on veterinary acupuncture and related development of members, to encourage the education treatment modalities is a first time event being of veterinarians in Veterinary Acupuncture and co‑sponsored by both the American Academy Traditional Chinese Medicine, and to provide of Veterinary Acupuncture and the International leadership and resources in the United States for the Veterinary Acupuncture Society. Both AAVA and advancement of these disciplines. IVAS are 501(c)(3) non‑profit organizations dedicated to promoting excellence in the practice of veterinary The AAVA/IVAS Joint Program Committee has acupuncture, as an integral part of the total veterinary put together a range of important topics with an health care delivery system. For almost 40 years impressive list of speakers. The focus topics for this IVAS has established uniformly high standards event are: for the practice of veterinary acupuncture through our educational programs leading to certification Veterinary Rehabilitation in veterinary acupuncture that is recognized Feline Medicine worldwide. IVAS is the foremost international Introductory Chinese Herbs for Acupuncturists association of veterinary acupuncture professionals Tongue and Pulse Lab dedicated to promoting the growth and value of Of course we will also have: education, responsible research, and the integration BBExhibitors of acupuncture into veterinary medicine to create and BBWelcome Reception maintain optimal health in all animals. AAVA was BBLunches founded in 1998 for the purpose of promoting the art BBGala Banquet – Perhaps a Masquerade Ball! Hotel Monteleone The home base for the conference is the landmark Make your reservations now by calling Hotel Monteleone in the French Quarter. She is the +(504) 523‑3341 or +1-800-217-2033. You may also “Grande Dame” of New Orleans hotels, delivering as reserve by fax at +(504) 528-1019. Reservations much character as the city she calls home. must be guaranteed with a major credit card. Room AAVA/IVAS have negotiated special lodging rates for reservations must be made no later than January attendees of this conference: 15, 2013. You may cancel the reservation 72 hours prior to date of arrival. Single or Double Room $169 per night Triple Room $194 per night Quadruple Room $219 per night
These rates are valid from May 12, 2013 through May 22, 2013. Plan to make it a vacation!
6 THE POINT A PUBLICATION OF THE INTERNATIONAL VETERINARY ACUPUNCTURE SOCIETY VOL.35 / NO. 4 November 2012
2013 Keynote Speaker Bonnie D. Wright, DVM, DACVA Keynote Topics Include: Current status of research and evidence as applied to acupuncture; Acupuncture for gastrointestinal and renal disease; Acupuncture and immune modulation, and Controversies in medicine: surgical versus non-surgical approaches.
Dr. Wright serves as the Chairperson of the Board of from 2000-2001 and served as a visiting professor Directors of the International Veterinary Academy until 2006. From 2001 to 2008, Dr. Wright has worked of Pain Management. She received her Doctorate of as an assistant professor in anesthesiology at CSU. Her Veterinary Medicine from CSU-CVMBS in 1995; job expanded in 2007 to include development of the she completed her post-doctorate work in anesthesia Integrative Pain Medicine Service with Dr. Robinson; at CSU in 1996, and her anesthesia and critical care together, they are actively expanding the breadth and residency at UC Davis in 2000. She has been a faculty depth of the pain medicine offerings at CSU. member at Ross University on St. Kitts, West Indies Speakers and Topics Beebe, Signe DVM – Chinese herbs for McConnico, Rebecca DVM – Designing acupuncture acupuncturists/Food Therapy trials Bessent, Chris DVM – Herbal product testing/forms Petermann, Uwe DVM – Canine/Equine ear and laser acupuncture Fougere, Barbara BSc, BVMS – Xiao Chai Hu Tang Ridgway, Kerry DVM – Equine rehabilitation/ Gaspar, Michele DVM – Feline TCM Therapy Physical Therapy Glinski, Maria DVM – Canine rehabilitation/ Schraeder, Michelle DVM – Proof of Acupuncture Physical Therapy Validity: Are Double Blind Studies the Only Choice of Iff, Isabelle Dr.Med.Vet – Pathophys and AP, Validity? Chronic Pain Schultz, Rikke DVM – Recent acupuncture studies, Lankenau, Cynthia DVM – Chinese herbal medicine Myofascial kinetic lines in the horse - An anatomical for equine sports injuries dissection study Luna, Stelio - A critical approach on acupuncture for Wallace, Wendy DVM - Acupuncture to Resolve treating chronic pain Peripheral Edema in ICU Patients
Speakers and Topics Subject to Change
7 THE POINT A PUBLICATION OF THE INTERNATIONAL VETERINARY ACUPUNCTURE SOCIETY VOL.35 / NO. 4 November 2012
2013 AAVA/IVAS Joint Congress Conference Schedule - Subject to Change Thursday, May 16 Time Keynote/Plenary Session Speaker Title 10:00-11:00 B. Wright Current status of research and evidence as applied to acupuncture 11:00-12:00 B. Wright Acupuncture for gastrointestinal and renal disease 12:00-1:00 Lunch 1:00-2:00 B. Wright Acupuncture and immune modulation 2:00-3:00 B. Wright Controversies in medicine: surgical versus non-surgical approaches
Friday, May 17 Large Animal and General Time Small Animal Track Introductory Track Interest Speaker Title Speaker Title Speaker Title Canine Rehab/ Equine Rehab/ Chinese Herbs for 8:00‑9:20 M. Glinski K. Ridgway S. Beebe PT PT Acupuncturist Canine Rehab/ Equine Rehab/ Chinese Herbs for 9:30‑10:20 M. Glinski K. Ridgway S. Beebe PT PT Acupuncturist 10:20-10:50 Coffee Break Canine Rehab/ Equine Rehab/ Chinese Herbs for 10:50-11:40 M. Glinski K. Ridgway S. Beebe PT PT Acupuncturist Canine Rehab/ Equine Rehab/ Chinese Herbs for 11:50-12:40 M. Glinski K. Ridgway S. Beebe PT PT Acupuncturist 12:40-1:40 Lunch Equine 1:40-2:30 U. Petermann Canine Ear AP I. Goesmeier Interstitial Lung C. Bessent Herbal Product Testing Disease Chinese Herbal Canine Laser 2:40-3:30 U. Petermann C. Lankenau Med for Equine B. Fougere Xiao Chai Hu Tang AP Sports Injuries Complementary and A critical Alternative Veterinary approach on Medicine (CAVM) 3:40-4:30 S. Luna acupuncture C. Bessent Herbal Forms 3:40 – 5:00 Curriculum Committee for treating Panel Discussion with chronic pain Mushtaq Memon
8 THE POINT A PUBLICATION OF THE INTERNATIONAL VETERINARY ACUPUNCTURE SOCIETY VOL.35 / NO. 4 November 2012
Saturday, May 18 Time Small Animal Track Large Animal and General Interest Speaker Title Speaker Title 8:30-9:20 M. Gaspar Feline TCM Therapy U. Petermann Equine Ear AP 9:30-10:20 M. Gaspar Feline TCM Therapy U. Petermann Equine Laser AP 10:20-10:50 Coffee Break 10:50-11:40 M. Gaspar Feline TCM Therapy I. Iff Pathophys and AP, Chronic Pain 11:50-12:40 M. Gaspar Feline TCM Therapy R. McConnico Designing AP Trials 12:40-1:40 Lunch Acupuncture to Resolve 1:40-2:30 S. Beebe Food Therapy W. Wallace Peripheral Edema in ICU Patients 2:40-3:20 S. Beebe Food Therapy M. Schraeder Double Blind Study Validity 7:00 - Midnight Banquet and Dance
Sunday, May 19 Time Wet Lab 1 Wet Lab 2 General Interest Lecture Speaker Title Speaker Title Speaker Title 8:30-9:20 S. Marsden Tongue & J. Huntingford Rehab R. Schultz News Hour: Recent Pulse Techniques AP Studies 9:30-10:20 S. Marsden Tongue & J. Huntingford Rehab R. Schultz News Hour: Recent Pulse (cont'd) Techniques AP Studies (cont'd) (cont'd) 10:30-10:50 Coffee Break 10:50-11:40 S. Marsden Tongue & J. Huntingford Rehab R. Schultz Myofascial kinetic Pulse (cont'd) Techniques lines in the horse (cont'd) - An anatomical dissection study 11:50-12:40 S. Marsden Tongue & J. Huntingford Rehab R. Schultz Myofascial kinetic Pulse (cont'd) Techniques lines in the horse (cont'd) - An anatomical dissection study (cont'd) 12:40-1:40 Lunch
9 THE POINT A PUBLICATION OF THE INTERNATIONAL VETERINARY ACUPUNCTURE SOCIETY VOL.35 / NO. 4 November 2012
REGISTRATION
A basic full Congress registration includes daily lunch buffet, one complimentary banquet ticket, and one copy of the Congress Proceedings.
A one or two day registration will include daily lunch for the days of attendance and one copy of the Congress Proceedings. Banquet ticket IS NOT included in the one or two day registration.
Wet Lab registration is separate. Wet Labs are $100.00 each and space is limited. To register, please detach and complete the Registration Form and mail to IVAS along with your check (US ONLY) or credit card information. You may also register by faxing the registration form with credit card information to IVAS at +970-266-0777.
ONLINE REGISTRATION AVAILABLE: http://events.constantcontact.com/register/event?llr=zokh7cjab&oeidk=a07e6fm3u5f8a0cf103
Remember to monitor AAVA and IVAS websites for updates.
10 Conference Registration Form AAVA/IVAS Joint Conference on Veterinary Acupuncture May 16 - May 19, 2013 - New Orleans, Louisiana USA STEP 1 - FILL OUT YOUR CONTACT INFORMATION:
Registrant Name:
Business Name:
Address:
City: State Zip/Postal Code
Country: Email:
Work #: Fax #: Home #:
STEP 2 - SELECT YOUR REGISTRATION (For the whole event or daily rate): Event Registration Fee: (Includes daily lunch, one Banquet Ticket and one copy of the Congress Proceedings) AAVA/IVAS Members (Current Dues) Early Registration before 1 April 2013...... US$595.00 AAVA/IVAS Members (Current Dues) Regular Registration - 2 April 2013 to Onsite...... US$795.00 Non-Members - Early Registration before 1 April 2013...... US$795.00 Non-Members - Regular Registration - 2 April 2013 to Onsite ...... US$895.00 Veterinary Students (Does not include Interns/Residents)...... US$200.00 Accompanying Spouse/Life Partner (meeting attendance only - Non-Veterinarian)...... US$200.00 Additional Banquet Tickets: Adult, How Many ______x US$75.00 ea. = ...... US$______Children 6-12, How Many (Under 5 Free)______x US$30.00 ea. = ...... US$______Daily Registration Fee: (Does not include Banquet Ticket) 1 Day - AAVA/IVAS Members (Current Dues)...... US$300.00 2 Days - AAVA/IVAS Members (Current Dues)...... US$500.00 1 Day - Non-Members...... US$400.00 2 Days - Non-Members...... US$700.00 3 or More Days - Full Price (see above) Choose your days Thursday Friday Saturday Sunday SUBTOTAL US$______
STEP 3 - SELECT YOUR WETLAB: (Select one only as labs are run simultaneously) (Wetlabs cannot be registered for at Congress - Attendance is Limited: 40 per wetlab) Tongue and Pulse with Steve Marsden (Sun. May 19th) ...... US$100.00 Rehabilitation Medicine with Janice Huntingford (Sun. May 19th)...... US$100.00
SUBTOTAL US $ ______
TOTAL STEPS 2 & 3 US $ ______
(CONTINUED ON NEXT PAGE) 11 TOTAL STEPS 2 & 3 from previous page: US $ ______
STEP 4 - INDICATE PAYMENT FOR EVENT REGISTRATION: VISA MASTERCARD AMEX
CC#: ______EXP. DATE:______SIC#______
Cardholder Name:______Billing Zip:______
Signature:______Today’s Date:______
If paying by check, ALL checks must be drawn on US Banks - US Dollars Only PAYABLE TO: International Veterinary Acupuncture Society or IVAS Refund Policy: Cancellation prior to April 1, 2013 will incur a US$100.00 administrative charge. Cancellations after April 2, 2013 will incur a US$250.00 administrative charge. No refunds after May 1, 2013.
Send Registration to: IVAS, 1730 S. College Ave., Suite 301, Fort Collins, CO 80525 USA or Fax to: (970) 266-0777 You will receive a written confirmation of registration by mail
12 THE POINT A PUBLICATION OF THE INTERNATIONAL VETERINARY ACUPUNCTURE SOCIETY VOL.35 / NO. 4 November 2012 Acupuncture Used to Treat Coxofemoral Osteoarthritis in a Shepherd Mix Dog Susan Bohrer, DVM Abstract Acupuncture therapy was used to successfully treat non-ambulatory lameness from coxofemoral osteoarthritis in a Shepherd mix. Treatment consisted of a 6 week course of weekly, dry needle acupuncture therapy. The lameness gradually improved after 3 weeks and the patient was walking again after 4 treatments. It was recommended to continue dry needle treatments every 3 to 4 weeks as needed to increase mobility and strength and decrease pain. The patient became ambulatory during the course of the 6 week treatment. History seemed to be decreased in the last few weeks. There A 8 year old male neutered Shepherd mix was no history of vomiting, diarrhea, cough, sneeze, presented for acupuncture therapy after a recent or flatulence. He was a warm seeker overall, but the worsening in his ability to ambulate on his right owner did not think he had a preference for soft or hind limb. He was adopted 7 years ago and he had warm places. He was not excessively thirsty nor did a previous left hindlimb midfemoral amputation he urinate excessively. His urine seemed to be yellow prior to his adoption. He has had a history of per the owner. worsening right coxofemoral osteoarthritis and has been intermittently non-ambulatory in his hindleg. The patient’s eyes were bright and hair coat His current medications were Metacam (1.5mg/ml) normal, BCS was 5/9 and patient was hiding under 1.8ml by mouth twice daily, Tramadol 50mg one chair at beginning of the exam. The patient was often tablet by mouth twice daily and Gabapentin 100mg fearful or unfriendly toward strangers but did seem to one tablet by mouth twice daily. These medications the owner to be the dominant dog in the household. were prescribed by his regular veterinarian and were His tongue color was pink to slightly pale and seemed continued during the course of therapy. wet. His pulse was bilaterally symmetrical, weak and slow. He did not seem warm at his chest and Physical Exam and Western Diagnosis was slightly cooler over his dorsum. No specific He presented only able to walk for a few steps acupuncture points seemed tender or swollen. in a crouched position in his right hind leg. Physical Because of his history of fighting at home and fearful exam showed no abnormalities in the stifle, tarsal, attitude toward the veterinarian, he was suspected to metatarsal and tarsal joints. No cranial drawer was be a Water Type Constitution (1). Spleen Qi Deficiency found in the stifle and there was decreased range of was suspected because of his poor appetite and motion and pain at the right coxofemoral joint. The Liver Qi Stagnation was consideration because of patient had a BCS of 5/9, slightly decreased muscle the signs of emotional disturbance (2). Liver Blood mass in the right hind leg and was other wise normal. Deficiency was also a concern due to his dandruff His eyes and nails were normal but he had marked and pale tongue color (3). Water Constitution dogs non-pruritic dandruff over his dorsum. Radiographs are prone to osteoarthritis from Kidney Deficiencies. of the hips and hindleg confirmed severe osteoarthritis Spleen Qi Deficiency arises from inadequate Source in the coxofemoral joint and all other joints appeared Qi, produced by the kidneys and Liver Blood normal. A CBC, chemistry and urinalysis showed no Deficiency can result from the Kidneys failing to abnormalities. produce adequate Essence, an ingredient in Blood (4). A diagnosis of Bony Bi syndrome was made based A diagnosis of worsening right coxofemoral on radiographic lesions, chronicity of the case and osteoarthritis was made based on history, physical decreased range of motion in the right coxofemoral exam and radiographic signs. joint (5).
TCM/Eastern Exam Diagnosis An underlying Kidney Yang and Qi Deficiency The patient had a history of slightly decreased and resulting Liver Blood and Spleen Qi Deficiency appetite in last few weeks, normal to wet stool with was also diagnosed based on the pale wet tongue, no significant smell. He would walk slowly for a few dandruff, heat seeking behavior, cool dorsum and minutes then sit down frequently. His energy level weak slow pulse (6).
13 THE POINT A PUBLICATION OF THE INTERNATIONAL VETERINARY ACUPUNCTURE SOCIETY VOL.35 / NO. 4 November 2012 Bi syndrome is a blockage of Qi and Blood osteoarthritis and spondylosis (5). The treatment plan cased by a cold damp invasion, Qi and Blood was to treat local points, tonify Kidney, Spleen and disruptions, Channel disorders, organ pathologies or Liver Qi and move Live Blood. disruption of the five elements(5) . A Kidney Yang Deficiency was suspected as the underlying pathology The treatment plan to treat Bony Bi (a leading to Liver Blood Deficiency due to a lack of manifestation of Kidney Yang Deficiency, Spleen Essence production from the Kidney. The Kidneys Qi Deficiency and Liver Blood Deficiency) was to also produce Source Qi to transform and transport transform Phlegm and move stagnant Qi and Blood food. With inadequate Source Qi from Kidney (5). By doing so the author expected to reduce pain and Deficiency, the Spleen and Stomach instead produce improve mobility. Phlegm and Damp. Accumulation of Phlegm in the joints causes stagnation of Blood and Qi. To address the Kidney Yang Deficiency the goal was to tonify Kidney Yang and Qi. This is Traditional/Western Treatment done to help produce adequate Essence and Source The patient was continued on Tramadol, Qi to treat Bony Bi Syndrome. Tonifying Kidney Metacam and Gabapentin as previously prescribed. Yang and Qi will also aid in nourishing the Liver and Spleen. Without adequate Kidney Yang there will TCM/Eastern Treatment be stagnation of Blood and Qi and accumulation of He was prescribed Liquid Ambar15 700mg Phlegm causing signs of osteoarthritis (4). 2 tablets twice daily for 3 months. Liquid Ambar15 is a Chinese Herb also known as Yao Tong Pian, it The patient was treated with acupuncture contains liquidambar, pyrola, geranium, cistanche, weekly for 6 weeks then every 3 weeks for 6 weeks, pterospermum, phoinia, kadsura, morus twig, then monthly as maintenance. Each time 0.25mm x loranthus, chuan-shan-long, rehmannia, myrrh, 13mm Hwato needles were place at a depth of 5mm carthamus, persica and achranthes. It is used to treat for 15 minutes. The following points were used for the treatments (7): Chinese Point Anatomic Location Use of each point Name On the lower border of the medial condyle of the tibia, in the Yin Ling SP 9 depressions between the caudal border of the tibia and the Eliminates Damp Quan gastrocneumius m. 1.5 cun lateral to caudal border of the spinous process of 1st Influential point for BL 11 Da Zhu thoracic vertebrae, mid-way from the spinous process to the Bone medial border of the scapula 8 cun proximal to the lateral malleolus, cranial to fibula, 2 Influential point for ST 40 Feng Long cun lateral from the tibial mid-line, between the m. tibialis Phlegm cranialis and m. long digital extensor 1.5 cun lateral to the caudal border of the spinous process of Association point for BL 18 Gan Shu the 10th thoracic vertebrae. Liver On the medial aspect of the second toe, proximal to the Live and Gall LIV 3 Tai Chong metatarsalphalangeal joint, midway between the medial and Bladder Disorders dorsal aspect of the bone. In the depression between the medial malleolus and the KID 3 Tai Xi common calcanean tendon, level with the tip of the medial Tonify Kidney Yang malleolus. KID 6 Zhao Hai In the depression immediately distal to the medial malleolus. Tonify Kidney Yang
14 THE POINT A PUBLICATION OF THE INTERNATIONAL VETERINARY ACUPUNCTURE SOCIETY VOL.35 / NO. 4 November 2012 Chinese Point Anatomic Location Use of each point Name Used as a distal Between the 1st and 2nd metacarpal bones, approximately in LI 4 Shang Yang point, also clears the middle of the second metacarpal bone on the radial side. Heat. In the depression cranial to the elbow when flexed, in the Local point for the LI 11 Qu Chi transverse cubital crease 1 cun cranial to the humeral condylar elbow crest. Cranial and distal to the acromium, on the cranial margin of Local point for the LI 15 Jian Yu the acromial head of the m. deltoideus shoulder Caudal and distal to the acromium, on the caudal margin of Local point for the TH 14 Jian Liao the acromial head of the m. deltoideus shoulder Local hip point BL 54 Zhi Bian Dorsal to the greater trochanter Master pt for hind legs 1/3 of the distance between the greater trochanter and the GB 29 Ju Liao Local hip point cranial dorsaliliac spine GB 30 Huan Taio Midway between the greater trochanter and the tuber ischii Local hip point Master point Yang Ling for tendons and GB 34 In the depression cranial and distal to the head of the fibula Quan ligaments Influential point Distal to the tibial tubersity and lateral to the cranial border of Used to tonify Qi ST 36 Zu San Li the tibia, in a depression approximately in the middle of the and Blood, used for cranial tibialis m. hind limb paralysis Master point for BL 40 Wei Zhong In the center of the popliteal crease the low back, consolidates Yang Qi In the depression between the lateral malleolus and the Low back pain, BL 60 Kun Lun common calcaneon tendon, level with the tip of the lateral aspirin point malleolus The points were dry needled and were done and GB 30 were used as local hip points. BL 40 was bilaterally, except for the left hind limb points as this used as the Master Point for low back, BL 60 was used patient had a left behind amputation. The patient as a distal point and as the “aspirin point” to relieve was needled using the following points for the first pain. ST 36 was used to tonify Yang and Qi. ST 40 3 weekly treatments. BL 11 was used as the Master was used to relieve phlegm. GB 34 was used as the Point for bone, BL 18 and LIV 3 were used to move Master Point of the tendons and ligaments. blood and Qi, KID 3, KID 6 were used to tonify Kidney Yang and Qi. BL 12 and SP 9 were used The owner reported no improvement in to transform phlegm. Because this patient had an ambulation after the first week but did have an amputation of the left hind leg he was putting much improved appetite. The owner was carrying him of this weight on his forelimbs to compensate for and towel slinging him to help him ambulate. The his arthritic right hind leg and lack of a left hind leg. clinical appearance of the tongue was unchanged, pink For this reason local acupuncture points were used to slightly pale and wet. His pulse was bilaterally for the shoulders, elbows and carpi during the first 3 symmetrical, weak and slow. He did not seem warm treatments. LI 15 and TH 14 were used as local points at his chest and was slightly cool over the dorsum. No for the shoulder, LI 11 was used as a local point for the specific acupuncture points seemed painful. elbow. LI 4 was used as a distal point. BL 54, GB 29
15 THE POINT A PUBLICATION OF THE INTERNATIONAL VETERINARY ACUPUNCTURE SOCIETY VOL.35 / NO. 4 November 2012 On the second and third weekly treatments medications, including Liquidambar 15 have been the owner reported he was able to walk farther and continued. seemed less painful. His tongue color was pink overall and seemed wet. His pulse was bilaterally Discussion symmetrical, weak and slow. He did not seem warm A Western diagnosis of severe osteoarthritis at his chest. No specific acupuncture points were was made based on radiographic evidence of arthritis tender or swollen. and the decreased range of motion in the right hip joint. This is consistent with an Eastern diagnosis of At the fourth, fifth and sixth weekly treatments Bony Bi Syndrome. Osteoarthritis represents many the local forelimb points, LI 15, TH 14, LI 11 and different patters in Eastern Medicine. Wandering BI is LI 4 were omitted as the focus became more toward arthritis where the pain wanders from place to place, the underlying Kidney Yang Deficiency and Bony Bi. such as panosteitis. Painful, (Cold) Bi is characterized The following points were used: BL 11 was used as by an arthritis that is worse in the winter. Fixed, Master Point for Bone, BL 18 and LIV 3 were used to (Damp) Bi is arthritis that is worse when the weather move blood and Qi, KID 3, KID 6 were used to tonify changes. Hot Bi is acute and often accompanied by Kidney Yang and Qi. BL 12 and SP 9 were used to general heat signs, such as fever. Bony Bi is arthritis transform phlegm. Because of the severity of the right where there is deformity on radiographs and gait hip arthritis BL 54, GB 29 and GB 30 were continued abnormalities related to joint restriction on physical to be needled each week as local hip points. BL 40 exam (5). A Kidney Qi and Yang Deficiency led to was used as the Master Point for the low back, BL 60 Bony Bi in this patient. Deficient Kidney Yang was used as a distal point and as the “aspirin point” to decreases the production of Essence. Essence, an relieve pain. ST 36 was used to tonify Yang and Qi. ingredient in Blood, is required for adequate function ST 40 was used to relieve phlegm. GB 34 was used as of all organs. A deficiency of Essence leads to the Master Point of the tendons and ligaments. inadequate production of Blood and a Liver Blood Deficiency develops(8) . Liver Blood Deficiency On the fourth treatment appointment he contributes to Bony Bi because it promotes stagnation presented with a marked improvement in his ability to of fundamental substances. This patient’s emotional ambulate. He could walk across the room although he disturbances and dry skin coat made Liver Blood was still somewhat crouched and unable or unwilling Deficiency likely. to fully extend his right hind leg. The owner reported he was able to go outside to the bathroom unassisted Phlegm and Damp are accumulations of and continued to have a normal appetite. His tongue useless substances which originate from inadequately color remained pink and wet. His pulse bilaterally transformed food by the Spleen and Stomach (5). symmetrical, weak and slow. He did not seem warm in Kidney Yang Deficiency, the Kidneys produce at his chest and was slightly cooler over his dorsum. inadequate Source Qi. The Spleen and Stomach No specific points seemed tender or swollen. Overall rely on Source Qi to transform and transport food. his tongue color seemed improved but his dandruff With inadequate Source Qi from Kidney Deficiency, remained. The treatment plan was narrowed over the Spleen and Stomach instead produce Phlegm the 4 weeks to focus on the unchanged diagnosis of and Damp. Accumulation of Phlegm in the joints Kidney Qi yang Deficiency resulting in Spleen Qi causes stagnation of Blood and Qi. Additionally, Deficiency and Liver Blood Deficiency. a Liver Blood Deficiency, worsens stagnation in the joints from a lack of smooth flow. The goal of On the firth and sixth weekly treatment he therapy therefore, was to tonify Kidney Yang and Qi, continued to improve, walking for longer durations tonify Spleen and Stomach Qi, relieve Qi and Blood at each visit. The patient never walked normally on Stagnation and treat Liver Blood Deficiency. his hind leg, but the patient improved significantly. The patients’ treatments were extended to every 2 to Because this patient had an amputation of 3 months as maintenance therapy. To date there have the left hind leg he was putting much of this weight been no significant relapses. He continued to have on his forelimbs to compensate for his arthritic right dandruff but his appetite has improved overall. All hind leg and lack of left hind leg. For this reason 16 THE POINT A PUBLICATION OF THE INTERNATIONAL VETERINARY ACUPUNCTURE SOCIETY VOL.35 / NO. 4 November 2012 local acupuncture points were initially used for the 4. Steven P. Marsden, DVM ND MSOM Lac. CVA shoulders, elbows and carpi. LI 15 and TH 14 were Dipl.CH RH(AHG), “Overview of Chinese Medical used as local points for the shoulder, LI 11 was used as Physiology and Pathology,” International Veterinary a local point for the elbow. LI 4 was used as a distal Acupuncture Society, San Diego Convention, San point and a point to drain Dam and Heat. After the Diego, Oct. 2009: 2.1.32-34. first three treatments these points were omitted and 5. Robert G. Schaffer, Jr., DVM, PhD, “Bi the focus became more toward the underlying Kidney Syndromes,” International Veterinary Acupuncture Yang Deficiency and resultant Bony Bi. Because Society, San Diego Convention, San Diego, Oct. of the severity of the right hip arthritis BL 54, GB 2009: 4.7.1-9. 29 and GB 30 were used as local hip points at every 6. Joel Skoien, Dipl. Akupunkteur und Herbalist SBO- treatment. BL 18 and LIV 3 were used to tonify and TCM, Dipl. Acupuncture (NCCAOM), “Zang Fu move Liver Blood and Qi. (2). Pathology,” International Veterinary Acupuncture Society, San Diego Convention, San Diego, Oct. The history of heat seeking and the pale pink 2009: 4.5.23. wet tongue indicated an underlying Kidney yang 7. Taylor-Limehouse, “Getting Started in Small Deficiency. ST 36, KID 3 and KID 6 were used to Animal Acupuncture” International Veterinary tonify Kidney Yang and Qi. ST 36 is the Master Point Acupuncture Society, San Diego Convention, San for the gastrointestinal tract as well as an excellent Diego, Oct. 2009: 3.7.3-3.7.31. point for Spleen and Stomach tonification. 8. Steven P. Marsden, DVM ND MSOM Lac. CVA Dipl.CH RH(AHG), “Review of the Five Elements BL 11 was used as the Influential Point for and their Corresponding Zang-Fu Organs,” bone. ST 40, BL 12 and SP 9 were used to transform International Veterinary Acupuncture Society, San Phlegm. BL 40 was used as the Master Point for the Diego Convention, San Diego, Oct. 2009: 4.2.1- low back, BL 60 was used as a distal point and as the 4.2.22. “aspirin point’ to relieve pain. GB 34 was used as the Master Point of the tendons and ligaments.
This patient responded well to acupuncture treatment as it was the only new treatment administered after many months of worsening ambulation and a suddenly non ambulatory worsening condition. This patient did not walk normally after 6 treatments but has had marked improvement and the owner is very satisfied. We will continue monthly to every other month treatments and assess the patient’s overall well being from an integrated Eastern and Western standpoint.
References: 1. Huisheng, Xie, DVM, PhD, MS, “Five Elements and Veterinary Clinical Application,” International Veterinary Acupuncture Society, San Diego Convention, San Diego, Oct. 2009: 4.8.23-24. 2. Steven P. Marsden, DVM ND MSOM Lac. CVA Dipl.CH RH(AHG), “Overview of Chinese Medical Physiology and Pathology,” International Veterinary Acupuncture Society, San Diego Convention, San Diego, Oct. 2009: 2.1.41. 3. Schoen, Allen M. Veterinary Acupuncture, Mosby pp.282.Inc 2001.
17 THE POINT A PUBLICATION OF THE INTERNATIONAL VETERINARY ACUPUNCTURE SOCIETY VOL.35 / NO. 4 November 2012 Acupuncture Was Used To Treat Intervertebral Disc Disease in a Dachshund Stephanie Sur, DVM Abstract Acupuncture was used to successfully treat paraparesis, loss of deep pain to the right pelvic limb and urinary and fecal incontinence in a Dachshund. A daily treatment of both dry needles and electroacupuncture were performed along with physical rehabilitation therapy for 3 consecutive days, twice the following week and one last treatment one week later. The patient improved rapidly and upon examination 5 weeks after the initial insult, was found to be completely functional and ambulatory. History incontinence as well. A diagnosis of intervertebral A four year old female spayed Dachshund disc disease, presumptive Hansen Type I Class IV, was presented to my colleague for acute paraparesis and made. An MRI and surgery for the dog were declined dragging of the right pelvic limb. The dog was also based on finances. unable to urinate or defecate on her own. The client had given 75 mg of Ibuprofen orally. Radiographs Clinical Signs/Diagnosis - TCM (Eastern) of the spine were taken and calcified discs were seen The dog was bright, alert and friendly with a between thoracic vertebra 11 and 12, thoracic vertebra good appetite, unable to control her defecation and 13 and lumbar vertebra 1, and the disc between unable to urinate without bladder expression. She T13 and L1 appeared to protrude into the spinal was unable to use her right pelvic limb at all and canal. It was not financially feasible to take the dog hesitant to use the left pelvic limb. She appeared to for an MRI and to surgery, so hospitalization with seek heat as she was under the blanket in her kennel drug therapy was instituted. The dog was started on in a rather warm ambient temperature environment. Buprenorphine (0.9 mg as needed for pain q 6-8 h IV), The dog had sharp pain in the thoracolumbar area at Dexamethasone (0.34 mg q 12 h IV), Methocarbamol BL 19, BL 20, BL 21 and BL 22. No Alarm Points (273 mg q 12 h IV), warm compresses were applied to were sensitive. There was no deep pain in the right the spine for 5 minutes BID, and bladder expressions pelvic limb, the limb was cold and pulses were deep were performed TID. The following day the dog was and weak in the right inguinal area, but pulses were switched to Tramadol (25 mg q 8 h PO as needed for superficial and strong in the left inguinal area. The pain), Prednisone (2.5 mg q 12 h PO for 3 days), and tongue was a lavender color with no other changes to Methocarbamol (500 mg q 12 h PO), as well as cold the tongue proper and no coating. The skin along the laser light therapy along the thoracolumbar spine at dorsum was dry and flaky and the hair felt dirty when Frequency 4 and 4 Joules q 24 hr, warm compresses touched despite a recent bath. A diagnosis was made for 5 minutes BID along the thoracolumbar spine, of Spleen and Kidney Qi Deficiency which lead to a passive range of motion exercise of the rear legs, and local Qi and Blood Stagnation. 4,9,10, 11,12,13,19,27 lateral hip thrusts for 30 seconds BID. This diagnosis was based on the presenting Clinical Signs/Diagnostics/Diagnosis- Conventional findings of sharp pain in the thoracolumbar area (Western) and the lavender tongue which indicate Qi and The dog was seen for a primary complaint Blood Stagnation. Heat seeking behavior and pain of unable to walk. Upon neurological examination that was ameliorated with warmth both indicate the dog was found to have absence of deep pain a cold pattern and in this case of a Qi Deficiency. in the right pelvic limb, paraparesis and conscious Paraparesis and the inability to urinate and defecate proprioceptive deficits in both pelvic limbs. The dog voluntarily indicate a Kidney Qi Deficiency. Pain was found to be painful along her thoracolumbar at BL 20 (the Spleen Association Point, Back spine with palpation. Radiographs were taken of her Shu Point), deep and weak pulses on the right spine and two calcified discs were found between and the skin and coat abnormalities all indicate a thoracic vertebra 11 and 12 and thoracic vertebra 13 Spleen Qi Deficiency. There is also most likely an and lumbar vertebra 1. The disc between T 13 and underlying Jing Deficiency associated with young, L1 appeared to protrude into the intervertebral space. chondrodysplastic breeds which may have contributed The dog also had a hypertonic urethral sphincter to the imbalance.34,9,10, 11,12,13,19,27 and was unable to urinate on her own and had fecal 18 THE POINT A PUBLICATION OF THE INTERNATIONAL VETERINARY ACUPUNCTURE SOCIETY VOL.35 / NO. 4 November 2012 Conventional (Western) Treatment point to help drain the affected channel of stagnation Previously prescribed Tramadol (25 mg q 8 and to tonify Spleen Qi.20 BL 18, BL 19 and BL 23 h PO as needed for pain) was continued for 2 weeks. were chosen as local points to treat the stagnation. Previously prescribed Prednisone (2.5 mg q 12 h BL 23 was also chosen because it is the Kidney PO) was given for 3 days, then q 24 h for 4 days, association point which will tonify Kidney Qi, as then every other day for 1 week. The previously well as promote urination and strengthen the lower prescribed Methocarbamol (500 mg q 12 h PO) was back.15,20 BL 40 was chosen as a distal point to open continued for 3 days. Cold laser light therapy along and drain the affected channel as well as its’ ability the thoracolumbar spine at Frequency 4 and 4 Joules to treat caudal back pain, urinary incontinence and once daily for 4 days, warm compresses for 5 minutes clear Qi stagnation.10,15,20 KI 7 was chosen as a Jing twice daily along the thoracolumbar spine for 3 days, river point to tonify Kidney Qi and to treat urinary then every other day for one week. Passive range incontinence.1,15,21 GV 14 and GV 4 were chosen for of motion exercises (bicycling) 15 times each pelvic their ability to tonify Kidney Qi, move Qi along the limb was performed twice daily and continued at back thus benefitting the lower back.1,3,7,9,22, 23 GV 4 home for 1 month. Lateral hip thrusts were done for was also chosen as a local point for pain. GV 14 was 30 seconds twice daily and continued at home for 1 also chosen as the Sea of Qi point.23 SP 10 was chosen month. Leg lifts were performed for 30 seconds while because it regulates Spleen Qi, as well as alleviating standing twice daily and continued at home for 1 lower back pain through its’ ability to treat sharp pain month. Aquatic therapy was done daily for 20 minutes associated with Blood disorders.9,12, 24 and continued at home for 1 month. The bladder was expressed q 4-6 h for 1 week, then at home for 1 week The day after the initial acupuncture treatment until bladder control returned. deep pain sensation was restored to the right pelvic limb and pain was diminished in the thoracolumbar TCM (Eastern) Treatment spine. This indicated that Blood stagnation was The TCM treatment principles were to tonify resolving. However, conscious proprioceptive Spleen and Kidney Qi and alleviate local Qi and deficits still remained in both pelvic limbs and the dog Blood stagnation. This was achieved by using points was still unable to stand on her own. Treatment was on the Bladder meridian both cranial and caudal to resumed on day 2 with no changes to the protocol. On the vertebral lesions, and appropriate distal points day 3 the right pelvic limb palpated much warmer and to help restore normal flow of Blood, decrease pain her right inguinal pulses were stronger. She was able and increase mobility as well as nourish Kidney Jing. to move her left pelvic limb, there was perianal tone, The use of dry needling and electroacupuncture were she could wag her tail and if helped to stand could stay chosen based on their ability to help relieve stagnation, up for 1-2 seconds. After 3 days of treatment the dog tonify and alleviate pain quickly. could stand unassisted for short periods of time and could drag her pelvic limbs when ambulating. BL 21 Dry needling technique was employed using was able to be needled at this time indicating that pain 0.25 x 13 mm Carbo needles at a depth of 5 mm for had diminished closer to the vertebral lesion due to a 20 minutes using an even needle technique. Electrical decrease in local Qi and Blood stagnation. This point stimulation of some points was also used at a low was then used as a local point for pain and to tonify frequency of 15 Hz, dense-disperse setting for 15 Spleen Qi.20 Treatment was not performed on the 4th minutes. The amplitude was augmented until slight day but it was noted that her withdrawal reflexes had muscle twitching was seen. In general, the same returned to her pelvic limbs, although stronger on the points were used in each session. As the patient’s level left than the right and she was walking but knuckling of pain decreased, needles were placed closer to the her hind limbs. A treatment was performed on the 5th vertebral lesions. Initial treatment consisted of BL day. The same point prescription was applied with the 17, BL 18, BL 19, BL 23, BL 40, KI 7, GV 14, GV 4 exception of the placement of the electrical stimulation and SP 10. Electrical stimulation was placed across at BL 20 to BL 22, bilaterally. BL 20 was important the lesion as close as possible, but still tolerable to because of its ability to regulate and tonify Spleen the dog at BL 19 to BL 23, bilaterally. BL 17 was Qi and BL 22 was important because of its’ ability to chosen for its influence over Blood, as a proximal tonify the Kidney and treat urinary incontinence.20 At 19 THE POINT A PUBLICATION OF THE INTERNATIONAL VETERINARY ACUPUNCTURE SOCIETY VOL.35 / NO. 4 November 2012 this time an herbal supplement was prescribed. Kan had returned, there were no conscious proprioceptive Herb Essentials Supple Spine formula (Du Huo Ji deficits and only a very slight gait abnormality could Sheng Tang) was dosed at 13 drops orally BID. This be seen in the left pelvic limb approximately every formula was chosen based on its ability to tonify the 10-15 steps that were taken. Her tongue was normal Kidney, tonify Qi and Blood, prevent Wind-Damp- and the temperature of her hind extremities was Cold pathogen invasion, relieve stagnation and back completely normal. This demonstrated that her Qi pain, and lumbar stiffness.14,25,26 Supple Spine was and Blood stagnation had been alleviated along with to be refilled for life if proven effective, especially the root problem of Spleen and Kidney Qi Deficiency. in the winter months when this susceptible patient No more acupuncture was prescribed and the only will be at risk for Wind-Damp-Cold invasion. 9 medication to be given was Supple Spine 13 drops days after starting treatment the dog still had a mild BID. ataxia but her conscious proprioceptive deficits were The anatomical locations and characteristics of nearly gone. The same treatment was performed at the points chosen are presented in Table 1. that time. One month after starting treatment all pain was diminished, complete bladder and fecal control TABLE 1 1, 2, 3, 7,9,10,12,13,14,15,20,21,22,23,24 IVAS Name ANATOMIC LOCATION INDICATION FOR USE Chinese Name Sea of Blood When stifle is flexed, the point 2 cun above the SP 10 Regulates Spleen Qi cranio-medial border of the patella, on the bulge Xua Hai Used to treat sharp pain associated with of the cranial portion of the Sartorius muscle Blood disorders 1.5 cun lateral to the caudal border of the Influential point for Blood BL 17 spinous process of the 7th thoracic vertebra, in Regulates and tonifies Spleen Qi and Ge Shu the depression caudal to the medial border of the Blood , invigorates and facilitates Blood scapula flow BL 18 1.5 cun lateral to the caudal border of the spinous Point cranial to the lesion used to treat Gan Shu process of the 10th thoracic vertebra stagnation BL 19 1.5 cun lateral to the caudal border of the spinous Local point used to treat stagnation Dan Shu process of the 11th thoracic vertebra BL 20 1.5 cun lateral to the caudal border of the spinous Local point used to treat stagnation Pi Shu process of the 12th thoracic vertebra Tonify Spleen Qi BL 21 1.5 cun lateral to the caudal border of the spinous Local point used to treat stagnation Wei Shu process of the 13th thoracic vertebra Tonify Spleen Qi Local point used to treat stagnation BL 22 1.5 cun lateral to the caudal border of the spinous Tonify the Kidney San Jiao Shu process of the 1st lumbar vertebra Treat urinary incontinence Local point used to treat stagnation BL 23 Kidney association point (Tonify Kidney 1.5 cun lateral to the caudal border of the spinous Shen Shu Qi) process of the 2nd lumbar vertebra Promotes urination Strengthens the lower back Master point for the caudal back BL 40 In the center of the popliteal crease Clear Qi Stagnation Wei Zhong Distal point to drain affected channel Treat urinary incontinence
20 THE POINT A PUBLICATION OF THE INTERNATIONAL VETERINARY ACUPUNCTURE SOCIETY VOL.35 / NO. 4 November 2012 IVAS Name ANATOMIC LOCATION INDICATION FOR USE Chinese Name Jing River point KI 7 2 cun above the tip of the medial malleolus, Tonify Kidney Qi Fu Liu cranial to the calcanean tendon. Treat urinary incontinence Tonify Kidney Qi GV 4 On the midline, between the dorsal spinous Local point to treat stagnation Ming Men process of the 2nd and 3rd lumbar vertebra Move Qi along the back On the midline, between the dorsal spinous Tonify Kidney Qi GV 14 process of the last cervical and 1st thoracic Move Qi along the back Da Zhui vertebra Sea of Qi Point Discussion A sharp, fixed and constant pain is commonly The presumptive western diagnosis of associated with a Blood stagnation, where a dull, intervertebral disk disease was made using digital intermittent pain is associated with a Qi stagnation.3 radiography and the patient’s clinical signs. Kaylee showed signs of both Qi and Blood stagnation Intervertebral disk disease is a degenerative disease demonstrated by sharp back pain, a lavender tongue that is classified into two different groups based and paraparesis.3,4 This was the initial pattern seen upon either extrusion or protrusion of the disk and treated, however, the underlying root problem for material into the vertebral canal. Hansen Type I is Kaylee was Spleen and Kidney Qi Deficiency. There defined as extrusion of the nucleus pulposus in a is also a component of Kidney Jing Deficiency that chondrodystrophic breed. Hansen Type II is defined may have contributed to the Kidney Qi Deficiency. as occurring in a non-chondrodystrophic breed where the annulus fibrosis bulges or protrudes causing nerve The explanation for the underlying root pattern root compression. There is further classification based that Kaylee suffered from starts with the premise that on the severity of clinical signs. Class I is defined as Blood is the Mother of Qi while Qi is the commander back pain with no neurological dysfunction. Class of Blood. Without Qi from the Spleen and Kidney, II is defined as back pain with mild paresis. Class Blood becomes Deficient.16 Without Blood, Qi is not III is defined as paraplegia with deep pain sensation nourished and so Qi stagnates.12 Stagnant Qi leads present. Class IV is defined as paraplegia with the loss to a local stagnation of Blood.16 This relationship of deep pain sensation. Surgery within 72 hours is the can be explained through the basics of the Zang-Fu treatment of choice for Class III and Class IV lesions, organs. The Spleen is responsible for creating Blood however acupuncture can be used successfully to treat through Gu Qi, which is derived from food, then all classes of intervertebral disc disease. 3 Since Kaylee ascends to the Lung where it is then distributed to is a Dachshund and was non-ambulatory with the loss the Heart and transformed into Blood. Spleen Qi is of deep pain, a presumptive diagnosis of Hansen Type also needed to create Ying Qi which combines with I Class IV was made. However, without an MRI a Body Fluid and is also transformed in the vessels into definitive diagnosis could not be made. Due to the Blood.13 The Kidney rules Bone and creates Blood financial constraints of the clients an MRI and surgery and Marrow, as in the vertebral skeleton. Spleen could not be performed. Conventional treatment and Kidney Qi Deficiency lead to Blood Deficiency with Prednisone, Tramadol and Methocarbamol was which leaves Qi malnourished creating Qi Stagnation started followed by physical rehabilitation therapy and creating local Blood Stagnation.16 When Kidney acupuncture. Qi Deficiency arises urinary and fecal incontinence are seen as well as lumbar/hind end weakness and From a TCM perspective, intervertebral Intervertebral disc disease can manifest.17,18 Kaylee’s disc material is under the influence of Blood (Xue). age and chondrodystrophic breed are often associated When the disc material degenerates it dehydrates and with an underlying Kidney Jing deficiency which also loses its elasticity. This is thought to be a lack of contributed to Blood Stagnation.3 An individual’s nourishment by the Blood resulting in a stagnation of original supply of Jing is inherited from the parents Qi or Blood due to an underlying excess or deficiency. and stored in the Kidney at birth. If there is a problem
21 THE POINT A PUBLICATION OF THE INTERNATIONAL VETERINARY ACUPUNCTURE SOCIETY VOL.35 / NO. 4 November 2012 early in life it is often due to a deficiency of the as close as possible to the lesions without causing Prenatal or Kidney Jing. Once Jing has been depleted too much pain. Initially this was BL 19 and BL 23 it is very difficult to replace and can lead to many bilaterally, then as pain diminished the needles were problems including Blood stagnation.7 placed closer to the lesion. Electrical stimulation was chosen for its ability to alleviate pain quickly and for The TCM treatment principles were to tonify its Yang-like energy which is beneficial in treating Spleen and Kidney Qi and alleviate local Qi and deficient conditions.8,10 Blood stagnation. Acupuncture can activate regrowth of destroyed axons in the spinal cord, decrease local After the initial acupuncture treatment pain had spinal inflammation, edema, spinal cord compression decreased in the thoracolumbar spine and deep pain and pain along with decrease in the formation of sensation was restored to the right pelvic limb. This scar tissue.6 Local stagnation is treated by selecting was an indication that Blood stagnation was resolving. points above and below the lesion. Points are then However, there was no resolution of the conscious also selected to restore Blood flow and alleviate pain, proprioceptive deficits in the hind limbs. Kaylee was as well as points to treat the underlying imbalance.3,6 still unable to stand on her own. The same treatment Acupuncture was used in Kaylee’s case to accomplish protocol was administered on day 2. On day 3 Kaylee all of these things as well as increase mobility and was able to move her left pelvic limb, there was reverse urinary and fecal incontinence. perianal tone, she could wag her tail and if helped to stand could stay up for 1-2 seconds. Her right Dry needling and electrical stimulation were pelvic limb also palpated much warmer and her right used in combination for each acupuncture session. inguinal pulse was stronger. After 3 days of treatment The needles employed were 0.25 x 13 mm Carbo Kaylee could stand unassisted for short periods of time needles at a depth of 5 mm for 20 minutes using an and could drag her pelvic limbs when ambulating. even needle technique. Electrical stimulation of some Pain had decreased closer to the vertebral lesion as points was also used at a low frequency of 15 Hz, indicated by the fact that BL 21 was able to be needled dense-disperse setting for 15 minutes. The amplitude at this time. No treatment was performed on day 4, was augmented until slight muscle twitching was but her withdrawal reflexes had returned to her pelvic seen. SP 10 was used for its’ ability to treat sharp limbs, although stronger on the left than the right. She pain associated with Blood disorders and to regulate was able to walk with a knuckling of her hind limbs at Spleen Qi. 9,12, 24 BL 17 was used for its’ ability to this time. A treatment was performed on the 5th day. influence and move Blood and to regulate and tonify The only difference in the treatment prescription from Spleen Qi.20 BL 18 was chosen as a proximal point day 3 was the placement of the electrical stimulation to open the affected channel and assist in draining at BL 20 to BL 22, bilaterally. Kan Herbs Essential stagnation. BL 19, BL 20, BL 21, BL 22 and BL 23 formula, Supple Spine (Du Huo Ji Sheng Tang), was were used as local points to decrease pain and alleviate prescribed for its’ ability to reduce low back pain and stagnation. BL 20 and BL 21 were also chosen to thoracolumbar stiffness through stagnation relief, tonify Spleen Qi.20 BL 22 was used to tonify the tonify the Kidney, tonify Qi and Blood and protect Kidney and treat urinary incontinence.20 BL 23 was against Wind-Cold-Damp invasion.14,25,26 It was also used to tonify Kidney Qi.20 BL 40 was used to administered at 13 drops orally BID. 9 days after alleviate Qi stagnation and caudal back pain and to starting treatment Kaylee still had a mild ataxia but open and drain the affected channel as a distal point her conscious proprioceptive deficits were mild and as well as strengthen the lower back and treat urinary her right pelvic limb pulses were normal. The same incontinence. 10,15,20 KI 7 was chosen because it is a treatment performed on day 9 as was performed on Jing river point and therefore addresses Kidney Jing day 5. Examination was performed one month after deficiency as well as tonifies Kidney Qi and treats starting treatment. Examination revealed all pain urinary incontinence.1,15,21 GV 4 was chosen as a was diminished, complete bladder and fecal control local point for pain. GV 14 was chosen as the Sea had returned, there were no conscious proprioceptive of Qi point.23 GV 4 and GV 14 were also chosen for deficits and only a very slight gait abnormality could their ability to tonify the Kidney and move Qi along be seen in the left pelvic limb approximately every 10- the back. 1,3,22, 23 Electrical stimulation was placed 15 steps that were taken. Kaylee’s tongue was normal,
22 THE POINT A PUBLICATION OF THE INTERNATIONAL VETERINARY ACUPUNCTURE SOCIETY VOL.35 / NO. 4 November 2012 both inguinal pulses were normal and the temperature Principles. Reddick, Florida: Jing Tang. 2007. of her hind extremities was completely normal. This p.441-443. demonstrated that her Blood stagnation had been 14) Wynn, Susan G., Marsden, Steve. Manual of alleviated and her Spleen and Kidney Qi Deficiency Natural Veterinary Medicine- Science and Tradition. had been addressed properly. No further acupuncture St. Louis, Missouri: Mosby Inc. 2003. p.468. was prescribed. Kaylee was to continue using Supple 15) Xie, Huisheng, Preast, Vanessa. Xie’s Veterinary Spine for life. Acupuncture, 1st Ed. Ames, Iowa: Blackwell Publishing Professional. 2007. p.165-172. References 16) Xie, Huisheng, Preast, Vanessa. Traditional 1) Wynn, Susan G., Marsden, Steve. Manual of Chinese Veterinary Medicine, 1st Ed.-Fundamental Natural Veterinary Medicine- Science and Tradition. Principles. Reddick, Florida: Jing Tang. 2007. St. Louis, Missouri: Mosby Inc. 2003. p. 668-705. p.123. 2) IVAS Examination Committee. IVAS Required 17) Xie, Huisheng, Preast, Vanessa. Traditional Points- Small Animal. IVAS Veterinary Acupuncture Chinese Veterinary Medicine, 1st Ed.-Fundamental Course Notes. 2008-2009. p. 3.1.1-3.1.6. Principles. Reddick, Florida: Jing Tang. 2007. 3) Todd, Gregory. Canine Intervertebral Disk Disease. p.116. IVAS Veterinary Acupuncture Course Notes. 2008- 18) Xie, Huisheng, Preast, Vanessa. Traditional 2009. p.8.1.3-8.1.7. Chinese Veterinary Medicine, 1st Ed.-Fundamental 4) Xie, Huisheng, Preast, Vanessa. Traditional Principles. Reddick, Florida: Jing Tang. 2007. Chinese Veterinary Medicine, 1st Ed.-Fundamental p.374. Principles. Reddick, Florida: Jing Tang. 2007. 19) Xie, Huisheng, Preast, Vanessa. Traditional p.226. Chinese Veterinary Medicine, 1st Ed.-Fundamental 5) Xie, Huisheng, Preast, Vanessa. Xie’s Veterinary Principles. Reddick, Florida: Jing Tang. 2007. Acupuncture, 1st Ed. Ames, Iowa: Blackwell p.257. Publishing Professional. 2007. p.261. 20) Lade, Arnie. Acupuncture Points Images and 6) Shoen, Allen M. Veterinary Acupuncture-Ancient Functions. Seattle, Washington: Eastland Press. Art to Modern Medicine. 2nd Ed. St.Louis, Missouri. 1989. p.136-159. 2001. p.195. 21) Lade, Arnie. Acupuncture Points Images and 7) Xie, Huisheng, Preast, Vanessa. Traditional Functions. Seattle, Washington: Eastland Press. Chinese Veterinary Medicine, 1st Ed.-Fundamental 1989. p.186. Principles. Reddick, Florida: Jing Tang. 2007. 22) Lade, Arnie. Acupuncture Points Images and p.81-82. Functions. Seattle, Washington: Eastland Press. 8) Shoen, Allen M. Veterinary Acupuncture-Ancient 1989. p.275. Art to Modern Medicine. 2nd Ed. St. Louis, 23) Lade, Arnie. Acupuncture Points Images and Missouri. 2001. p.102. Functions. Seattle, Washington: Eastland Press. 9) Xie, Huisheng, Preast, Vanessa. Traditional 1989. p.284. Chinese Veterinary Medicine, 1st Ed.-Fundamental 24) Lade, Arnie. Acupuncture Points Images and Principles. Reddick, Florida: Jing Tang. 2007. p.85. Functions. Seattle, Washington: Eastland Press. 10) Xie, Huisheng, Preast, Vanessa. Traditional 1989. p. 95. Chinese Veterinary Medicine, 1st Ed.-Fundamental 25) Wrinkle, Alisa, Stropes, Laura, Potts, Teo. A Principles. Reddick, Florida: Jing Tang. 2007. Practitioner’s Formula Guide A Comprehensive p.489. Guide to Plum Flower® and Min Shan® Brand 11) Xie, Huisheng, Preast, Vanessa. Traditional Formulas. Oakland, Ca: Elemental Essentials Press. Chinese Veterinary Medicine, 1st Ed.-Fundamental 2008. p. 73. Principles. Reddick, Florida: Jing Tang. 2007. 26) Xie, Huisheng, Preast, Vanessa. Xie’s Chinese p.77-78. Veterinary Herbology. Ames, Iowa: Blackwell 12) Xie, Huisheng, Preast, Vanessa. Traditional Publishing. 2010. p. 419-420. Chinese Veterinary Medicine, 1st Ed.-Fundamental 27) Xie, Huisheng, Preast, Vanessa. Traditional Principles. Reddick, Florida: Jing Tang. 2007. Chinese Veterinary Medicine, 1st Ed.-Fundamental p.430-439. Principles. Reddick, Florida: Jing Tang. 2007. 13) Xie, Huisheng, Preast, Vanessa. Traditional st p.254. Chinese Veterinary Medicine, 1 Ed.-Fundamental 23 THE POINT A PUBLICATION OF THE INTERNATIONAL VETERINARY ACUPUNCTURE SOCIETY VOL.35 / NO. 4 November 2012 Vestibular Syndrome in a Golden Retriever Dog Treated with Conventional Medicine and Acupuncture Lee Gregory, DVM Abstract A geriatric canine patient was treated with a combination of conventional western veterinary medicine and dry needle acupuncture to resolve the symptoms of nystagmus, ataxia, and head tilt associated with a dysfunction of the vestibular apparatus. Resolution of clinical signs was deemed subjectively to occur faster with this combined approach than with conventional western medicine alone. Incorporating acupuncture with western medicine may help decrease hospitalization time, cost, and patient discomfort for a common geriatric disease. History all within normal limits. Ear cytology revealed yeast A 12 year old female spayed Golden Retriever and cocci in both ears. dog weighing 31.8kg presented to the emergency service at the Veterinary Emergency, Critical Care, The diagnoses were otitis externa AU of and Cancer Treatment Center of New Hampshire with mixed bacterial and yeast etiology, and a right-sided acute onset of vestibular symptoms beginning the vestibular lesion of peripheral or central etiology. The morning of presentation. The patient was owned by owner was offered and declined referral for advanced the same owners since it was a puppy, and this was imaging and CSF analysis to determine the underlying the first time that the owners were aware of that the etiology for the vestibular symptoms. The owner patient had exhibited vestibular symptoms. declined a thyroid panel.
The patient had a history of hypothyroidism, Clinical Signs/Diagnosis-TCVM and was taking Soloxine 0.6mg BID for some years. The pulse was fast and superficial, indicating The patient had a history of chronic ear infections, heat. The tongue was red and purple with prominent for which she had received otic and oral antibiotics small capillary vessels along the margins, indicating on multiple occasions throughout her life. She was Heat and Blood Stasis, especially in the Liver and not on any current medications for this condition. Gallbladder. The hair coat was in good condition The patient also had some degree of hind limb except in the region of the ears. The Ears were proprioceptive/sensory/motor deficit for a few months exudative indicating Damp. Palpation for sensitivity preceding the vestibular episode which resulted in of the alarm and association points was not performed. her falling in her hind limb only. This would happen intermittently, but especially when the patient was at The vestibular symptoms were indicative of play and in the motion of pivoting on her hind limb(s). pathogenic Wind 1,2.
Clinical Signs/Diagnosis- Conventional Acute otitis externa is an excess condition The patient presented laterally recumbent with involving invasion of Wind-Heat, with a usual episodic horizontal nystagmus, with the fast phase underlying pattern of Liver Fire or Damp Heat in the to the left. Pulses were moderate and synchronous, Liver or Gallbladder 3. Chronic otitis can indicate and she was tachycardic at 140 bpm. She was febrile Qi deficiency, stagnant Liver Qi, Yin deficiency, and with a rectal temperature of 103.6 degrees Fahrenheit. Liver Fire 3. Exudate was visualized in both external horizontal ear canals, and the hair within the canals was stained The history of hind limb deficit points to a light pink to brown color. Tympani were visualized the possibility of a weak back, indicating Kidney AU. A neurologic exam revealed mild hyporeflexia. deficiency4 . Often times with a vestibular disorder A cranial nerve exam and proprioceptive testing was there is an underlying Kidney Deficiency1 or a Kidney not performed. The remainder of the physical exam Shen deficiency2 . was within normal limits. The TCVM diagnosis was Invasion of Wind- Diagnostics included a complete blood count, Heat, Liver Fire, Damp-Heat causing blood stasis in biochemistry panel, and electrolyte panel which were the Liver and Gallbladder, with an underlying Kidney 24 THE POINT A PUBLICATION OF THE INTERNATIONAL VETERINARY ACUPUNCTURE SOCIETY VOL.35 / NO. 4 November 2012 Yin Deficiency suspected. patient was able to walk with minimal assistance in the hind limb only. Conventional Treatment The patient was admitted into hospital for A follow up appointment was performed 2 supportive care. An 18g, 1.5 inch intravenous weeks after initial presentation. The owners had catheter was placed in the left cephalic vein, and reported that the patient had a decreased appetite for Lactated Ringer’s Solution was started at 66ml/kg/ the first 3 days after discharge from the hospital, and hr intravenous infusion rate. 0.2mg/kg of midazolam had vomited once in that time period. The patient was administered intravenously with little effect. had vastly improved after the initial first 3 days, One hour later, an additional 0.2mg/kg of Midazolam and was reported to be at approximately 95% of was administered intravenously, as well as 0.025mg/ normal. The patient’s hind limb weakness at play was kg acepromazine intravenously. Within 2 hours, the unresolved (present before the vestibular episode). patient was able to right herself sternal, but remained All medications scripted at the time of hospitalization non-ambulatory, and continued to exhibit signs of had been finished, and the patient was currently on vestibular pathology with continual nystagmus, and a Cephalexin 1 gram BID prescribed by the referring right-sided head tilt. veterinarian.
Treatment for the otitis was initiated with A western exam revealed mild tachycardia, a combination otic topical ointment containing mildly ceruminous external ear canals AU, and a gentamicin sulfate, betamethasone valerate and stilted gait in the hind limb. A TCVM exam revealed clotrimazole. This was applied to the external ear a thin and rapid pulse, indicating Yin deficiency canal, and was indicated for use BID. and blood deficiency4 , and a pale lavender tongue indicated Qi stagnation 5. The cerumen in the ears TCVM Treatment indicated Damp. The alarm and association points After failure of conventional medicine to were not palpated for reactivity. entirely resolve the clinical signs of vestibular syndrome, acupuncture was employed within 8 hours The diagnosis at that time was Qi deficiency, of initial presentation. The treatment principles Qi stasis, and Yin deficiency with false heat. The included Eliminate Wind-Heat, Resolve Damp Heat, hind limb weakness indicated an underlying Kidney Clear Liver Fire, and Calm the Shen. deficiency pattern, consistent with the underlying pattern suspected for the vestibular episode. Dry needling was employed using 0.35mm x 25mm (#28 x 1”) Kingli brand needles in all points Follow-up treatment principles included Tonify except the distal limb points, for which 0.20mm x Qi, nourish Yin, and Tonify the Kidney. Points were 13mm (#36 x 0.5”) Kingli needles were used. An also selected to benefit the ears and strengthen the even needling technique with a needle retention time caudal back. These points were wholly different than of 20 minutes was used as this was considered an the points selected to treat the Wind Heat pattern on excess condition. initial presentation. These points were LU 7, BL 23, BL 40, GV 3, TH 17, GB 34, ST 36, BL 60, KI LIV 3 was used to sedate Liver Fire, and was 3. LU 7 and TH 17 were chosen to benefit the ears. used in combination with LI 4 (“four gates”) to clear BL 23, KI 3, and GV 3 tonified the Kidney (BL 23 in wind and calm the mind. GV 20 was also used to particular to nourish Kidney Yin). ST 36 was used to clear heat and calm the mind. GV 14, GB 20, and TH tonify Qi. GB 34 was used to dispel damp and benefit 3 were used to dispel Wind-Heat, and are indicated for the flow of Qi. BL 23, BL 40, GV 3, GB 34, BL 60, fever and brain problems. ST 40 and BL 23 were used and KI 3 were indicated to strengthen the caudal back. to resolve Damp-Heat and dispel and transform damp. The patient was not seen again for follow-up TH 3 and BL 23 were also used to benefit the ear. acupuncture. It was learned from the owner that The patient was discharge from the hospital 12.5 hours approximately 11 weeks after initial presentation, the after initial presentation with complete resolution of patient had a “neurologic” episode at home and died the nystagmus and head tilt, and minimal ataxia. The quickly and peacefully at home.
25 THE POINT A PUBLICATION OF THE INTERNATIONAL VETERINARY ACUPUNCTURE SOCIETY VOL.35 / NO. 4 November 2012 Table 1. Points 8, Anatomic location and indication 9. IVAS Point Anatomic Location Indication On the medial aspect of the second toe, sedate Liver excess/Liver Fire; used proximal to the metatarsophalangeal joint, in combination with LI 4 (“four LIV 3, Tai Chong midway between the dorsal and medial gates”) to clear internal wind and aspect of the bone calm the mind. Between the 1st and 2nd metacarpal bones, expel Wind Heat and calm the Shen, LI 4, He Gu approximately in the middle of the 2nd and is indicated for fever. metacarpal bone on the radial side On the dorsal midline of the skull, on a line between the anterior edge of the base of the GV 20, Bai Hui clear Wind and calm the Shen. ears, in the notch between the sagittal crest and the frontal crest clear Wind-Heat and Interior On the dorsum of the forefoot, between the Heat, and benefits the ear and TH 3, Zhong Zhu 4th and 5th metacarpals, in the depression mind. Indicated for ear problems, proximal to the metacarpophalangeal joints fever, and depression when used in combination with GV 20 In the dorso-cranial aspect of the neck, below the occipital bone, in the depression medial to the jugular process of the clear Wind and Heat and is indicated GB 20, Feng Chi occipital bone in the depression between for fever and brain problems. the m. sternomastoideus and the m. sternooccipitalis On the midline, between the dorsal spinous dispel Wind-Heat, clear the brain GV 14, Da Zhui processes of the last cervical and first and calm the Shen; indicated for thoracic vertebrae fever and brain problems. 8 cun proximal to the lateral malleolus, cranial to the fibula, 2cun lateral from the ST 40, Feng Long resolve Damp and clears Heat tibial mid-line, between the m. tibialis cranialis and m. long digital extensor association point of the kidney, was 1.5 cun lateral to the caudal border of the used to strengthen the brain, benefit BL 23, Shen Shu spinous process of the 2nd lumbar vertebra the mind, dispel and transform Damp, and benefit the ear. Proximal to the styloid process master point of the head and neck, indicated LU 7, Lie Que of the radius, 1.5 cun above the for any problem of the head and neck transverse crease of the carpus master point for the caudal back and BL 40, Wei Zhong In the center of the popliteal crease hip region, indicated for problems with the caudal back, hip and stifle Largent deficiency point located between the tonifies Kidney Yang, strengthens GV 3, Yang Guan dorsal processes of L4-L5, L5-L6, or L6-L7 the caudal back and rear legs Ventral to the ear, in the depression between TH 17, Yi Feng expels wind and benefits the ear the mandible and mastoid process
26 THE POINT A PUBLICATION OF THE INTERNATIONAL VETERINARY ACUPUNCTURE SOCIETY VOL.35 / NO. 4 November 2012 IVAS Point Anatomic Location Indication influential point for the sinews, In the depression cranial and distal to the benefits patency of the flow of Qi, GB 34, Yang Ling Quan head of the fibula dispels damp, strengthens caudal back and extremities 3 cun distal to ST 35, distal to the tibial tuberosity and lateral to the cranial border of ST 36, Zu San Li tonifies Qi the tibia, in a depression approximately in the middle of the cranial tibial muscle. In the depression between the lateral malleolus and the common calcanean BL 60, Kun Lun strengthens caudal back and hock tendon, level with the tip of the lateral malleolus In the depression between the medial KI 3, Tai Xi malleolus and the common calcanean source point for the kidney. tendon, level with the tip of the medial Strengthens the caudal back malleolus Discussion Kidney Qi and Shen deficiency. Vestibular disease is a common geriatric disorder seen in both the emergency and general IN TCVM, vestibular disease is seen as practice setting. Peripheral lesions leading to an excess condition involving primarily the Wind disruption of the vestibular apparatus include otitis pathogen, Wind can be exogenous or Internal. Internal media/interna, ototoxicity, hypothyroidism, or wind is especially common with dysfunction of idiopathic. Central lesions include brainstem infarct, the Liver, however it may also be seen in relation central vascular accident (CVA) or neoplasia. to dysfunction of the Heart or Kidney 7. Wind can propagate patterns that include other pathogens, In the case of larger dogs with vestibular including Wind-Heat and Wind-Damp. Often there is symptoms, secondary problems from immobility, such an underlying deficiency, as in Kidney Shen, Qi or Yin as basic sanitary care, pain from arthritic conditions, deficiency. and muscle loss, can lead to prolonged hospitalization and can contribute to owner frustration and financial Treatment principles for vestibular disorders limitations. Prolonged morbidity may contribute thus include dispelling Wind, clearing secondary to increased mortality rates in these patients due to pathogens such as Heat and Damp, calming the Shen, euthanasia. and sedating Liver Fire. The otitis externa in this case was also consistent with an excess pattern of Wind- Spontaneous recovery from vestibular Heat and Damp-Heat in the Liver and/or Gallbladder symptoms is typically seen within 72 hours of onset, channels. Points used to address these issues included and resolution is usually within 1-3 weeks 6. The Liv 3, LI 4, GV 20, TH 3, GB 20, GV 14, ST 40, and patient described in this report achieved recovery in BL 23. 12.5 hours from presentation, and resolution of signs was achieved within 3 days. Once the excess condition is treated, the underlying deficiency pattern of Kidney, Liver, or The patient described in this report was Heart deficiency may come to the forefront. In this diagnosed with vestibular disorder based on the patient’s case, Kidney Qi and Yin deficiency was presenting clinical signs of recumbency, ataxia, identified on follow-up exam primarily on the basis of horizontal nystagmus, a head tilt, and normal serum tongue and pulse diagnosis as well as history. Follow- chemistries and a CBC. An Eastern diagnosis of up treatment principles included Tonify Qi, nourish pathogenic Wind-Heat, Wind-Damp, Liver Fire and Yin, and Tonify the Kidney. Points were also selected Damp-Heat was made, along with an underlying to benefit the ears and strengthen the caudal back. The 27 THE POINT A PUBLICATION OF THE INTERNATIONAL VETERINARY ACUPUNCTURE SOCIETY VOL.35 / NO. 4 November 2012 point prescription included LU 7, BL 23, BL 40, GV 3, TH 17, GB 34, ST 36, BL 60, KI 3. This was a long- standing deficiency that had led to hind limb weakness and proprioceptive deficits, and as of such, would have required more time and treatment to address properly.
References 1. Todd, Gregory. Integrating East and West, 2009 IVAS Veterinary Acupuncture Course Notes, 2009: 427 2. Kline, Karen L; Caplan, Elaine R.; Joseph, Richard J. Acupuncture for Neurologic Disorders, in Veterinary Acupuncture; Ancient Art to Modern Medicine, 2nd edition, edited by Schoen, Allen M., International Veterinary Acupuncture Society Mosby, 2001: 189 3. Bierman, Naomi. Acupuncture for Dermatologic Disorders, in Veterinary Acupuncture; Ancient Art to Modern Medicine, 2nd edition, edited by Schoen, Allen M., Mosby, 2001: 286-287 4. Skoien, Jim. Zang Fu Pathology, 2009 IVAS Veterinary Acupuncture Course Notes, 2009: 351 5. Marsden, Steven P. Looking and Touching: Basic Pulse and Tongue Diagnosis, 2009 IVAS Veterinary Acupuncture Course Notes, 2009: 130 6. Rosychuck Rod A.W.; Luttgen Patricia. Diseases of the Ear, in Textbook of Veterinary Internal Medicine, Volume 1, 4th edition, edited by Ettinger S.J. and Feldman E.C., Saunders and Company, 1995: 546. 7. Xie, Huisheng; Preast, Vanessa. Traditional • Hundreds of products including Chinese Veterinary Medicine; Fundamental t-shirts, sweatshirts, hats, and Principles, Chi Institute 2007: 212 polos. 8. Hwang, Yann-Ching, Limehouse, John B. Canine • Ladies and youth sizes available. Acupuncture Atlas, in Veterinary Acupuncture; • Name and number on the back. Ancient Art to Modern Medicine, 2nd edition, edited by Schoen, Allen M., Mosby, 2001: 127-148. • Customize select designs. 9. Schafer, Richard A. Getting Started in Small
animal Acupuncture: Acupuncture Points and Visit Us Today At: Meridians, 2009 IVAS Veterinary Acupuncture http://www.fieldhouse.com/ivas Course Notes, 2009: 143-175. Fieldhouse.com/IVAS
28 THE POINT A PUBLICATION OF THE INTERNATIONAL VETERINARY ACUPUNCTURE SOCIETY VOL.35 / NO. 4 November 2012 Laser Acupuncture in Infectious Diseases and Wound Infections Including MRSA Infections Uwe Petermann, DVM Abstract Pulse Controlled Laser Acupuncture (PCLAC) is the combination of two very effective treatments each for its own, acupuncture and Low Level Laser Therapy (LLLT). Laser Acupuncture will be described as an alternative treatment of all kinds of diseases arising from infectious germs. These are infectious diseases of organs like tonsillitis, acute bronchitis, pneumonia, kidneys, bladder and intestinal infections. Also any tissue infection deriving from injuries or post-operation including phlegmons (cellulitis infections), as well as joint and tendon sheath infections can be positively influenced or healed by laser acupuncture treatment. If there is enough experience in laser acupuncture with patients like these, all these diseases can be treated without antibiotics. This is from a very special interest in cases of MRSA infections, when antibiotic treatment has no effects. Introduction Yang meridians of the hindlimb and CV 3 for the Yin Acupuncture. Acupuncture can be carried out in meridians of the hindlimb. So one can see, it is a very many different ways to reach the aim of stimulating simple but nevertheless extremely effective concept. the immune system and strengthen the infected organ, tissue or joint. Just to mention some of these LLLT (Low Level Laser Therapy) of the many points that come into consideration, LI 4, SP infected tissue is added as a very effective anti- 6, ST 36, GV 14, LU 11, etc. The election of these inflammatory therapy. For this LLLT I use a 90 watt points is dependent upon many specific factors of impulse lasers with 904 nm wavelength, because the inflammation. But there are two specific most only these lasers can penetrate deep into tissue that important acupuncture points that we can use in enough laser energy reaches the infected cells. The general, that means in any kind of infection not main principle of the anti-infectious force of LLLT depending on specific factors, and which I treat in any is the clearance of peroxide radicals in the infected case of infection. These are two Luo points combined tissue (KARU, T); another one is activation of by TCM Midday- Midnight- rule, TH 5 and SP 4. different kinds of immune cells like lymphocytes and The Midday- Midnight rule is one of my favorite macrophages and mediators like Lysosomal enzymes. acupuncture rules because it balances in every case Laser light also leads to demarcation of infected and a Yin and a Yang meridian, one on the hand, one on traumatized tissue. That means laser light separates the foot and it balances the circadian energy because the infected cells which are on the border to cell death both have an interim of 12h in their circadian rhythm. and stimulates their phagocytosis. The cells that have a These two Luo points are TH 5, which is the Thymus chance to survive are strengthened by laser energy. point of Ear Acupuncture* and SP 4, which is the There are two specific impulse frequencies that are Interferon point of Ear Acupuncture*. I call them in resonance with infected tissue and of much better “Switch on points for the immune system”. In case of value than any other frequency. It is Fr. A’ and A’’ organ infections one combines them with the specific according to Nogier (A’ = 292 Hz and A’’ = 37376 organ point; e.g. the organ point of the lung at the ear Hz). Because in impulse lasers every beat is one or the identical body point LU 7, the tonsil point (or energy impulse the frequency A’’ has more than 150 LU 11), the kidney point (or KID 7), the uterus point times more energy /sec than A’. In the moment there (or SP 5) etc. In infected wounds, joints, abscesses, is only one laser worldwide that is able to provide us phlegmons, etc., one combines the two “Switch with this high energy frequency (Physiolaser, 90 watt on points” with the concerning Tendino-Muscular impulse laser, Reimers & Janssen, Berlin). The kind of Meridian (TMM). The TMMs are opened by their treatment and the results are explained on several case Ting point, their Tonification point and a specific studies. Reunion point, which depends on if we treat a Yin or Yang meridian and if it is situated on the fore- or 1. Infectious arthritis and tendonitis. Infectious hindlimb. We have four Reunion points for the TMMs: arthritis and tendonitis is positively affected by LLLT GB 13 for the Yang meridians of the forelimb, GB 22 that offers a good chance of healing. In these cases it is for the Yin meridians of the forelimb, SI 18 for the essential to find the focus of the infection and include
29 THE POINT A PUBLICATION OF THE INTERNATIONAL VETERINARY ACUPUNCTURE SOCIETY VOL.35 / NO. 4 November 2012 it to the treatment plan. Especially with infections Case Report 1. Figure 1 shows a neglected wound after minimal invasive surgery we find the invasive with a swelling nearly as big as a handball over the channels as the focus and have to treat them very fetlock of a foal. The foal had been outside in the carefully by LLLT. We also treat the whole infected pasture night and day. After the wound in the foal was joint or tendon sheet with LLLT (frequency A’/A’’) discovered by the owner it received standard treatment with the laser for about 2 minutes (fr. A’’) or about 20 including bandages and antibiotics for about 2 weeks minutes (fr. A’) and with special attention we have to before it came in that state for laser acupuncture. treat the surgery channels where we found a focus of The following therapy included daily LLLT with infection. Again we treat the TMM (with Fr. A’ 30sec 6 x 90Watt impulse laser shower for 15 minutes. or A’’ 5sec or by dry needles) and TH 5, SP 4 (Fr. 5, Additionally laser acupuncture (LA) of SP 2 (wound 20sec, or dry needles) healing), TH 5, SP 4 (immune stimulation) was carried against inflammation. out. No other treatment such as antibiotics, etc. had For acupuncture we been applied. Picture 2 shows the situation 3 weeks treat. after beginning Laser Acupuncture: the wound is contracted and shows good epithelialization and sound 2. Wound granulation tissue. The swelling is reduced by half. In infection. Laser picture 3 the healing was finished after 4 months of treatment is highly treatment. Over that time the foal was treated nearly recommended for every day, most of the time by its owner. I saw the foal infected wounds, every 2 weeks. fistulas, disturbed wound demarcation and deep wounds. Again we treat the TMM and the immune stimulating points. For local wound Figure 1 healing process of a neglected wound in a foul treatment we add LLLT with Fr. A’/A’’. Especially in horses we see the development of hyper- granulation tissue in wounds at the lower part of the limbs. Besides the foregoing described above, treatment with “Wound Water” is also recommended. The “Wound Water” contents copper vitriol, healing earth and homeopathic dilution of Arnica, Echinacea and Hamamelis (recipe can be ordered). A very special indication for Laser Acupuncture is treatment of MRSA and Pseudomonas infections where antibiotic Figure 2 treatment has no effects. The treatment follows the same principles as described above (see case studies).
30 THE POINT A PUBLICATION OF THE INTERNATIONAL VETERINARY ACUPUNCTURE SOCIETY VOL.35 / NO. 4 November 2012 truthfully that I didn’t treat MRSA infections before, but many other antibiotics resistant infections have successfully been treated.
The infection had started 4 months previously when the dog was presented to the veterinary hospital because of a small wound unclear in origin. The wound was cleaned and treated with antibiotics.
Figure 3 Case Report 2
Figure 5
Despite the therapy, the wound swelling increased rapidly, showed suppurative fistulation and pain. A tissue sample from the infected area was taken for investigation; an MRSA infection was verified by culture and sensitivity. The clinic tried a further therapy with selected combinations of antibiotics that were changed several times. But this also showed no improvement. Swelling, fistulation and pain became worse. As a last resort a wide-scale excision of the Figure 4 diseased tissue was considered which was carried out very carefully. But the wound after a few days, The case of an MRSA infection in a dog shows the showed a dehiscence with massive infection. The excellent anti-infective effect of Laser Acupuncture clinic advised the euthanization of the dog, as the even in such cases, in which antibiotics have no effect. infection and pain became too strong and was no You can go as far as to say that Laser Acupuncture is longer manageable. There was no chance of healing currently the only successful treatment possibility. any more.
A three-year-old German shepherd mix was At this stage the dog came to me. The wound presented for Laser Acupuncture. The dog had been showed a highly destructive infiltrative infection. treated twice weekly at a small animal hospital for The granulation tissue was tubercular and incredibly four months. During this time the treatment was secretive (fig. 4). completely unsuccessful and treatment had been stopped. Euthanasia of the dog was recommended to At the beginning of the Laser Acupuncture the owner, because there was finally no way to help. medical therapy (antibiotics and anti-inflammatory But the owner asked me whether Laser Acupuncture drugs) was spontaneously discontinued. In addition would be able to cure MRSA infection. I answered to LLLT of the wound with the frequency A’ for 10
31 THE POINT A PUBLICATION OF THE INTERNATIONAL VETERINARY ACUPUNCTURE SOCIETY VOL.35 / NO. 4 November 2012 minutes the immune stimulating points TH 5 (Thymus of this dog was completely paralysed. There were no point) and SP 4 (Interferon inducing point) were reflexes and no sensitivity in the whole leg, including treated. Already during the first session the wound loss of conscious proprioception and deep pain. showed a typical spontaneous superficial secretion and Hoping to help the dog, the plate was removed by a a spontaneous reduction in pain could be observed. second surgery, but the limb didn’t improve within After 10 days (5 treatments) a significant contraction the next year. Now the dog came for acupuncture treatment. There were still no reflexes and no sensitivity. The musculature was completely atrophied in the leg. It was only skin and bone. The operation wound looked nasty but was closed completely. Beneath and beside the scar one could only feel the femur bone. In the scar I found a severe disturbing focus (by RAC reaction to the laser frequency A’). After two treatments with two days interim as described above the wound that had been closed for one year opened and started demarcation.
During the next two days the scar became more and more swollen and showed fluctuation. A big abscess developed and after a further two days 150 Figure 6 ml of pus came out when the abscess opened. Now I started to treat the neurological problem, treating with beautiful epithelialization and clean granulation the Shu points from Kidney to Large Intestine, that tissue was seen (fig. 6). One month after the start of all showed strong RAC reaction with frequency C Laser Acupuncture the wound had healed without a and the Governor Vessel between the spines with visible scar. frequency E, according to the spinal cord in the same area. Also a strong reaction was shown on frequency 3. Disturbing foci. In other cases we see E medial along the femur bone. I believe it was a very often that the wound only seems to heal on part of the sciatic nerve. Additionally the point KI 4, the skin surface and is closed but doesn’t heal the influential point of nerve tissue, was treated with properly inside. Wound demarcation stopped inside Fr. E. This treatment was carried out for one further the wound and there are small granulomas formed month daily by the owner with a rented impulse laser under or in the scar. These granulomas can work 90 Watt. When the patient came for the next visit after as the typical disturbing foci or perturbative fields this time, the dog was able to stand on the leg and to which we see regularly as causal trigger factors in move a little bit. All reflexes could be generated and chronic allergic and chronic degenerative disease. the skin sensitivity was back again. The treatment was In cases of badly healed, old scars, laser treatment stopped. At the next visit in my practice 2 months later provokes exacerbation of the granulomatous tissue the dog walked and ran perfectly and the muscles had and exudation of necrotic tissue (that had been stored developed again. The dog was completely restored. inside the granuloma). So the healing of the primary This example shows us that disturbing foci can wound, especially the non-demarcated tissue starts provoke severe problems like complete paralysis and again and a final healing will be achieved. The treatment of the disturbing focus opens the door to following acupuncture points should be stimulated: healing. LIV 3, SP 2 and to improve demarcation TH 5 and KID 3. In cases of wound infection we add SP 4. What 4. Abscesses and phlegmonia (cellulites) can happen from these granulomas and the way to Laser treatment is also exceptionally useful treat this, I will describe in a case report. in local inflammations. In very many cases phlegmonic processes, e.g. after the infection of Case report 3. A femur fracture in a dog was fixed by wounds, in mastitis and even in acute to sub-acute a metal plate. After healing of the fracture, the limb thrombophlebitis can be cured when previous 32 THE POINT A PUBLICATION OF THE INTERNATIONAL VETERINARY ACUPUNCTURE SOCIETY VOL.35 / NO. 4 November 2012 A’/A’’. Acupuncture points are TH 5, SP 4 and KI 3. With this treatment we also can avoid disturbing foci in the navel.
6. Acute infections of organs. Even acute organ infections can be treated by laser acupuncture using the same basic points with additional LLLT. Beside the Immune Wake up Points we only have to treat the organ point at the ear or their corresponding body point*. These are: KI 7 for the kidneys, LU 7 for the lung etc. (see the corresponding body points in figure 8). This is accompanied by LLLT of the organ with fr. A’/A’’. The LLLT of course is more effective in superficial and smaller organs than the bigger organs which are covered deeper in the body. So LLLT is considered more when infection starts with tonsillitis, sinusitis, pharyngitis, laryngitis, mastitis or bladder infection. Here we can stop infection in the state of a Biao illness before it goes deeper in the body Figure 7. Fistulation starts after first and develops a Li illness like pneumonia, intestine or Laser acupuncture treatment. See the kidney infection. tip of the big arrow, the small arrows show the size of the nasty scar *Ear acupuncture aroused from western treatment with antibiotics have proved ineffective. thinking. So we knew the point of the organ “Thymus” Much easier, fresh infections can be treated before at the ear and the “Interferon inducing point” at the ear antibiotics have been applied. Laser irradiation also for now more than 40 years. has an outstanding effect on the maturation and demarcation of abscesses (see case study above). This About 15 years ago we started to transpose also applies, for example, to hoof ulcers or infected the body points to the ear as well. There we found inflammations of the hoof dermis which do not mature TH 5 at the same place at the ear as the former and diffusely spread into the rest of the hoof dermis known “Thymus point”, SP 4 at the same place as the and which are normally very difficult to manage. “Interferon point” and many other important body points in the place of organ, glandular and hormonal 5. Infections of the navel and fistulas of the points that had been known on the ear before. This urachus. Navel infections often cause navel hernias was the moment, when ear- and body acupuncture as in dogs and foals. Especially in foals we also see well as eastern thinking and western thinking came infections starting from the navel and leading to together in harmony. severe general joint infections. In foals we also see sometimes that the urachus doesn’t close after the But even when this has already happened, we umbilicus cord is ruptured and urine is dripping out can use the concept successfully. I personally see the of the umbilicus. With laser acupuncture we can best results when I don’t use any drugs additionally do the best prophylaxis I can imagine for all these to laser acupuncture. So I treat these diseases problems. We treat the navel with frequency A’ for without antibiotics in every case. But one must prove 30 sec each and TH 5 and SP 4 (with their special conscientiously in every special situation what is the meridian frequency according to Reininger or needle best for the patient. acupuncture). In cases when infection has already taken place we must treat the navel much longer (3-5 minutes with Frequency A’ or 20 sec with fr. A’’). In urachal fistulas in foals we find a strong RAC reaction in the area of CV 9 that we also treat with frequency 33 THE POINT A PUBLICATION OF THE INTERNATIONAL VETERINARY ACUPUNCTURE SOCIETY VOL.35 / NO. 4 November 2012 Ear Point Body Point Conclusion These examples and hundreds of successfully Lung Point LU 7 treated patients with infectious diseases show that Tonsils/Larynx Point LU 11 Laser Acupuncture should be considered as a very Kidney Point KID 7 efficient anti-infective therapy. This is even true for Liver Point LIV 8 patients that did not respond to antibiotics or other Pancreas Point SP 2 (right side) anti-inflammatory therapies. Spleen Point SP 2 (left side) Ovary Point SP 5 Reference Uterus Point SP 6 1. Karu, T.I. Photobiological fundamentals of low- Figure 8 Ear Points on Identical Body Points. power laser therapy. IEEE Journal of Quantum Electronics 1987; QE-23:1703-1717.
IVAS Course in Veterinary Chinese Herbal Medicine
• Clinically-oriented post-graduate training • Covers both TCM and scientific understanding of herbal medicine • Flexible format via distance education • Self-paced study with personal tutor • Complete the course in 6 months to 2 years • Veterinary Acupuncture Certification not required
Presented by The International Veterinary Acupuncture Society in conjunction with the College of Veterinary Integrative Therapies
34 THE POINT A PUBLICATION OF THE INTERNATIONAL VETERINARY ACUPUNCTURE SOCIETY VOL.35 / NO. 4 November 2012 Hind End Weakness and Decreasing Energy in a 10 year old Dog Successfully Treated with Ba Wei Di Huang Wan Including MRSA Infections Tracy Henderson, DVM
Abstract Some of the more common signs seen in aging dogs include stiff and sore joints, hind end weakness, decreased stamina and failing eyesight and hearing. Other than anti-inflammatories for osteoarthritis, conventional veterinary medicine does not have many drugs to help with what are commonly seen as unavoidable symptoms of a natural process. There are however herbal formula’s that can help re-invigorate older dogs and slow the progression of aging signs. This case report deals with a ten year old Shepherd cross who presented for decreasing energy and mild hind-end weakness. She was being treated intermittently with a non-steroidal anti-inflammatory for pain relief but it has no effect on energy or on her hind end strength and stability. She was started on a Chinese classical formula called Ba Wei Di Huang Wan, or Rehmannia 8, and showed significant improvement after 2 months of treatment. Case Report subcutaneous masses on her ventrum and mildly Aster, a ten year old 21 kg spayed female cool extremities. There were no abnormalities on Shepherd cross was seen for decreasing energy neurological exam and she allowed full flexion and weakness in the hind end. She has previously and extension of her hips, stifles and hocks. She been diagnosed with two small lipomas (via fine did have decreased range of motion in both carpal needle aspirate and cytology) on her ventrum interphalangeal joints. She was tender at BL 23, the and radiographic evidence of arthritis in several Kidney Back Shu point, and, BL 26 and CV 12, the metacarpal-phalangeal and inter-phalangeal joints in Stomach Alarm point, both were warm. Her tongue both front feet. was red and dry with increased redness at the tip. Her pulse was deep, weak, thin and easily compressed. In the last month, Aster had shown a significant decrease in stamina when exercising, was sleeping Blood work done six months prior to more, and was notably weaker in the hind end. Her presentation was all normal and the owner declined back legs would five out on her when she was turning any further blood work or x-rays. quickly or jumping. All of these symptoms were worse in warm weather. For the last two years she From a Western medical standpoint, Aster had had been given Metacam (Meloxicam, Boehringer arthritis in her front feet, bilateral nuclear sclerosis, Ingleheim 2 mg every 24 hrs) on an “as needed” basis several small lipomas and loss of hearing and low to alleviate the stiffness and soreness in her front feet. back stiffness. From a Traditional Chinese Medicine Although the non-steroidal anti-inflammatory worked standpoint she was diagnosed with deficient Kidney well for the front end lameness, it did not help with Yang, Yin, and Qi, deficient Liver Blood and Bony Bi the collapsing in the hind end nor did it have any syndrome. positive effect on her energy level. She was a heat- seeker choosing to lie in the sun or by the fireplace Aster was started on Bai Wei Di Huang Wan when possible and the owner thought she was drinking (KAN: 550mg) at 1.5 tablets once a day then increased a little more than normal and that her hearing was to twice a day dosing on the fourth day of treatment. deteriorating. After 3 weeks on the herbs the owner reported On physical exam, she was in ideal body that Aster was sleeping less and her energy had condition, her ears were a bit moist but had no odor, increased. By the time of recheck eight weeks after erythema or unusual discharge. She had a very treatment had begun, Aster was back to her normal mild bilateral nuclear sclerosis, several enlarged energetic self, running and jumping normally with metacarpal-phalangeal and interphalangeal joints only very occasional, episodes of hind end weakness in both front fee, tender iliopsoas and quadratus that were much subtler than they had been. Her pulse lumborum muscles bilaterally, several small was wider and more moderate in depth although it was
35 THE POINT A PUBLICATION OF THE INTERNATIONAL VETERINARY ACUPUNCTURE SOCIETY VOL.35 / NO. 4 November 2012 still fairly easily compressed. Her tongue was pinker, Spleen Qi deficiency and Dampness. Her moist had lost the red tinge to the tip, was still dry and ears on presentation also fit with this notion. The now had slight lavender colour centrally. The only arthritic joints of her front legs (Bony Bi) from the active point found was slight tenderness at GB 25, obstruction of the normal flow of Qi and Blood was the Kidney Alarm point. The owner did not think her likely caused by her underlying deficiencies. Kidney hearing had improved at all. Yang deficiency (Schoen 2001, 162), Yin deficiency (Xie, Preast, 519) Blood deficiency and Dampness Discussion: (Macciocia 2005, 307) and deficiencies of Qi (Xie, From a Western medical standpoint, Aster had Preast, 529) can all cause obstructions to the smooth symptoms typical of an aging dog. Her arthritis was flow of Qi and Blood and thus lead to Bony Bi. A worsening, she was getting stiffer in her hind end, less thin pulse, tiring easily, cool extremities and dry energetic and was periodically collapsing in the back tongue all suggest some degree of Blood deficiency end when running on slippery surfaces. The lack of in Aster in addition to the Dampness and Kidney any neurological signs and lack of pain in the joints deficiencies noted above. and muscles of the hind end, with the exception of the iliopsoas and quadratus lumborum muscles, suggested The worsening of back end weakness and that pain was not playing a significant role in her poor energy during warm weather is curious –given hind end weakness although it could not be entirely that this dog was generally a heat-seeker. Perhaps it ruled out as a contributing factor. The fact that suggests there was some degree of both Yin and Yang Metacam only helped alleviate the forelimb stiffness deficiency making exertion in warm, or Yang, weather further supports this assumption. Without further more of a stress on her system. With decreased Yin diagnostic tests however, mild type II intervertebral and Blood available to counter the heating and drying disc disease, early neuromuscular degeneration effects of Yang energy created through physical and chronic degenerative joint disease could not be exertion and from the ambient air, any pre-existing definitively ruled out. Normal blood work and an sluggish Qi and/or Blood flow would be exacerbated. otherwise healthy looking dog made systemic disease Another possibility is that in some patients their highly unlikely as a cause of either the weakness or Qi and Blood can become scattered and ineffective decreasing energy. of delivering power and nourishment if Yang has excessively mobilized them to the periphery. This In Traditional Chinese Medicine, the gradual would happen on a hot day especially. As a symptom, loss of hearing, sight, energy and strength and many it would signal that the dog must be tonified and is other aging signs, are caused by diminishing Kidney not ready for moving herbs yet, since moving without Essence (Macciocia 2005, 590),( Xie, Preast 2007, tonifying would mimic the effects of a hot day and 81). The aging Zang-Fu organs have decreased ability worsen the animal. to generate new Qi and Blood and ultimately post- natal Essence. With less post-natal Essence present Aster was put on Rehmannia Eight to spare the consumption of pre-natal Essence, Combination or Ba Wei Di Huang Wan (BWDHW) to the stores of the latter are drawn upon and aging address her Kidney Yang, Yin and Qi deficiency and symptoms progress. Kidney Yin and Essence are Blood deficiency. This ancient formula is primarily inextricably linked and thus as Essence declines so a Kidney Qi tonic (Marsden 2006, 12). It warms too does Kidney Yin. Essence makes Qi and Yang Kidney Yang and tonifies Yin and Blood, boosts Qi also, so a decline in Essence also leads to some (Chen 2009: 669, 673), and thus supports the geriatric degree of Kidney Yang deficiency and ultimately Qi patient who is often deficient in all of these. The as well, leading to a further progression of lower back ingredients of BWDHW are Rehmannia root (Shu weakness, decreasing energy and many other aging Di Huang), Chinese Yam root (Shan Yao), Asiatic symptoms. Cornelian Cherry or Cornus (Shan Zhu Yu), Poria (Fu Ling), Asian Water Plantain rhizome (Ze Xie), Tree In this dog, the pre-existence of lipomas and Peony bark (Mu Dan Pi), Chinese Cinnamon bark a life-time diet of commercial refined carbohydrate (Rou Gui) and Sichuan Aconite root (Fu Zi). The dog food would suggest she had some degree of herbs and their actions can be found in Table I. 36 THE POINT A PUBLICATION OF THE INTERNATIONAL VETERINARY ACUPUNCTURE SOCIETY VOL.35 / NO. 4 November 2012 In people, the formula is commonly used to swelling and sped healing in people with sprains, treat low back pain, weak legs, wasting syndrome, bruises or arthritis. This is not surprising as we endocrine disorders including diabetes mellitus, know that several herbs found within BWDHW have Cushings and hypothyroidism (Chen and Chen, demonstrated anti-inflammatory properties, such as 672). It is also used to treat multiple disorders of Cornus, (Chen and Chen 2004, 1006), Tree Peony the cardiovascular system including coronary artery bark, (Chen and Chen 2004, 161) and Poria, (Chen disease, arteriostenosis, hyper and hypotension, 2004, 440). pulmonary disorders, multiple genitor-urinary disorders and eye diseases. (Chen and Chen 2009; It has been suggested that osteoarthritis shares 673). In animals it is most commonly used for the same biochemical and inflammatory profile as chronic renal failure although other indications include many of the symptoms and diseases associated with hypothyroidism, degenerative myelopathy, diabetes, metabolic syndrome in humans (Katz, Agrawal, infertility and asthma (Marsden 2006, 12). Velasquez 2010). These include hypercholesterolemia, other triglyceride abnormalities, hypertension, type II Aster’s improved energy and mobility and diabetes and obesity BWDHW and/or many of it’s improvements in pulse and tongue suggest that she constituent herbs haven’t been shown to be useful had a good response to the tonifying effects of this in the treatment of many of these problems including formula. We see not only improved strength and normalizing plasma cholesterol and triglyceride mobility from the broad Kidney tonification properties levels (Hanaka 1986), improving lipid metabolism of the formula but also corresponding positive changes (Yoshida, Kusukawa, Watanabe, Ohtsuke, Sakamoto, in the pulse, tongue and active points. The depth of Haranaka 1985) (Haranaka, Okada, Kosoto, her pulse became more moderate as Kidney Yang was Ohwada, Kobayashi, Yoshida 1986) and reducing replenished and the Kidney back Shu point was no the damage caused by oxidative stress in diabetic longer active. The redness of her tongue, particularly rats (Kim, Yokozawa, Cho, Yamabe, Yagi,Kanba at the tip, from Heart Fire secondary to Kidney Yin 2005) (Yokozawa, Yamabe, Cho, Nakagawa, Oowada deficiency also resolved as Kidney Yin and Blood 2004). Individual herbal constituents of BWDHW were fortified and her pulse became wider. have also proven effective for treating many of these diseases. Chinese wild yam rhizome has been shown The connection between the Heart and the to lower blood glucose levels (Chen and Chen 2001, Kidneys was restored by this formula by reintegrating 861) as does Cornus (Chen and Chen 2001, 1006). the upper and lower jiaos- specifically Yin was added, Rehmannia and Alisma have both been shown to and Yang to steam it up to the upper burner and at the lower blood pressure as well as lowers, cholesterol same time, the addition of both Yin and Yang to the and triglycerides (Chen and Chen 2001, 387,926). Kidney resulted in the generation of Qi. Given BWDHW’s beneficial effect on many of these disease associated with metabolic syndrome, and, the The lavender tinge of the tongue upon recheck common physiochemical pathways and biochemical would suggest some Qi or Blood stagnation was environments these diseases share with osteoarthritis, persisting and the dryness of the tongue also indicated it is sensible to think that BWDHW would also be more Yin tonification was still needed and at this effective in alleviating symptoms of osteoarthritis. stage a moving formula would have been helpful. This hypothesis of course warrants much more study. Unfortunately Aster’s owners were heading away on an extended holiday and did not want to change the We can also look at the known effects formulation before they left as they were so pleased of individual constituent herbs of BWDHW to with how well Aster was doing. understand some of the treatment effects that were seen in this case study. Rehmannia, a major A review of the scientific literature on the constituent of BWDHW, is an herb that is found use of BWDHW provides further insight into the in many formulas used to treat arthritis and aging positive results seen in this case study. Case studies (Dharmananda). Catapol, an iridoid glycoside conducted by Hijikata et al (2007) suggested that isolated from Rehmannia has been shown to be BWDHW might have helped alleviate pain and neuroprotective (Bi, Jiang, Liu, Lei, Zhang 2008)
37 THE POINT A PUBLICATION OF THE INTERNATIONAL VETERINARY ACUPUNCTURE SOCIETY VOL.35 / NO. 4 November 2012 (Zhang, AN, Bao, Wang, Jiang 2008)(Kim, An, Jung, biochemical standpoint the known analgesic, anti- Choo, Park, Nam 1999) ( Liang, DU, Xu, Jiang, inflammatory and pro-metabolic properties of many Hao, Bi, Jiang 2009). With several of these studies of the herbs in the formula could all have contributed and others (Yu, Kim, Jung, shin, Park, So, Kim, Lee, to the improvements noted. Ba Wei Di Huang Wan You 2006,) (Bi, Jiang, Liu, Lei, Zhang, An 2008) proved to be an effective treatment for this patient identifying the anti-oxidative properties of catapol and should be considered for similarly deficient dogs as one mechanism of action. Catapol has also showing mild to moderate signs of hind end weakness been shown to increase energy metabolism (Zhang, and decreasing energy. An, Bao, Wang, Jiang 2008) and although their study looked solely at brain energy metabolism and cognition, the mechanism(s) of action may be similar on upregulating energy metabolism in other systems of the body as well. Moved or Circumstances Changed? Please take a moment and update your information with us Aconite root, another constituent of BWDHW, so you don’t miss out on all the wonderful things that IVAS acts as a positive inotrope and chronotope, increases has to offer. Keep us posted, so we can keep you posted. cardiac contractility and output and it also has analgesic and anti-inflammatory effects (Chen and Chen 2004, 440). Tree Peony bark has shown an ability to increase perfusion of coronary arteries and decrease blood pressure (Chen and Chen 2001, 161). In people, Yamada et al (2005) found that administering BWDHW increased energy in twelve patients who had major depressive disorder. All of these herbs might thus have played a role in Aster’s increasing energy and stamina. International
Rou Gui (Cinnamon) was effectively used to Veterinary treat 102 human patients with low back pain from Kidney Yang deficiency (Chen and Chen 2004, 449). Acupuncture This herb would also have helped Aster if there had been any Cold invasion, particularly if it was Society obstructing the channels and collaterals. Similarly Aconite, another Yang tonic and Cold dispersing herb, would also have been beneficial. Several other herbs IVAS in BWDHW have anti-inflammatory and analgesic effects. Cornus and Tree Peony bark have been shown to have anti-inflammatory effects (Chen and Chen 2001, 1006, 161) and Xhi et al (1990) showed the anti‑inflammatory and analgesic properties of alkaloids (aconitines) isolated from aconite root in rats and mice. Advertise in “The Point”: One of the benefits of being an IVAS Member is the placement of a free Conclusion: classified ad in “The Point”. Ads must be no more Ba Wei Di Huang Wan was an effective than 100 words and submitted via email office@ivas. formula to treat the hind end weakness and decreasing org or via fax +970-266-0777 by these deadlines: energy in this geriatric dog. Known primarily as a 1st Qtr. Jan. 15 2nd Qtr. April 15 Kidney tonic formula, this dog showed direct and 3rd Qtr. Jul. 15 4th Qtr. Oct. 15 indirect evidence of the formula’s ability to tonify Yang, Yin, Qi and Blood. From a more western, 38 THE POINT A PUBLICATION OF THE INTERNATIONAL VETERINARY ACUPUNCTURE SOCIETY VOL.35 / NO. 4 November 2012 Abstracts on Recent Research from Phil Rogers [Epub ahead of print] Acupuncture anesthesia Am J Chin Med. 2011;39(3):423-31. Acupuncture for open heart surgery in contemporary China. in obstetrics and gynecology: an overview of Zhou J, Chi H, Cheng TO, Chen TY, Wu YY, systematic reviews. Ernst E, Lee MS, Choi Ty. Zhou WX, Shen WD, Yuan L. Source Department Source Complementary Medicine, Peninsula of Cardiothoracic Surgery, Shu Guang Hospital Medical School, University of Exeter, Exeter, UK. affiliated with the Shanghai Traditional Medicine Edzard. [email protected]. University, Shanghai, China. Acupuncture is often recommended for BACKGROUND: Although the use of obstetrical and gynecological conditions but the acupuncture anesthesia for open heart surgery, which evidence is confusing. We aim to summarize all was introduced in China four decades ago, has recent systematic reviews in this area. Western declined in recent years, there is a renewed interest and Asian electronic databases were searched for in it in contemporary China due to the escalating systematic reviews of any type of acupuncture for medical costs associated with open heart surgery. This any type of gynecological conditions. Our own files study was aimed to determine whether a combined were hand-searched. Systematic reviews of any acupuncture-medicine anesthesia (CAMA) strategy type of acupuncture for any type of gynecological reduces early postoperative morbidity and medical conditions were included. Non-systematic costs in patients undergoing open heart operation reviews and systematic reviews published before under cardiopulmonary bypass. 2004 were excluded. No language restrictions were applied. Data were extracted according to METHODS: From July 2006 to October predefined criteria and analyzed narratively. 24 2010, CAMA was applied in 100 patients undergoing systematic dysmenorrhea, premenstrual syndrome, open heart surgery in comparison with another 100 nausea/vomiting, breech presentation, back pain patients under the conventional general anesthesia during pregnancy, and procedural pain. Nine (GA). For all the CAMA patients, an abdominal systematic reviews arrived with clearly positive breathing training program was practiced for the 3 CONCLUSIONS; however, there were many consecutive days prior to operation. About 10 to contradictions and caveats. The evidence for 20min prior to surgical incision, acupuncture needles acupuncture treatment of obstetrical and gynecological were inserted into the bilateral points Zhong Fu, conditions remain limited. PMID: 21598411 [PubMed Lie Que, and Xi Men. During operation, patients - in process] were kept on spontaneous breathing. Endotracheal intubation was not employed buy only prepared as Am J Chin Med. 2011;39(3):433-40. Effects of standby. The narcotic drugs, fentanyl and midazolam, auricular acupressure on weight reduction and were intravenously injected but in very low doses abdominal obesity in Asian young adults: a as compared to GA. Open heart procedures were randomized controlled trial. Hsieh CH, Su TJ, performed routinely in both groups. Fang YW, Chour PH. Source Department of RESULTS: Compared with GA patients, the Nursing, Chang Gung Institute of Technology, CAMA patients had a less usage of narcotic drugs Chia-Yi, Taiwan. [email protected]. (p<0.001), less postoperative pulmonary infection The current study was designed to test the (p<0.05) shorter stay in intensive care unit (p<0.05), efficacy of auricular acupressure on weight reduction and a lower medical cost (p<0.05). and changes of waist circumference and waist‑to‑hip CONCLUSIONS: A combined ratio. This study used a randomized design with one acupuncture‑medicine anesthesia strategy reduces the control group and one experimental group consisting postoperative morbidity and medical costs in patients on Asian young adults with a waist circumference undergoing open hear surgery under cardiopulmonary >=80 cm in the females and >=90 cm in the males. bypass. Copyright © 2011 Elsevier Ireland Ltd. At completion of eight weeks of auricular therapy, All rights reserved. PMID: 21570137 [PubMed - as the total sample size was 55 young adults who ranged supplied by publisher] in the age from 18 to 20 years old. Each participant was treated weekly for ear acupressure in ten‑minute 39 THE POINT A PUBLICATION OF THE INTERNATIONAL VETERINARY ACUPUNCTURE SOCIETY VOL.35 / NO. 4 November 2012 sessions. Sessions continued for eight weeks wherein CONCLUSIONS: EA can attenuate the control group received acupressure only while RD‑induced delay in gastric emptying of solids and the experimental group received acupressure with this ameliorating effect may be mediated via the the Japanese Magnetic Pearl on the ear acupoints. opioid pathway. EA may have a therapeutic potential While both the control treatment groups showed for treating delayed gastric emptying attributed to significant reduction (p<=0.05) to body weight and lower gut distension. PMID: 21593428 [PubMed‑as waist circumference after eight weeks of treatment, supplied by publisher] only the group treated with Japanese Magnetic Pearls Complement Ther Med. 2011 Feb;19(1):3-11. showed decreased waist to hip ration. Thus, auricular Epub 2011 Jan 17. Taichi Qigong improved lung acupressure may be a beneficial addition to weight functions and activity tolerance in COPD clients: loss programs for young adults. Auricular acupressure a single blind, randomized controlled trial. Chan is thus a reasonable option in the treatment of AW, Lee A, Suen LK, Tam WW. Source The overweight and obesity in young adults. PMID: Nethersol School of Nursing, Faculty of Medicine, 21598412 [PubMed‑in process] Esther Lee Building, The Chinese University of Hong Kong, Shatin, NT, Hong Kong. AM J Physiol Regul Integr Comp Physiol. 2011 [email protected] May 18. [Epub ahead of print] Electroacupuncture Improves Rectal Distension‑induced Delay in Solid OBJECTIVE: To evaluate the effectiveness Gastric Emptying in Dogs. Yin J, Chen JD. Source of a Tai chi Qigong (TCQ) program in enhancing University of Texas Medical Branch. respiratory functions and activity tolerance in clients with chronic obstructive pulmonary disease (COPD). The aim of this study was to investigate the effects and mechanisms of electroacupuncture (EA) on DESIGN: A single-blind, randomized rectal distension (RD)‑induced delay in solid gastric controlled trial. emptying in dogs. SETTING: Five general outpatient clinics in METHODS: Gastric emptying of solid was Hong Kong. assessed in twelve dogs chronically implanted with a INTERVENTION: In total, 206 COPD clients duodenal cannula by collecting samples at different were randomly assigned into one of the three groups, points from the cannula and measuring the dried namely, TCQ, exercise, and control group. Subjects weights of the samples. Bethanechol and atropine in the TCQ group received a TCQ program consisting were used to qualitatively validate the method. In of two 60‑min sessions each week for three months. separate experiments, gastric emptying of solid was Subjects in the exercise group were taught to practice measured in a number of sessions: control, RD, RD + breathing techniques combined with walking as an sham‑EA, RD + EA of 6 mA, RD + EA of 3 mA and exercise. Subjects in the control group were instructed RD + EA + Naloxone. to maintain their usual activities. Data collection was RESULTS: 1) The method of gastric emptying performed at baseline and at the 6‑week and 3‑month by collecting and drying gastric chyme from the marks. duodenal cannula was found to be accurate and OUTCOMES: Lung functions, 6‑min walk reliable. Using the method, gastric emptying was test, and COPD exacerbation rate. found to be accelerated with Bethanechol (70.01 ± 8.10% vs. 82.61 ± 4.15%, P=0.04) and delayed RESULTS: Results of repeated measures with atropine (4.31 ± 1.57%, P<0.001 vs. control). of analysis of covariance demonstrated that there 2) RD substantially and significantly delayed gastric were significant interaction effects between time emptying. EA but not sham‑EA attenuated delayed and group forced vital capacity (p=.002, (2)=.66), gastric emptying induced by RD (48.79 ± 9.47% forced expiratory volume in 1s (p<.001, (2)=.02), vs. 74.28 ± 5.96%, P<0.01). 3) The effect was more walking distance (p<.001), and exacerbation rate potent with EA of 6 mA the EA of 3 mA and blocked (p=.006,(2)=.06) at 3 months. Improvements were by Naloxone. noted in the TCQ group. No changes observed in the exercise group, while a decline in lung functions was noticed in the control group. 40 THE POINT A PUBLICATION OF THE INTERNATIONAL VETERINARY ACUPUNCTURE SOCIETY VOL.35 / NO. 4 November 2012 CONCLUSION: Taichi Qigong was able to evaluated the clinical characteristics of acute and improve respiratory functions and activity tolerance subacute ischemic stroke patients who electively level in COPD clients. The breathing and walking joined the HPSAAT. The study also evaluated the exercise helped maintain lung functions and slow safety and clinical benefits of adjuvant acupuncture in down disease progression. Copyright © 2011 treating acute and subacute ischemic stroke patients. Elsevier Ltd. All rights reserved. PMID: 21296261 Twenty–six HPSAAT participants and 52 age‑sex [PubMed‑indexed for MEDLINE] matched random controls were enrolled. The stroke baseline of the HPSAAT participants was more Evid Based Complement Alternat Med. sever than the non‑HPSAAT controls. Although 2011;2011:260510. Epub 2011 Apr 26. Review the stroke severity closely correlates to mortality of evidence suggesting that the fascia network and comorbidity, this study noted no significant could be the anatomical basis for acupoints and complications in the HPSAAT participants during the meridians in the human body. Bai Y, Wang J, Wu acupuncture treatment course. Adjuvant acupuncture JP, Dai JX, Sha O, Tai Wai Yew D, Yuan L, Liang was considered safe at the acute and subacute stages of QN. Source Department of Anatomy, Southern ischemic stroke. Due to uneven baseline severity, the Medical University, Guangzhou 510515, China. clinical benefits in reducing neurological deficits and functional recovery were not concluded in this study. The anatomical basis for the concept of Free Article PMID: 21584251 [PubMed - in process] meridians in traditional Chinese medicine (TCM) has not been resolved. This paper reviews the evidence Explore (NY). 2011 May-June;7(3):148-54. supporting a relationship between acupuncture point/ Effects of Acupuncture in Reducing Attrition and meridians and fascia. The reviewed evidence supports Mortality in HIV-Infected Men with Peripheral the view that the human body’s fascia network may Neuropathy. Shiflett SC, Schwartz GE. Source be the physical substrate represented by the meridians Laboratory for Advances in Consciousness and of TCM. Specifically, this hypothesis is supported Health, Department of Psychology, University of by anatomical observations of body scan data Arizona, Tucson, AZ. demonstrating that the fascia network resembles the theoretical meridian system in salient ways, as well as OBJECTIVE: A clinical trial reported in physiological, histological, and clinical observations. JAMA (Shay et al, 1998), involving acupuncture and This view represents a theoretical basis and means for amitriptyline in HIV‑infected patients, concluded applying modern biomedical research to examining that there was no effect for either acupuncture or TCM principles and therapies, and it favors a holistic amitriptyline on neuropathic pain. However, a recent approach to diagnosis and treatment. Free Article reassessment of this study showed that there were PMID: 21584283 [PubMed - in process] really three different and independent clinical trials, each with a different research design, which had been Evid Based Complement Alternat Med. combined into a single database and consequently 2011;2011:689813. Epub 2011 Apr 18. Pilot scheme analyzed with a relatively insensitive statistics. of health policy in stroke adjuvant acupuncture When only the first substudy, factorially crossed therapy for acute and subacute ischemic stroke in design involving acupuncture and amitriptyline, was Taiwan. Wei YC, Sun MF, Chang KC, Chang CJ, reanalyzed by itself using more powerful statistics, Hung YC, Lin YJ, Chiu HH. Source Department it was found that acupuncture and amitriptyline of Neurology, Change Gung Memorial Hospital at both worked independently to reduce pain, but also Keelung 20401, Taiwan. that acupuncture worked best in the absence of amitriptyline, and that there may have been adverse To reduce the health care burden of strokes, events associated with the combination of the two the Taiwan Department of Health launched the Pilot treatments. The present study reports the reanalysis of Scheme of the Health Policy in Stroke Adjuvant th second of the original independent studies involving Acupuncture Therapy (HPSAAT) in 2006. This only acupuncture and sham acupuncture, to determine cross‑sectional, hospital‑based, match‑controlled whether the results confirm acupuncture‑related study at Chang Gung Memorial Hospital‑Koahsiung findings from the first substudy. Medical Center during 2008~2008 retrospectively
41 THE POINT A PUBLICATION OF THE INTERNATIONAL VETERINARY ACUPUNCTURE SOCIETY VOL.35 / NO. 4 November 2012 PARTICIPANTS: Subjects were 114 HIV– Fertil Steril. 2011 May 7. [Epub ahead of print] infected men with pain associated with peripheral Selecting a control for in vitro fertilization and neuropathy in the early 1990s, when antiretroviral acupuncture randomized controls trials (RCTs): drug cocktails were just beginning to be available in how sham controls may unnecessarily complicate experimental form. the RCT evidence base. Manheimer E. Source Center for Integrative Medicine, School of RESEARCH DESIGN: The second of the Medicine, University of Maryland, Baltimore, independent studies in the original report by Shay et Maryland. al involved a single factor with two levels: a 14‑week standardized acupuncture regiment and its control OBJECTIVE: To examine the theoretical (off‑point sham acupuncture). In addition, physical and methodologic rationales for the use of sham functioning at baseline (high or low, based on the acupuncture controls in trials of adjuvant acupuncture Karnofsky scale), was factorially crossed with the for in vitro fertilization (IVF), and to identify the acupuncture factor in our analyses. Primary data were drawbacks of using a sham acupuncture control that reanalyzed using repeated‑measures ANCOVA in an may have its own effects on the pregnancy outcome. intention‑to‑treat procedure, and categorical data were BACKGROUND: Acupuncture has analyzed by the Pearson chi‑square test. typically been tested in trials that evaluate subjective OUTCOME MEASURE: Pain intensity, pain patient‑reported outcomes such as pain. Ratings of relief, mortality, and attrition. pain and similar subjective states can be strongly influenced by respondents’ prejudgments, preference RESULTS: Whereas the results were and expectations about treatment benefits. Therefore, inconclusive for the pain measures, acupuncture had controlling for these expectations or for “placebo a strong and positive effect on attrition and mortality. effects” by using a sham acupuncture control group These results were most pronounced among patients is critically important in trials of acupuncture for with poorest physical functioning at the beginning of pain‑related conditions may have led to the belief that the study. Overall, acupuncture was associated with sham acupuncture is always the most “rigourous” lower attrition rate (27.6% vs. 44.6%, P=.058), and control, and that it should therefore be used for a zero mortality rate (0% vs. 12.5%, P=.047). This all acupuncture trials, including trails of adjuvant protective effect of acupuncture was visible primarily acupuncture for IVF. in subjects in poor health (0% vs. 23.8%, P=.047). CONCLUSIONS: In trials of adjuvant CONCLUSIONS: Acupuncture was clearly acupuncture for IVF, the outcome is pregnancy, which effective in reducing attrition and mortality in this is entirely objective and unlikely to be affected by sample, especially when health status was taken into a patient’s expectations of a benefit of acupuncture. account, but results for pain relief were mixed. These Because it seems unlikely that an IVF patient’s results add further evidence that the use of the most knowledge of whether she was receiving adjuvant sensitive statistics available increases the change of acupuncture would affect her ability to become detecting actual effects due to acupuncture (and other pregnant from IVF, using sham acupuncture to control treatments as well). Moreover, these results replicated for expectation/placebo effects seems unnecessary most of the findings that did not involve the presence in this context. Even if adjuvant acupuncture of amitriptyline from the initial independent study were to increase IVF success rates only through a in this research project. The combined results of psychosomatic effect mechanism, such as by reducing these two studies strongly support the importance of stress, this stress‑reduction effect would be integral recognizing the interactions involving acupuncture and to the working mechanism by which adjuvant other treatments, may positively as well as negatively acupuncture increases IVF pregnancy rates; therefore, modify main effect results in clinical trials, and thus it seems inappropriate to control for and separate must be recognized and systematically explored. out any such stress‑reduction effect by using a sham Findings are discussed in terms of their implications control. Because of the risk that the sham is not an for moving toward a whole‑system approach to inert placebo but rather an active treatment that may biomedical research. Copyright © 2011. Elsevier Inc. affect the pregnancy outcome, using sham acupuncture All rights reserved. PMID: 21571233 [PubMed-in as the control but rather an active treatment that may process] 42 THE POINT A PUBLICATION OF THE INTERNATIONAL VETERINARY ACUPUNCTURE SOCIETY VOL.35 / NO. 4 November 2012 affect the pregnancy outcome, using sham acupuncture (-0.99%), abdominal subcutaneous adipose tissue as the control may unnecessarily confuse rather than (SAT) volume (-5.63%), and intrahepatic triglyceride clarify the interpretation of the effects of IVF adjuvant (IHTG) content (-9.03%) were also observed, acupuncture. Using both theoretical concerns and although these were not significant (p > 0.05). There epidemiologic evidence, researchers should carefully was a significant correlation between the level of weigh the benefits and drawbacks of using sham abdominal fat (SAT, VAT) and anthropometric acupuncture to blind patients in adjuvant acupuncture parameters (weight, BMI, waist circumferences, hip for IVF trials, and should question, rather than circumferences). There was no statistically significant automatically accept, whether “placebo effects” are correlation between IHTG and anthropometric an important risk of bias in this context. Copyright © parameters or abdominal fat content. 2011 American Society for Reproductive Medicine. CONCLUSIONS: The first direct Published by Elsevier Inc. All rights reserved. PMID: experimental evidence is provided demonstrating 21570069 [PubMed - as supplied by publisher] that acupuncture therapy significantly reduces BMI and abdominal adipose tissue by reducing abdominal J Altern Complement Med. 2011 May;17(5):413-20. VAT content without significant changes in body Effects of acupuncture therapy on abdominal weight, waist circumference, hip circumference, fat and hepatic fat content in obese children: a WHR, abdominal SAT, or IHTG content. Thus, the magnetic resonance imaging and proton magnetic use of acupuncture therapy to selectively target a resonance spectroscopy study. Zhang H, Peng Y, reduction in abdominal VAT content should become Liu Z, Li S, Lv Z, Tian L, Zhu J, Zhao X, Chen M. more important and more popular in the future. PMID: Source Department of Radiology, Beijing Hospital, 21595560 [PubMed - in process] No. 1 Dahua Road, Dongcheng, Beijing, China ABSTRACT OBJECTIVES: The aim of this Philos Trans R Soc Lond B Biol Sci. 2011 Jun study was to use magnetic resonance imaging (MRI) 27;366(1572):1849-58. Placebo studies and together with proton magnetic resonance spectroscopy ritual theory: a comparative analysis of Navajo, ((1)H-MRS) to study the influence of acupuncture acupuncture and biomedical healing. Kaptchuk therapy on abdominal fat and hepatic fat content in TJ. Source Beth Israel Deaconess Medical Center, obese children. Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, USA. ted_kaptchuk@hms. DESIGN: The design was a longitudinal, harvard.edu clinical intervention study of acupuncture therapy. Using a comparative analysis of Navajo SUBJECTS: Subjects were 10 healthy, obese healing ceremonials, acupuncture and biomedical children (age: 11.4 ± 1.65 years, body-mass index treatment, this essay examines placebo studies [BMI]: 29.03 ± 4.81 kg/m(2)). and ritual theory as mutually interpenetrating MEASUREMENTS: Measurements included disciplines. Healing rituals create a receptive person various anthropometric parameters, abdominal fat susceptible to the influences of authoritative culturally (assessed by MRI) and hepatic fat content (assessed sanctioned ‘powers’. The healer provides the sufferer by (1)H-MRS) at baseline and after 1 month of with imaginative, emotional, sensory, moral and acupuncture therapy. aesthetic input derived from the palpable symbols and procedures of the ritual process-in the process RESULTS: One (1) month of acupuncture fusing the sufferer’s idiosyncratic narrative unto a therapy significantly reduced the subjects’ BMI by universal cultural mythos. Healing rituals involve 3.5% (p = 0.005), abdominal visceral adipose tissue a drama of evocation, enactment, embodiment and (VAT) volume by 16.04% (p < 0.0001), abdominal evaluation in a charged atmosphere of hope and total adipose tissue volume by 10.45% (p = 0.001), uncertainty. Experimental research into placebo effects and abdominal visceral to subcutaneous fat ratio demonstrates that routine biomedical pharmacological by 10.59% (p = 0.007). Decreases in body weight and procedural interventions contain significant (-2.13%), waist circumference (-1.44%), hip ritual dimensions. This research also suggests that circumference (-0.33%), waist-to-hip ratio (WHR) ritual healing not only represents changes in affect,
43 THE POINT A PUBLICATION OF THE INTERNATIONAL VETERINARY ACUPUNCTURE SOCIETY VOL.35 / NO. 4 November 2012 self-awareness and self-appraisal of behavioural adequate blinding; there were 130 (4%) RCTs which capacities, but involves modulations of symptoms both used adequate randomization methods and through neurobiological mechanisms. Recent scientific allocation concealment; and there were only 100 (3%) investigations into placebo acupuncture suggest RCTs which used adequate randomization methods, several ways that observations from ritual studies can allocation concealment, as well as blinding. In the be verified experimentally. Placebo effects are often RCTs published in foreign journals, the adequate described as ‘non-specific’; the analysis presented here randomization methods, allocation concealment suggests that placebo effects are the ‘specific’ effects and blinding accounted for a relatively large of healing rituals. PMID: 21576142 [PubMed - in proportion (25%, 26%, and 60%, respectively) and process] increased with years, while in the RCTs published in Chinese journals, only the adequate randomization Trials. 2011 May 13;12:122. [Epub ahead of print] methods improved over time. The quality of non- Quality assessment of reporting of randomization, drug intervention (chiefly acupuncture) RCTs was allocation concealment, and blinding in traditional higher than that of drug intervention RCTs. In drug Chinese medicine RCTs: a review of 3159 RCTs intervention, the quality of listed drugs is higher than identified from 260 systematic reviews. He J, Du the others. The quality of all included RCTs of all L, Liu G, Fu J, He X, Yu J, Shang L. Source types of diseases was generally poor and no studies Chinese Cochrane Centre, Chinese Evidence-Based that were large in size and of high quality were found. Medicine Centre, West China Hospital, Sichuan CONCLUSION: The quality of the current University, Chengdu 610041, China. TCM RCTs as judged by their publications is BACKGROUND: Randomized controlled generally poor, especially those published in Chinese trials (RCTs) which are of poor quality tend to journals. In future, researchers of TCM RCTs should exaggerate the effect estimate and lead to wrong attach more importance to experimental design and or misleading conclusions. The aim of this study methodological quality, receive relevant training, and is to assess the quality of randomization methods, improve reporting quality using the Consolidated allocation concealment and blinding within traditional Standards of Reporting Trials (CONSORT) statement, Chinese medicine (TCM) RCTs, discuss issues so as to improve the quality of TCM clinical research identified for current TCM RCTs, and provide and ensure truth and reliability of CONCLUSIONS. suggestions for quality improvement. Free article PMID: 21569452 [PubMed - supplied Publisher] METHODS: We searched Chinese Biomedical Database (CBM, 1978 to July 31, 2009) and the Vopr Kurortol Fizioter Lech Fiz Kult. 2011 Cochrane Library (Issue 2, 2009) to collect TCM Mar-Apr;(2):5-7. [Assessment of the results of systematic reviews and meta-analyses according to 24-hour arterial pressure monitoring in patients inclusion/exclusion criteria, from which RCTs could with arterial hypertension treated with fixed be identified. The quality assessment involved whether combinations of corenitec and gyzaar with and the randomization methods, allocation concealment without acupuncture reflexotherapy]. [Article in and blinding were adequate or not based the study Russian] [No authors listed] reported. Stratified analyses were conducted of different types of diseases published in different This study has demonstrated that the treatment journals (both Chinese and foreign) using different of patients with grade II-III arterial hypertension interventions. SPSS 15.0 software was used for using fixed combinations of corinetec and gyzaar statistic analyses. supplemented by acupuncture reflexotherapy resulted in a significantly more pronounced decrease of RESULTS: A total of 3159 RCTs were daily monitored arterial pressure than in patients included, of which 2580 were published in Chinese who received the drug therapy without acupuncture. journals and 579 in foreign journals. There were 381 PMID: 21574291 [PubMed - in process] (12%) RCTs which used adequate randomization methods; 207 (7%) RCTs which used adequate allocation concealment and 601 (19%) which used
44 THE POINT A PUBLICATION OF THE INTERNATIONAL VETERINARY ACUPUNCTURE SOCIETY VOL.35 / NO. 4 November 2012 Zhen Ci Yan Jiu. 2011 Feb;36(1):46-51. lobe, hippocampal gyrus, etc. and being apparently [Characteristics of PET cerebral functional different to those of the control group (P<0. 001,k> 10 imaging during “Deqi” of acupuncture in healthy voxels). volunteers]. [Article in Chinese] Zhang GF, CONCLUSION: Acupuncture of Waiguan Huang Y, Tang CZ, Wang SX, Yang JJ, Shan BC. (SJ 5) mainly produces feelings of soreness, Source School of Chinese Medicine, Southern numbness, distending and heaviness, and the activated Medical University, Guangzhou 510515, China. cerebral areas mainly involve the left temporal lobe, [email protected] superior temporal gyrus, etc.; while acupuncture of OBJECTIVE: To observe the characteristics its neighboring non-acupoint chiefly induces a feeling of needling sensation of “Deqi” (feelings of soreness, of tingling in the healthy subjects, and the activated numbness, distending and heaviness, SNDH) by regions predominately involve the left limbic lobe, using positron emission tomography (PET) based on hippocampal gyrus, etc. PMID: 21585059 [PubMed - changes of glucose metabolism in different functional in process] brain areas. Zhen Ci Yan Jiu. 2011 Feb;36(1):52-6. [Effect of METHODS: Eighteen normal volunteers [9 acupoint-catgut-embedment on mammary gland men and 9 women, mean age (23.23-1- 3. 32) years] hyperplasia]. [Article in Chinese] Zhou L, Lu were randomly divided into control, Waiguan (SJ 5) X, Feng ZG, Shen XX, Wu JQ. Source Jinhua and non-acupoint groups (n=6 in each group). SJ 5 Municipal Hospital of Chinese Medicine, Jinhua and non-acupoint (the midpoint between SJ 5 and the 321017, China. [email protected] running course of the Small Intestine Meridian on the right forearm) were punctured by using a sterilized OBJECTIVE: To evaluate the clinical filiform needle. PET scan of the brain began 40 min therapeutic effect of acupoint-catgut-embedment after intravenous 18 F-fluorodeoxyglucose (FDG) therapy in the treatment of mammary gland injection (0. 11 mCi/kg body weight, left opisthenar hyperplasia (MGH). vein). Needling sensations including “Deqi”(n= 5), METHODS: Eighty MGH patients were tingling (n 5) and no-apparently-specific-feeling equally randomized into acupoint-catgut-embedment (NASF) were acquired by acupuncture stimulation (ACE) group and medication (Rupixiao, a herbal and grouped. The needling sensations were evaluated patent drug for relieving MGH) group according by using Visual Analog Scale(VAS). The acquired to odd-numbered days or even-numbered days image data of different needling-sensation groups of visiting. Subcutaneous catgut-embedment were analyzed using SPM 2. 0 software in the Matlab was performed in Wuyi (ST 15), Rugen (ST 18), Platform. Tanzhong (CV 17), Xuehai (SP 10), Zusanli (ST 36) RESULTS: After receiving acupuncture and Yanglingquan (GB 34), once every 15 days for stimulation of SJ 5, 5 volunteers in the Waiguan (SJ 3 months. Patients of the medication group were 5) group experienced fee- lings of SNDH, with the treated by oral administration of Rupixiao (3 tablets, mean VAS score being 4.23 +/- 1. 50, and 5 volunteers 3 times per day, 3 months altogether). The degree of the non-acupoint group had a tingling feeling, of breast pain and the size of the hyperplastic lump with the mean VAS score being 5.73 2.40. The VAS were observed before and after the treatment. Serum score of the tingling group was significantly higher estrodiol, progesterone and prolactin contents on day than that of SNDH group (P<0. 05). Compared with 1 to day 3 of menstruation were detected by using an the NASF control group, the activated cerebral areas automation chemiluminescence immune analysator. were Brodmann area (BA) 7, 13, 20, 22, 39, 42 and RESULTS: After the treatment, of the two BA 45 in the SNDH group, mainly involving the left 40 MGH patients in the ACE and medication groups, temporal lobe, superior temporal gyrus, etc. and being 16 (40. 0%) and 5 (12. 5%) were cured basically, obviously different to those of the control group (P<0. 8 (20. 0%) and 8 were improved markedly in their 001,k>10 voxels). The activated cerebral areas in the symptoms and signs, 16 (40. 0%) and 22 (55. 0%) tingling group were BA 18, 19, 22, 24, 25, 32, 36, 40 were effective, and 0 and 5 (12. 5%) failed in the and BA 45, predominantly involving the left limbic treatment, with the effective rates being 100% and
45 THE POINT A PUBLICATION OF THE INTERNATIONAL VETERINARY ACUPUNCTURE SOCIETY VOL.35 / NO. 4 November 2012 87.5%, respectively. The therapeutic effect of the was given once every other day continuously for ACE group was significantly better than that of the 12 weeks. Patients of the medication group were medication group (P<0. 05). In comparison with treated with oral administration of Acitretin capsules the pretreatment, the pain grades and the size of the (20 mg/d, for 12 weeks). The therapeutic effect was hyperplastic lump in both ACE and medication groups evaluated by using psoriasis area and severity index decreased significantly after immediate termination (PASI) scoring method. Results After the treatment, of the treatment and 6 months after the treatment the integrative scores of PASI in both medication (P<0.01), and the therapeutic effects of the ACE group and acu-moxibustion groups decreased significantly were significantly superior to those of the medication (P<0. 01), and that of the acu-moxibustion group was group in reducing pain grade and hyperplastic lump significantly lower than that of the medication group size (P<0. 01). After the treatment, serum estrodiol (P<0. 05). Of the both 30 psoriasis patients in the and progesterone contents were decreased evidently medication and acu-moxibustion groups, 1 (3. 33%) in both ACE and medication groups (P<0. 01, P<0. and 4 (13. 33%) were cured basically, 15 (50. 00%) 05). Type-B ultrasonic examination showed that of and 17 (56. 67%) were improved significantly, 12 (40. the two 40 MGH patients in the ACE and medication 00%) and 6 (20. 00%) were effective, and 2 (6. 67%) groups, 16 and 5 cases turned to normal in their and 3 (10. 00%) invalid, with the effective rates being mammary glands, and the cure rate of the ACE group 93. 33% and 90. 00%, respectively. The cured plus was evidently higher than that of the medication group markedly effective rate of the acu-moxibustion group (P<0. 01). was significantly higher than that of the medication group (P<0. 05). CONCLUSION: Acupoint-catgut-embedment is effective in relieving MGH, and its therapeutic CONCLUSION: Acu-moxibustion therapy effect is apparently superior to that of medication is effective in the treatment of psoriasis and is (oral administration of Rupixiao). PMID: 21585060 remarkably superior to that of medication. [PubMed - in process] PMID: 21585062 [PubMed - in process]
Zhen Ci Yan Jiu. 2011 Feb;36(1):62-5. [Randomized controlled trials for treatment of 30 cases of ordinary psoriasis by acupuncture and moxibustion]. [Article in Chinese] Wu JP, Gu SZ. Source Fangshan Hospital of Chinese Medicine, Beijing 102400, China. OBJECTIVE: To observe the therapeutic effect of acu-moxibustion for ordinary psoriasis, so as to find a better curative method for it. METHODS: A total of 60 cases of psoriasis were equally randomized into medication group[(8. 67 - 6. 53) months in duration of disease, (39. 25+/- 10. 21) years in age] and acu-moxibustion group [(9. 16 7. 37) months in duration of disease, and (37. 38 +/- 11. 36) years in age] according to a random number table. For patients of acu-moxibustion group, main acupoints used were Feishu (BL13), Geshu (BL17), Ganshu (BL18), Pishu (BL 20) and Shenshu (BL 23), combined with other acupoints [Hegu (LI 4), Weizhong (BL 40), etc. ] according to the affected part of the body. Moxibustion was applied to Shenshu (BL 23) and the injured skin area for about 3 min every time. Acu-moxibustion treatment
46 THE POINT A PUBLICATION OF THE INTERNATIONAL VETERINARY ACUPUNCTURE SOCIETY VOL.35 / NO. 4 November 2012 Horse Special Acupoints: Where Acupuncture Doesn’t Work Francesco Longo, DVM, Repr. Spec., Italian Veterinary Acupuncture Society; Italian Veterinary Acupuncture Clinical Center. Bologna, Italy. In clinical practice, the energetic diagnosis horse general wellness.1 is followed by the definition of a treatment protocol: treatment acupoints are selected according to their Therefore, there are possible to identify for traditional energetic indications, but also considering each group of diseases or for every organic system experimental and clinical evidences, always in respect some acupoints that have a very important effect of the individual needs of the treated subject. in restoring the condition of homeostasis. These acupoints can be added to the treatment to improve the Sometimes, in spite of a correct choice of the subject’s physiological conditions2 acupoints, they seem to have no effect or they work very well in a starting phase of the illness, but after Cardio-vascular System. they arouse no further effects. It controls the relationship HT – KI HT 9 It controls the growth in young horses In many cases the reduction of therapeutic (Shaochong) It regularizes the rhythmic activity of the effects of acupoints is due to energetic conditions of HT great general stagnation of Qi and Xue. This stasis is caused by the use of allopathic drugs and by their Respiratory System. symptomatic effects, by the extend in time of the Chronic respiratory diseases illness or by its recurrence. Respiratory diseases treated during BL 14 the summer (Jueyinshu) These situations are imputable to engrams. Respiratory diseases aggravated by They are cooperation schemes among the nervous Heat - Dry in environment or climate bundles at NCS level and they form the neurogramma, It promotes communication genital the neuro - humoral and hormonal signals operating organs – heart – head as body memory. Engrams involve many encephalic It improves therapies for bronchitis GV 12 structures: limbic system, hippocampus, amygdala, and asthma (Shenzhu) PAG, cerebellar nucleus and they operate by RNA It is Middle Gate3: it regulates Lung molecules. Qi It disperses the Wind – Heat Environmental stimuli or drugs administrated It replaces LU 1 (Zhongfu) in the Shu during long time make some biochemical products KI 27 – Mu technique to treat respiratory that determine permanent biochemical modifications (Shufu) diseases in summer, bringing the right in nervous bundles and in their cooperation schemes. amount of Yin to the LU From these alterations derive the persistent or It is stimulated by bleeding to recurrent or seasonal diseases. Xue Tang eliminate heat from the LU4 Chronic respiratory diseases It intervenes an habit status in which GABA, Fei Pan endorphins, serotonin determine an attenuation of COPD They are stimulated by moxibustion the stress stimuli, but the general condition of the Qi Hai – Bi to eliminate Tan from the respiratory body is heterostasis: digestive and immune systems Guan are involved. Moreover the excessive production of track endogenous cortisol damages the hippocampus. Acupuncture, Tuina, cytoskeleton reshaping (fascia), postural modulation are able to recode engrams and it determine a coordinated answer of the whole organism that induces a new healing situation and improves the
47 THE POINT A PUBLICATION OF THE INTERNATIONAL VETERINARY ACUPUNCTURE SOCIETY VOL.35 / NO. 4 November 2012 Gastrointestinal System. Reproductive System. 6,7,8 Hui Fu Point GB 26 It treats all ovary diseases It acts on HT (it regulates the Shen (Daimai) CV 12 functions according to outside) It treats all ovary and uterus (Zhongwan) Shen Shu It treats all diseases that involve diseases ST (Huang) Bachmann Point BL 51 It is stimulated only by It treats all ovary and uterus (Huangmen) moxibustion diseases Meeting Point of the TMM of SP It promotes the elimination of CV 8 (Shenque) - HT KI 3 (Taixi) exceeding fluids in the uterus, also It improves the Qi flow in Middle during the PMIE9 and in Lower Burners promoting 5 Xi Point of Yin Wei Mai the development of deep energies It avoids spontaneous abortion Meeting Point of the TMM of hind (it prevents pregnancy spasms – it KI 9 (Zhubin) Yang Channels (ST – BL – GB) invigorates the pelvis – it tonifies Point of Yang Qiao Mai KI) ST 3 (Juliao) It eliminates the pain during It has eugenic action abdominal colics It regulates the ST – KI Sense Organs. relationship EYE The most important point to LR 3 Meeting Point of SI - BL PM regularize the energetic functions (Taichong) Meeting Point of SI - BL DM of the LR BL 1 Meeting Point of SI - ST PM (Jingming) Course Point of HT DM Urinary System. Course Point of GV DM Ho point Meeting Point of Yang Qiao Mai – Ben point Yin Qiao Mai Starting point of KI DMP Yu Yao EYE It is closely linked to BL 40 (Jingshu) Meeting Point of TH - BL PM (Weizhong) SI 19 EAR It acts on genital organs – urinary KI 10 (Yingu) (Tinggong) Meeting Point of GB – TH PM ways – spine HT 7 TONGUE It regulates the KI – HT (Shenmen) Yuan Point relationship It influences the Jing Chamber NOSE It deletes pelvic pain affecting the Qi Hai – Bi They act on nose – lachrymal movements of hind limbs Guan ducts They clear obstructions in nostrils SKIN (TOUCH) BL 11 It treats dermatological diseases (Dazhu)10 regulating the LU
Nervous System. Meeting Point of ST – TH – GB Tai Yang PM (Naoshu) 11 treats all Neurological diseases It improves the Wei Qi
48 THE POINT A PUBLICATION OF THE INTERNATIONAL VETERINARY ACUPUNCTURE SOCIETY VOL.35 / NO. 4 November 2012
Meeting Point of ST – BL PM General Functions. GV 24 It acts on nape – head – brain – Luo Point of CV (Shenting) cerebellum It is linked Da Feng Men Shen disturbances to GV 9 Zhiyang It improves every other treatment to GV 1 Changqiang They are stimulated by Pai Fa - to edge ribs (it improves Tuina technique diaphragmatic function) Tong Tian – CV 15 (Jiuwei) Neurological diseases Yuan Point of Gao Long Hui They eliminate Tan from Control Point of reproductive respiratory track organs It acts on HT (behaviour - exterior) It is stimulated by Nie Fa - Tuina It regularizes the energetic flows technique from solar plexus to brain13 Nei Chun Yin It calms the horse Behavioural problems Block of the hind limbs It relaxes Shen Wei Gen Back pain Lower Heater Locomotor System. Acute gastrointestinal diseases Hui Point for Bones and Joints Wei Ben Acute back pain Meeting Point of SI – BL - GV Middle Heater Shu Point of Chong Mai It is very important in emergency BL 11 (Dazhu) Course Point of energetic Wei Jian It energizes the body influences that flow along the Upper Heater spine12 Ting Point REFERENCES. 1 LR 1 (Dadun) Ben Point Longo F. Engrams and Synchronicity: The role It acts on Hock – Stifle - Shen of Acupuncture in Chronic – Rebel – Recurring Diseases. In Proceedings of 5th International It is stimulated by An Fa - Tuina Symposium Veterinary Acupuncturist of the technique Mediterranean, 2010 Paris, France. CV 1 (Huiyin) It invigorates Qi and Xue and it Longo F. Special Acupoints in Horse Acupuncture. Yin Shu activates Zhong Jin In: Proceedings of 6th International Symposium Meeting Point of CV - Chong Mai Veterinary Acupuncturist of the Mediterranean, - GV 2011 Barcelona, España. Hui Point of Yang 3 Wong E. Classico della purezza e della quiete. It acts on the lumbar area Edizioni Mediterranee, Roma 2006. BL 35 Diagnostic Point of the Hock 4 Chuan Y. Traditional Chinese Veterinary (Huiyang) It induces a correct position of Acupuncture and Moxibustion; China Agricoltural Sacrum Press, Beijing 2005. It improves Wei Qi 5 Silburn L. La Kundalini o l’energia del profondo; Block of the hind limbs Wei Gen Adelphi Editore, Milano, 1997. Back pain 6 Longo, F., Mayr G. Equine reproduktion aus sicht Acute gastrointestinal diseases Wei Ben der TCM. In: Proceedings of STVAH/AVSAH Acute back pain Congress, 2011, Herzberg in Asp, Switzerland. Spine diseases 7 Longo F. Management of the equine reproduction Wei Jian Back pain by acupuncture. In: Proceedings of 2nd International It is very important in emergency Symposium Veterinary Acupuncturist of the Mediterranean, 2007, Nice, France.
49 THE POINT A PUBLICATION OF THE INTERNATIONAL VETERINARY ACUPUNCTURE SOCIETY VOL.35 / NO. 4 November 2012 8 Longo F. Reproductive problems in the mare: Veterinary Acupuncturist of the Mediterranean, acupuncture therapy. In Proceedings of the 30° 2008, Mallorca, España. international congress on veterinary acupuncture 11 Longo F. Clinical employment of the acupoint – International Veterinary Acupuncture Society - Tai Yang in equine neurology. In: Proceedings of IVAS, 2004, Oostende, Belgium. 10th International Seminar of Italian Veterinary 9 Longo F., Po E., Rizzato G., Mislei B., Mari G. Acupuncture Society ItVAS – SIAV, 2009, Torino, Acupuncture treatment in persistent mating induced Italy. endometritis (PMIE) in the mare, proceedings 9th 12 Prade F. Yi King Mèdicale; Servranx Editions, National congress of Italian Animal Reproduction ‑ Bruxelles 1997. SIRA, 2011, Bari, Italy. 13 Aïvanhov O.M. Centri e Corpi Sottili; Edizioni 10 Longo F. Tai Yang and Du Mai: Motion and Skin in Prosveta, 2005. Horse. Proceedings of 3rd International Symposium
50 THE POINT A PUBLICATION OF THE INTERNATIONAL VETERINARY ACUPUNCTURE SOCIETY VOL.35 / NO. 4 November 2012 Herbs for Ruminants Cynthia Lankenau, DVM, CVA, CVCHM Ruminants are very efficient herbivores. Their saliva or too dry, if it feel hot or cold, and especially system is uniquely designed to maximally utilize the the underside color of the tongue. If there is any plant material they consume. Traditional Chinese blood stagnation, the underside will be very purple. I Herbal Medicine has a sophisticated herbal tradition in also always look at the color of the vaginal mucosa; the treatment of animals that has been recorded since looking to see if it is pale or injected. Goats, I usually the Shang Dynasty (1600 to 1100 B.C.) During the stick my finger in just behind the lower incisors and Western Zhou to the Spring- Autumn period (1100 try to feel, hot or cold, wet or dry. If they vocalize to 476 B.C.), full time veterinarians were already much, you can usually get a fairly good look at not tubing animals with herbal decoctions. With this only the surface but also the underside. Finally try long standing herbal tradition with thousands of years to see if there is any coating on the tongue. If there of clinical experience, Traditional Chinese Herbal is any tongue coating present, that is very significant medicine is wonderfully suited to treat a wide range of for a ruminant. A white tongue coating can indicate a medical conditions many of which have no effective very deep interior cold, yellow coat, excess damp heat. treatment with Western drug therapy. The pulse used in the cow is the coccygeal Due to the influence of the Flexner report, artery. In the beginning, just try to feel if it is very which developed the impetus to standardize medical strong or very thin. Most cows that I treat live in education with only a small percentage of the very small dairies and are used to being handled. In curriculum allowed for “alternative” modalities, our these cows the carotid pulse in the jugular groove medical training is very limited with great bias against can be used. In any larger herd, as soon as you start herbal traditional therapies. As Holistic practitioners, reaching around their neck, their pulse rate shoots up we have the ability to learn and use this powerful and the force with increase, supplying you with poor healing tool. Herbal Medicine is the perfect modality diagnostic information. With Goats (good luck!!!), I to blend into any clinical practice. often use the femoral or jugular. Surrogate pulses can also be used very effectively. To use Chinese Herbal Medicine properly, there must be an understanding of how an herbal With your tongue and pulse information prescription is made. Each individual patient must and from looking at the animal and examining and have a working Chinese diagnosis. This diagnosis palpating and listening, you can have a fairly good is based on that unique individuals “pattern of TCM diagnosis. For example, a cow with an acute disharmony”. IBR infection; her tongue would be red, her pulse surging and fast, her lungs would sound heavy and One of the basic diagnostic tools used to help wet. Your diagnosis would be an Excess of Heat/ differentiate the pattern is looking at the pulse and Damp in the Lungs. tongue. If there is Excess Heat, the tongue with be red and the pulse is strong and fast. If instead there is So now, Step 2: how to figure out what herbal a deficiency heat, the tongue could still be red but dry formula to use. Good News is that the Chinese have and the pulse would be instead thin, thready and fast. been working on these formulas for thousands of An Excess Cold would have a pale or purple tongue years. Once you have your basic diagnosis, you can with a strong but slow pulse. A deficiency Cold the go to a multitude of reference Herbal books that will tongue would still be pale, with the pulse being weak easily get you into the ballpark of the proper formula a deep. Ha, tongue diagnosis in a ruminant!! This can and since you would have taken a Chinese Herbal be a challenge. If the cows are feeling well enough to Class, it will be a piece of cake. be ruminating and clearing their noses, no problem, just look. But usually we see them when they are Every herb has a temperature, taste, direction feeling sick and aren’t. So when you do your oral of action, and some have strong affinities for specific exam, feel if the tongue is strong, if there is too much medians, or specific physiologic action. A Cold herb
51 THE POINT A PUBLICATION OF THE INTERNATIONAL VETERINARY ACUPUNCTURE SOCIETY VOL.35 / NO. 4 November 2012 will purge Heat and Fire and Cool the Blood. They disharmony, and then match that pattern with the are anti-inflammatory, anti-spasmodic, and sedative, a herbal formula that can balance the dis-eased pattern. cool herb will relieve heat, and resolves toxins. They will reduce fevers, detoxify, lower blood pressure, and Special notes: Dairy cows almost always soothe nerves. There are neutral herbs that have gentle have an underlying spleen qi or liver blood deficiency/ regulation effects which mediate and harmonize all stagnation. It is usually this underlying deficiency that of the herbs, the warm herbs promote circulation and makes them susceptible. If you are treating an excess alleviate chills by warming the interior and dispersing condition, always closely monitor as very cooling the Cold. Hot herbs actively tonify Yang Qi and herbs can injure the Spleen energy. Many cows will activate the channels; they improve organ functions have a Triple Heater Obstruction. They will present by stimulating and strengthening them. The taste or as if they are a Liver excess, make sure to palpate the flavor of an herb will reflect its chemical composition Gall Bladder points. It is easy to miss it. and will indicate its physiologic action. The five flavors are Sour, Bitter, Sweet, Pungent, Salty. (There Doses: Extract Granules: Two table spoon is also bland). Herbs that are sour have an astringent twice a day adult cow. 1 tsp twice daily for a goat. affect which contracts flaccid tissue; stops abnormal Herbal Powders - adult cow two tablespoons twice a secretions, promotes digestion, improve enzyme day; a goat: 1 tsp-1 tablespoon twice a day. Remember secretion and liver function. These herbs tend to that in any acute problem this dose can easily be have a high percentage of organic acids including increased 3-8 times. flavonoids. Bitter Herbs eliminate Heat-Damp and are anti-inflammatory; antipyretic; detoxifying; Herbs storage- Herbs need to be cool and dry increase bile secretion from the liver, and promotes and out of the direct sunlight. If there is any excessive the secretion of hydrochloric acid by the stomach. moisture, please be aware of any mold. Herbal Bitter herbs are high in alkaloids such as Berberine. suppliers should give an indication of the products Sweet herbs tonify, nourish, and soothe. These herbs shelf life. are high in saponins glycosides. Pungent herbs have a strong diaphoretic effect and stimulate the blood Herbs can be top dressed on grain, drenched, circulation to distribute the energy form the interior of or placed in gelatin capsule and pilled. the body to the surface. These pungent herbs are high in terpenoid volatile oils or other complex aromatic Tonic herbs can be given for long periods of compounds. Salty herbs soften hardness and purge the time unless there is an acute excess condition that intestines; they have a strong diuretic effect. Bland develops. Heat clearing herb should be stopped as herbs have a diuretic effect. soon as the problem has resolved.
So just by understanding the temperature and Meat and milk withholding: Personal flavor of an herb, you can already begin to understand conversation with Dr. Xie in 2002 was that there are what effect they will have on a body. A Warm and “no worries” about any residue. Of course, we worry pungent herb will ascend up and out. These would for our organic herds (or any herd) that is shipping be used to treat and invasion of a Wind Cold, for milk. There have been very few studies. I tell my milk example an herb like Ginger, Shen Jiang. On the other producers that while on any formula that has strong hand if you had a cold, bitter herb, they would have anti-bacterial effect, to hold the milk while on the a descending direction and could be used to excrete formula. In twenty years, I have had no problems. damp/heat and purge the intestines, for example an herb like rhubarb root, Da Huang. It is always a Chinese Herbal Medicine is at its heart fascinating lesson watching an animal graze. They exquisitely simple. Yet it also demands a life time of will crave the flavor plant they need if they are given study. With a basic foundation, it is with in the grasp the opportunity. of every practitioner to be able to recognize several key patterns of disharmony of many of our common This is the heart of Chinese Herbal Medicine. conditions and be able to match it with an appropriate First determine the patient’s unique pattern of herbal formula. 52 THE POINT A PUBLICATION OF THE INTERNATIONAL VETERINARY ACUPUNCTURE SOCIETY VOL.35 / NO. 4 November 2012 Favorite herbal formula for more specific conditions: additional sixteen blood invigorating, stasis removing Traumatic injuries can happen to any animal. and pain relieving herbs present. (The Great Mender) The first herbal formula to have on hand is a patent Any tongue with a blood stagnation diagnosis should Chinese Medicine called Yunnan Paiyao. This Herbal have a purple discoloration. The pulse should be formula is designed to stop bleeding, dispel blood tense. Caution should always be used with any blood stasis, disperse swelling, clear heat, resolves toxins, moving herb during pregnancy. This formula is and relieves pain. It can be used topically to stop advised to be prohibited during pregnancy. I usually bleedings in traumatic wounds including dehorning give an adult cow 20-30 tea pills two to three times a wounds and castration wounds. It also will prevent day; a goat would receive 8 three times a day. infection. Internally it can be taken for any swelling or bruising for acute trauma, also from postpartum Another formula that is indicated in cases of hemorrhage. This makes it one of my most favorite trauma or generalized Blood stagnation is Shen Tong herbs to use for any calving or kidding or lambing Zhu Yu Tang. I use this formula frequently toward the trauma. If there seems to be any septic nature from end of the winter when the cows are achy and stiff or a retained placenta, it helps both as an intrauterine for any residual stiffness from a slip on the concrete. infusion and as an oral anti-septic. It is helpful for The main formula is prohibited during pregnancy nosebleeds, blood in the stool. It is very helpful since there are so many Blood moving herbs in the in some cases of BVD (Bovine Viral Diarrhea) or formula. For pregnant animals, I use a variation bleeding abomasal ulcers. In clinical studies it has produced by Jing Tang Herbal Company called Body been shown to reduce clotting time by 33 % to 50%. Sore for Pregnant Mom. This formula has only two The complete formula has never been revealed but the mild herbal blood movers; Corydalis, Yan Hu Suo, main ingredient is Notoginseng, Sheng Tian Qi. The which moves Qi and Blood and resolves stagnation formula is both anti-bacterial and hemostatic. The and relieves pain and Leonurus, Yi Mu Cao, which formula comes with a “little red pill”, which is to be also moves Qi and Blood and benefits the pregnant taken to prevent shock from blood loss. This herbal Mom. The tongue of an indicated animal could be product is indicated for any traumatized bleeding normal or a little purple; the pulse would be fast. It is animal with any pulse or tongue diagnosis. I even safe to use this herb for months. Dose: large Holstein- had this formula give marked relief to a cow that 3-4 tablespoons twice a day if needed, a small Jersey- was severely affected with Hardware disease. This one to two tablespoons twice a day. formula should be used with caution if pregnant. Dose: one vial twice a day for a cow; one capsule Many of my clients have some very old twice a day for a goat or calf. animals. One dairy that I go to has five 19 year old Holsteins that are still milking. Many of these Another patent Chinese Medicine that is old girls have developed some significant low back wonderful for acute trauma, kicks, and bruises is Jin arthritis. They show poor signs of heat and have a Gu Die Shang Wan, “Muscle, Bone Traumatic Injury tendency to step on their teats. Milk production is Pill”. This is an excellent medicine for acute trauma poor when out on grass since they really don’t want with swelling or even chronic swelling and pain from to walk much. Caution must be used if pregnant, but old injuries. It invigorates blood, breaks blood stasis, I use this commonly when we have not been able to tonifies blood, stops bleeding, strengthens sinew and see signs of heat due to a perceived pain issue in a bone, dredges and opens the channels and collaterals well cycling cow. A formula modified for four- legged and relieves pain. I have used this formula with great patients from a two-legged formula is Equine Du results in cases of broken bones with a splint on, Huo made by Jing Tang. The main indication for ruptured cruciate ligaments in cows, or heifers that this formula is back pain, chronic joint pain, arthritis, have been bred by a bull that was too big. It is also rheumatism and old chronic injuries in animals that wonderful for stepped on teats. Its main ingredients are Kidney Yang deficient. The tongue will be pale are Notoginseng, Sheng Tian Qi; Daemonorops, Xue and cold, the pulse is weak and deep. The main herb Jie; Angelica, Dang Gui Wei; Boswellia, Ru Xiang; in this formula is Angelica, Du Huo which relieves Myrrha, Mo Yao; and Carthamus, Hong Hua. The pain and eliminated Wind-Cold –Damp. Also in the brand I use is from Plum Flower and is has and formula is Epimedium, Yin Yang Huo, which is a great
53 THE POINT A PUBLICATION OF THE INTERNATIONAL VETERINARY ACUPUNCTURE SOCIETY VOL.35 / NO. 4 November 2012 herb to help will infertility problems which are caused is given a variation on the classic Spleen qi tonic Si by a Kidney deficiency. For the pregnant animals, in Jun Zi Tang called Wei Qi Booster. A pure tonic is the cold weather often added top dressing a bit Fennel contraindicated in the presence of a fever and acute and Cinnamon will also warm the low back. infection or inflammation. There are many formulas available for intestinal enteritis but in almost all of Disease of the Young are often met with these cases there is a severe Spleen Qi deficiency. Hot difficulties. They have minimal resistance to the toxin eliminating herbs can damage the Spleen Qi yet invasion of pathogenic influences. Many herbal the secondary pathogen must be cleared. Pure Spleen formulas are able to strengthen these young animals tonification is not indicated in face of high fever and allowing them to overcome their disease. I just infection. One must balance these two opposing recently had one calf that was born with no conscious patterns of disharmony. Shen. Her core autonomic nervous system was functioning but there was no connection between her When Bovine Viral Diarrhea is suspected, Zhi Heart and Kidney. I ground up 40 tea pills of Sang Li Tang is a favorite formula. It is available today Piao Xiao Wan and we tube fed her the mixture. through Jing Tang as Red Back Door. This formula Within a few hours, she was up and nursing. The uses the Coptis Resolve Toxin Pills, Huang Lian Jie formula connects a disconnected Heart and Kidney. Du Wan; Coptis, Huang Lian; Scutellaria, Huang It uses Sang Piao Xiao, Ootheca Mantidis, to tonify Qin; Phellodendron, Huang Bai; and Gardenia, Zhi the Kidney and nourish the essence. Long Gu, Os Zi to Clear the Damp Heat from the entire body and Draconis, calms the shen and stabilizes the essence; detoxify, with Sanguisorba, Di Yu to cool the blood Gui Ban, Plastrum Testudinis, to nourish the yin and and stop bleeding with several blood nourishing and tonify the heart and kidney; Ren Shen, Ginseng, and qi tonifying herbs. The dose is cows would be two Dang Gui, Angelica sinensis, to tonify Qi and Blood, tablespoons two or three times a day. Huo Xiang and Yuan Zhi, Polygala root, Shi Chang Pu, Acori Zheng Qi Wan is another herbal formula to consider Tatarinowii, and Fu Shen, Poria Paradicis, to calm the with not only calf or kid diarrhea but also for adult Shen and to restore harmony to the Heart and Kidney. animals. There is a synergistic pairing of two herbs, The incredible thing is that this formula used primarily Agastache, Huo Xiang, and Perilla, Zi Su Ye, that for bed-wetting, yet it fit the pattern of disconnect work against aerobic bacteria such as Salmonella. between the Heart and Kidney and was able to This formula dispels pathogenic factors, resolves the reconnect them. This case reminded me to never be exterior, clears summer heat and dispels damp, dispels limited in your thinking in regards to herbal medicine. turbidity, stems counter flow ascent of Stomach qi, harmonizes the middle jiao, and relieves diarrhea. This Diarrheal diseases are difficult because the formula deals the best with severe phlegm. The pulse root problem is a lack of Wei Qi that was not given to in the animal should reflect this by being very slippery. the young properly. (Colostrum) So there is a Spleen qi deficiency with a pathogenic factor of phlegm Coccidiosis is often a frustrating condition to since the animal is unable to properly transform and treat in that the environmental hygiene is the causative transport any food. They are then totally susceptible issue. Of the many herbal formulas available to to an invasion of either with Heat or Cold-Damp. To help this situation, I have found Health Concerns, control the pathogenic factor, the core herbal formula Aquilaria 22 to be of the most help in decreasing the I use is Mume Powder, a Jing Tang product. This number of oocytes shed and controlling the diarrhea. formula is designed to treat diarrhea in young due to The formula is composed of herbs that directly kill bacteria, viruses or parasites. This formula clears the parasites, support the spleen function, move intestinal heat, detoxifies and astringently stops the diarrhea. It qi and resolve intestinal damp. The dose I use is three contains Coptis, Huang Lian; Curcuma, Jiang Huang, tabs times a day for a calf; one tab three times a day Mume, Wu Mei; and Terminalis Chebula, He Zi. A for a kid or lamb. typical dose given is; kids or lambs is 1/2 tsp twice a day; for Calves 1-2 tsp twice a day. But these Navel infections can often lead to life animals need more Wei Qi support and Spleen qi threatening sequela. Chuan Xin Lian is a patent tonification so at least once a day; the affected animal Chinese Medicine which contains Andrographis, 54 THE POINT A PUBLICATION OF THE INTERNATIONAL VETERINARY ACUPUNCTURE SOCIETY VOL.35 / NO. 4 November 2012 Chuan Xin Lian; Taraxacum, Pu gong Ying; and pneumonia with abscess formation, Wei Jing Tang is Isatis, Ban Lan Gen. This formula is very effective often very helpful to clear this final lung heat/damp. for acute heat toxin inflammation of the blood, lymph, Phragmites, Lu Gen and Isatis, Ban Lan Gen clear and at the organ level. Xian Fang Huo Ming Yin Lung heat; Cordyceps, Dong Gua Zi, and Platycodon, is the Sublime Formula for Sustaining Life. This Jie Geng, transform phlegm and dispel pus; Persica, formula can help in the early onset of abscess and Tao Ren, moves blood; and Coix, Yi Yi Ren is used to sores not only naval abscesses but also very useful drain damp and dispel pus. In all of these acute febrile in treating Joint Ill and Caseous Lymphangitis. Jin diseases, the tongue should be red with a surging fast Yin Hua, Lonicera, clear heat and eliminates toxins; pulse. (There are many, many formulas for invasion Fang Feng, Radix Saposhnikoviae, and Bai Zhi, of Lung-Heat/Damp. I find that often every farm has Angelica Dahurica, disperse and dispel heat toxins; a specific formula that works the best. It has been a Dang Gui Wei, tips of Angelica sinensis, Chi Shao, matter of diligently working through these patterns Red Peony, Ru Xiang, Frankincense, and Mo Yao, to find the best formula that best fits each individual Myrrha, activate blood circulation and remove blood farm’s energy.) circulation; Bei Mu, Fritillary, and Tian Hua Fen, Trichosanthes, resolves phlegm, clear heat, reduce Metritis is a common problem. Sheng Hua selling, dispels pus, and break hardness Chuan Tang is a formula useful for blood stagnation at the Shan Jia, Squama Manis, and Zao Jiao Ci, Spina uterus, smelly uterine discharge, and poor uterine Gleditsiae, drain abscess and soften nodules; Chen Pi, involution. This formula would be used very soon Pericarpium Citri Reticulatae, regulates Qi flow; and after kidding or calving when there is an initial Gan Cao clears heat, eliminates toxins and harmonizes retained placenta. The tongue would be purplish the Stomach. Both of these formulas are cooling and reflecting the blood stagnation with a choppy pulse. caution must be used if the calf or kid has Spleen or The herbs used in this formula Angelica, Dang Gui, Stomach deficiencies. The tongue color in an indicated and Ligusticum, Chuan Xiong, move blood to resolve patient would be red with a surging and fast pulse. The the stagnation. Dang Gui is a great blood tonic also to formula Shi Liu Wei Liu Qi Yin will also treat nodules build the animals up after giving birth. Persica, Tao and inflammation of the lymph glands and will also Ren is used to break down the blood stasis, ginger, tonify qi and blood making this formula a favorite if Gan Jiang to warm the uterus, and Licorice, Gan Cao there is a severe underlying deficiency of qi or blood. to harmonize the formula. If the metritis becomes It incorporates in Si Wu Tang, the premiere blood longer standing, often Bai Che San is needed to Tonic, with Si Jun Zi Tang, the premier Qi tonic with clear the damp-heat from the uterus. This formula several herbs that activate qi and blood circulation, actively drains Damp-Heat for the lower Jiao by using and disperse stagnation and drain pus. In the bulk Phellodendron, Huang Lian, and Plantago, Che Qian herbal powders, the typical dose for a calf is up to a Zi. There are two formulas that are excellent for tablespoon three times a day, a kid would receive one acute mastitis and metritis, when the cow or goat has teaspoon three times a day. a high fever. The first is Long Dan Xie Gan Tang. This formula is great for any excess Damp/ Heat. The Infectious Disease: In cows, Infectious tongue would be red and wet and the pulse fast and Bovine Rhinotracheitis and secondary Pasturella surging. LDXGT is useful for mastitis when the udder pneumonia is always a worry. A simple very useful is hot and swollen with lots of thick clots, pink eye, formula for many types of viral diseases that has high metritis, hepatitis, and foot rot. Long Dan, Gentian fevers is Huang Lian Jie Du Tang. This is a beautiful sedates the fire in the Gallbladder and Liver and clears formula that clears excess heat, fire and toxins in the damp/heat in the lower Jiao; Huang Qin, Scutellaria, total body. Yin Qiao San is a formula with strong and Zhi Zi, Gardenia, sedate the fire and damp-heat in action against viral infections. It uses Lonicera, Jin all three jiaos; Ze Xia, Alismatis, Mu Tong, Akebia, Yin Hua, and forsythia, Lian Qiao, as the King herbs and Che Qian Zi, Plantago, dispel damp-heat through to clear the heat toxin. Jing Tang has a slight variation the urine; Shen Di Huang, Rehmannia, and Dang Gui, of the classic formula modified for horses that I Angelica sinensis nourish and protect the yin and have found to work better on cows than the classic blood; Chai Hu, Bupleurum, regulates Liver Qi ; Gan formula. If the disease has progressed into bacterial Cao, Licorice, harmonizes the formula. If the animal
55 THE POINT A PUBLICATION OF THE INTERNATIONAL VETERINARY ACUPUNCTURE SOCIETY VOL.35 / NO. 4 November 2012 is very spleen deficient and cannot tolerate strong heat cows’ tongues remain cold and pale even after she has clearing herbs, Si Miao San is a formula to use. The received Calcium IV and they seem to be the ones that tongues will red and damp, the pulse would be weaker are more predisposed to acute cardiac problems while and more slippery. Si Miao San is a beautifully simple receiving IV Calcium. Once she is up, she must be formula containing Cang Zhu (Atractylodes), Huai watched closely because this is when, with Chinese Niu Xi (Achryanthes), Yi Yi Ren (Coix Seed), and Herbal Medicine, we can prevent the spiral of Ketosis Huang Bai (Phellodendron bark). and Displaced Abomasums.
Metabolic diseases are an issue. I find that If the animals’ Liver Blood is slightly deficient, almost all dairy cows have some type of an underlying her tongue will be pale and dry; pulse will be thinner Spleen qi deficiency with then Qi stagnation with often and fast. She will tend to have dry eyes, and be a bit concurrent Liver Blood deficiency with then Liver irritable, kicking at the milker and more intolerant of Blood Stagnation. Then whole mess can fulminate as milking procedures. A true Liver Blood deficiency an acute Damp/Heat obstruction in the Triple Heater can be treated with Yi Guan Jian, but I rarely use Meridian with an acute Right Torsed Abomasum or this formula because I always want to also tonify extreme nervous ketosis. (But occasionally there the Spleen. A better choice would be Xiao Yao San is Cold invasion in the Liver Meridian which is a or Dang Gui Shao Yao San. Xiao Yao San is the completely different pattern with Fennel as the herb of formula of choice when Liver Blood Deficiency is choice.) General rule that I have learned, always use a adversely affecting Spleen function. I use this formula formula that will also treat the next anticipated pattern frequently to prevent and treat ketosis. It helps Liver because it will always occur. So, if she looks like a Blood deficiency, Spleen Qi deficiency and Liver simple Qi deficiency, make sure you also anticipate Qi Stagnation.; your picture of a ketotic Jersey cow. the need for a qi mover because these girls can crash Dang Gui Shao Yao is helpful when there are more so fast due to their fragile metabolic state. Milk Fever signs of Dampness. The tongue would be wetter and is an example of extreme Spleen Qi deficiency with the pulse would be slippery. The cows that seem to a possible concurrent Kidney qi/yang exhaustion. respond better to this formula look a bit bloated. They Their tongues are cold and wet and swollen. Pulses are the ones you would swear have a DA, but none are deep and slow. A favorite formula for this is Bu are found. When Dampness is acting as a significant Zhong Yi Qi Tang. It is very important that you use internal pathogen, firstly there can be severe qi a formula that uses real Ginseng (Ren Shen) and not stagnation which manifests as a Left Displaced replaced with Codonopsis (Dang Shen). BZYQT Abomasum. At this stage, I also use Xiang Sha Liu uses Ginseng, Ren Shen, and Astragalus, Huang Qi Jun Zi Tang. This formula is the Four Gentlemen to tonify the Qi; Atractylodes, Bai Zhu, to tonify Qi with Ban Xia, Pinellia, and Chen Pi, Citrus, to break and strengthen Spleen; Citrus, Chen Pi is a qi mover up qi and damp stagnation and correct the reserved to resolve stagnation; Angelica, Dang Gui, is used flow of qi with Mu Xiang, Aucklandia and Sha Ren, to nourish blood; and very importantly to prevent a Amomum, to warm the middle jiao and activate qi uterine prolapse and to help her pick her rear end up, circulation and relieve fullness. But is this Dampness is Bupleurum, Chai Hu, and Cimicifuga, Sheng Ma; and qi stagnation is not resolved immediately, Gan Cao, Licorice us used to harmonize the formula. obstruction of the Triple Heater is imminent. This is Severe Spleen exhaustion seems often to create or when she is dying from a Right Torsed Abomasum. predispose her to a disconnection of their Kidney Triple Heat Obstruction can be life-threatening. Xiao Yin and Yang, making it impossible for her to get up. Chai Hu is one of the few formulas that can rescue Rehmannia 8, Ba Wei Di Huang Wan, is often needed. this situation. This is one of the only formulas that Ba Wei Di Huang Wan can reestablish the kidney can expel this deeply penetrated pathogen that has yin and yang energy. It uses the premier Kidney yin lodged in the Shao Yang level. This formula uses cool tonic. Liu Wei Di Huang Wan, of Rehmannia, Shu Di and pungent Bupleurum to expel the pathogen from Huang; Shan Zhu Yu, Cornus, Shan Yao, Dioscorea, the Shao Yang level, while bitter and cool Scutellaria, and Fu Ling, Poria; Mu Dan Pi, Moutan; Ze Xie, Huang Qin, descends the yang energy back into the Alismatis; with two Kidney Yang herbs, Rou Gui, lower burner; Ginseng (Ren Shen), Jujube (Da Zao), Cinnamon bark, and Fu Zi, Prepared Aconite. These and Licorice (Gan Cao) treat the Qi deficiency, while 56 THE POINT A PUBLICATION OF THE INTERNATIONAL VETERINARY ACUPUNCTURE SOCIETY VOL.35 / NO. 4 November 2012 Pinellia (Ban Xie) transforms the pathogenic phlegm. Reference: Ginger also harmonizes the middle jiao. One of the 1. IVAS Course in Chinese Herbal Medicine: diagnostic aids for this syndrome is the amazing Lecture Notes, 2008 reactivity on the GB acupuncture points. GB 25 in 2. Chi Institute of Chinese Medicine: Chinese particular will be very painful. This formula is also Veterinary Herbal Medicine; Training Program, very useful for abomasal Lymphoma. www.chi-institute.com. 2002. 3. Dharmananda, Subhuti; Chinese Herbology: Nervous ketosis is also an example of Triple A Professional Training Program, Institute for Heater obstruction when the animal has lost her Traditional Medicine and Preventative Health mind. Liver Blood stagnation usually has led to Care, 1992. liver stagnation which creates heat and it is this heat 4. Chen and Chen, “Chinese Herbal Formula and pathogen that obstructions the Triple Heater and Applications”, Art of Medicine Press, Inc., 2009. allows the Liver Fire to flare upwards into her mind. 5. CIVT; IVAS Course in Chinese Herbal Medicine:, A variation of Xiao Chai Hu is used; Chai Hu Long Lecture Notes, 2008. Gu Mu Li Tang. This is Bupleurum with Dragon 6. Fratkin, Jake P., “Chinese Herbal Patent Bone and Oyster Shell. The heavy minerals in Oyster Medicines, The Clinical Desk Reference”, 2001. Shell and Dragon Bone help drag her mind back down 7. Xie, Huisheng; “Chinese Veterinary Herbal into her body. Gui Zhi (Cinnamon twig) with Poria Handbook”, Chi Institute of Chinese Medicine, (Fu Ling) are added to leech more damp out of the 2004. Triple heater Rhubarb root (Da Huang) is added to aid in conducting any heat pathogen out through the Qi or Herbal Suppliers: Yang Ming Level. There are many good quality sources; I apologize for those I omitted As you can see, with thirty different formulas, Patent Chinese Herbs: Mayway Corporation, 1338 the majority of serious ruminant issues can be treated Mandela Parkway, Oakland, CA, 94607; www. in an effective and safe manner. Of course there are mayway.com several hundreds of issues this paper did not have Bulk Powdered Herbs: Dr. Xie’s Jing Tang Herbs, Inc., time to address, but any pattern of disharmony can Reddick, Fl, 32686. be addressed through Chinese Herbal Medicine. 8. Herbal tinctures: K’an with Natural Path herbs (A Herbivores are meant to eat Herbs!! This is a Time to Heal also carries these herbs), Santa Cruz, wonderful addition to any practitioner’s arsenal of CA; www.kanherb.com therapeutic weapons. 9. Extract Granules: Sun Ten Laboratories, 9250 Jeronimo Drive, Irvine, CA 92618; KCP Product Inc., Irvine, CA, 92618; www.kpc.com Herbal tablets: Health Concerns, 8001 Capwell Drive, Oakland, CA 94621
57 THE POINT A PUBLICATION OF THE INTERNATIONAL VETERINARY ACUPUNCTURE SOCIETY VOL.35 / NO. 4 November 2012 Yin and what it Means in a Quantum Holographic World Kimberly Henneman, DVM, Dipl ABT, FAAVA, CVA, CVC Animal Health Options Park City, Utah, USA “Every great and deep difficulty bears in itself its own solution. It forces us to change our thinking in order to find it.”– Niels Bohr (Nobel Prize Quantum Physicist)
INTRODUCTION: (much like the ancient Chinese explanations of Yin The duality of Yin and Yang is one of the most and Yang). It looks to explain why subatomic particles important concepts of Traditional Chinese Medicine, don’t follow the universal laws of Newtonian physics. whether in human or veterinary practice. Even among It looks at the world as relationships in states of being acupuncture practitioners, there is currently often- and the probabilities of being there. In other words, it heated discussion that these ancient foundations have sounds a great deal like Chinese medicine. nothing to do with modern scientific principles and cannot be substantiated with evidence-based medicine Current medical research has been slow to (EBM). The use of the modern medical theories has incorporate a quantum paradigm even though many explained acupuncture to a point and now seems to be traditionally non-physics-based disciplines have stuck; this has lead to a ‘duality’ in acupuncture and not. Ground-breaking research combining fractal, a breaking off of groups who say that they can only holographic, locality & non-locality, nonlinear practice that part of acupuncture that fits within these dynamics, network and quantum field theories with theories and paradigms. But here lies the problem. the fields of biology, neurology, pharmacology and psychoneuroimmunology (to name a few) are starting Acupuncture has always been described to provide insights into not only viewing the body and taught through ancient times as a modality organism as a whole that is both greater and different that manipulates total Qi or body energy through than the sum of its parts, but also the future integration the recognition body part relationships that have of established ancient medical techniques and modern strayed from a healthy state of harmonious balance. healing medicine that can beneficial to the TCVM The majority of modern Western medical research practitioner, our patients and society in general. models are still based in mechanistic and Newtonian physics paradigms - paradigms that reduce the In this presentation and discussion, we will behavior of large objects such as planets and apples look briefly at how the holographic and quantum to following simple universal laws. While these models of particle and wave behavior patterns, as universal laws of Newtonian physics are adequate well as new research in biological tissue and water for a more reductionist medical model that is based molecular structures, both in vivo and in vitro, may on understanding ad nauseum about the parts that support and provide explanations for many of the make up the whole, they do not and cannot account ancient foundational teachings of Yin function in the for the type of energetic and functional behavior that body. occurs within the whole organism. Thus we now are witness to Western medicine’s current failure to ‘fix’ While it is impossible to truly practice TCVM (much less understand the cause) of many deeply without using the dual nature of Yin within Yang rooted and chronic disease states such as cancer, and Yang within Yin, for the purposes of this and immune‑mediated, Alzheimer’s and depression (just to subsequent presentation, only Yin will be discussed name a very few). on its (mostly) own. True, this is the reductionist approach that has shown such limitations in medicine. But over the past century, a gradual paradigm But life at all levels is about duality, even here. shift in thinking has been occurring with the Within a reductionist systems approach can come development of quantum physics. Quantum physics understanding of the parts (or particles) that make looks at the duality of particles and waves – both of up the quantum paradigm (or totality, systems or which are interconnected and cannot be separated holographic approach – it still lacks consensus on
58 THE POINT A PUBLICATION OF THE INTERNATIONAL VETERINARY ACUPUNCTURE SOCIETY VOL.35 / NO. 4 November 2012 what to call it); within the quantum paradigm there particular behavior is measured at a particular time, are still the individual parts that have the relationships that is the behavior always. (1) Reductionism applied to that make the greater whole. Similar to how the medicine is thinking in a two-dimensional algorithm ‘Unifying Theory’ resolving the inconsistencies of ‘if this, then that’. There are even those groups in between Newtonian and Quantum thought is currently medicine which claim to subscribe to a ‘wholistic’ the Holy Grail of physics, medicine’s ability to merge, paradigm of ‘the whole is more than and different integrate, include the dualities of both reductionist from the sum of its parts’, yet still reduce it. As and holographic approaches in a clinical and research Pribram states, “because they can discern emergent approach is the answer that will move medicine into properties as they investigate higher orders and can try a new era. Therefore, the veterinary practitioner is to reduce the higher order to the lower ones either as encouraged to rebuild this ‘Yin particle’ discussion to their properties or the theoretical terms that describe back into a more enriched and complete understanding their relations.”(2) An example in practice: five horses of the total power and potential of not only the may present with such varying signs as weight loss, principles of TCVM, but also the importance of the refusal to enter an arena, bucking after jumping or practitioner-healer’s own place in this process. The diarrhea. They may all have different tongue and same can be recommended when looking at the pulse presentations (symptom patterns) to a quantum, particles of ‘Yang’. TCVM practitioner, but to a more conventional Western veterinarian, they may all be diagnosed with PATTERNS AND MEDICAL SYSTEMS: gastric ulcers and all put on the same pharmaceutical No matter where they happen in the infinite treatment. The variable differences between each of time and/or space, the healing arts, as practiced by individual are reduced to focus on the common humans, is simply about the recognition of a pattern symptoms. of state of dis-ease. Through collective experience of clinical observation, data recording and research, In a ‘Wholistic’, ‘Systemic’ or ‘Holographic’ a single or group of like-minded practitioners gives system of pattern recognition, knowledge of each a certain pattern of symptoms a naming ritual and and every discrete part is expanded into a dynamic derives a (hopefully) successful treatment. The only understanding of the relationships over space of time difference between the many paradigms, approaches, of all of the parts within the whole. All aspects and and techniques of medicine developed over the parts of a pattern are entangled throughout a dynamic millennia throughout the world is in the perception everywhere and every when with no linear cause and of the pattern and how the disease patterns are put effect. (2) In other words, one part can affect other parts together. Disease symptoms can be combined in that are not near in space or time. This is a concept numerous ways to make numerous patterns. Conflict understood by many integrative practitioners, but one seems to regularly occur between the practitioners that is still ignored by more conventional Western of systems that are reductionist (emphasizes a linear, science and research. static, non-branching knowledge of the discrete parts and commonalities of the whole) and those that are Newtonian-based medicine treats organisms systemic (emphasizes all of the dynamic and mutable relationships that occur between the parts that are encompassed within the whole). Organisms are patterns of particles
Proponents of both systems believe that the current Western medical reductionist system perceives Particles are patterns of energy patterns so differently than those formulated by the Eastern medicine ‘totality’, ‘systemic’ or ‘wholistic’ systems, that the two have little to no common ground. Quantum-based medicine treats energy, vital force, Qi A reductionist system is based on a linear, static, Newtonian paradigm; everything can be explained Both systems have their own strengths and by knowing and understanding the behavior of each weaknesses, validated with successful research and and every discrete building block; additionally, if a treatments of suffering humans and ailing animals.
59 THE POINT A PUBLICATION OF THE INTERNATIONAL VETERINARY ACUPUNCTURE SOCIETY VOL.35 / NO. 4 November 2012 What is needed in medicine is much as what is being regarding where to place certain acupuncture points searched for in physics - a unifying theory that brings such as LI4 and LV3. It may very well be that the lack the two systems together. On close look, they are not of consensus of location of these points (even in the as far apart as it would seem. We can all agree that same individual practitioner in different patients) may diseased biological organisms are apparently made of be that the probability of a point being in a specific matter. Matter is made of patterns (quantum physics location varies with the individual circumstance. would say these are unfocused patterns). Organisms are patterns of organs, organs are patterns of cells, The second component is the Heisenberg cells are patterns of molecules, molecules are patterns Uncertainty Principle which states that in quantum of atoms, atoms are patterns of subatomic particles systems, it is a given that you cannot accurately and subatomic particles are patterns of energy. measure two values at the same time (usually position -YIN- and momentum -YANG, but it can also be Using a holographic, quantum paradigm in applied to time-YIN- and energy-YANG). In the biological systems is slowly starting to take hold in process of trying to precisely measure one value, the research as demonstrated by recent work done in less precisely you can measure the other. As we will the fields of neurology and biophysics which will be see when we look at new quantum biophysics research discussed later. First, we need to have a little review on acupuncture meridians, this will be important when (or explanation) of the basics of quantum theory. designing AND interpreting research looking at wave propagation along meridians. QUANTUM MECHANICS IN AN INFINITE ACUPUNCTURE NUTSHELL: Third, but not least is what is called the When one mentions quantum theory to the “observer effect” in particle physics. This states that average medical person (physician and veterinarian the act of measuring a particle or wave behaving in alike), most people immediately think of Albert a certain way will alter the way that particle or wave Einstein...and end of discussion. When pressed, some is behaving. It’s the same as you suddenly paying can dredge the words ‘special’ and ‘general’ and attention to breathing after your meditation instructor ‘relativity’ from the depths of memory (which has tells you to start noticing your breath, but without recently shown to be stored in a quantum way and changing it (4, 5). recalled in a Newtonian way – duality at work in the real world) (3). The basic tenant of quantum theory So what does this ‘observer effect’ mean to the is that all matter exists as a duality of particles and average practitioner? First, it means if acupuncture waves that act independently of, yet dependently to, is behaving according to quantum mechanical each other – much like the ancient Chinese foundation paradigms, then measuring acupuncture effects and theory of Yin and Yang. Subatomic particles such as responses using Newtonian principles could result electrons, protons, mesons and quarks are discrete, in vague or negative results. If you are using a information and physical entities (as much as one can two dimensional measuring tool to describe a three be to a quantum physicist) with mass (Yin) which dimensional object, then it is a given that a full picture move in energy waves (Yang). No matter where you of the object is impossible to obtain. That doesn’t are in quantum theory, just as in Traditional Chinese mean that useful information won’t be gathered. But thought, it all boils down to the duality. it will be the equivalent of trying to create a functional picture of a dog’s abdomen or a horse’s foot at a given Additionally, there are three key components moment by using a single radiograph or MRI. of quantum theory. The first is: life is all about probabilities, not givens. No one ever really knows This makes it critical for acupuncture where a particle (or wave) is even as you prepare practitioners to take study design into account when to measure it. To the quantum physicist, you can performing or interpreting acupuncture research. only guess the probability that you are going to Newtonian-based problem solving (ie current know where something is, more or less…Remember double-blind, controlled studies) says that a single, this, because this may play an important role in the measurable outcome will or will not occur in response discussion and lack of agreement among practitioners to a particular question. Duality or quantum theory 60 THE POINT A PUBLICATION OF THE INTERNATIONAL VETERINARY ACUPUNCTURE SOCIETY VOL.35 / NO. 4 November 2012 states that the observer has only a probability that generated from the pressure entrance of the rock into the right packet of information will be measured. the water (much like a needle into tissue). Interference But which packet (or quantum)? And just because would occur when the waves from different sources you miss measuring it, can you say that the packet (including the original coherent waves from one of of information truly does or doesn’t exist? Each and our rocks after bouncing off a new object like a log or every case we work on in practice is essentially its a beach) collide into each other. The more coherent own research study. The hypothesis question must (fixed or pure phase) a wave is, the higher resolution be asked within the paradigm to result in relevant the interference pattern will be; thus, holographic and meaningful results. Is it a particle or wave pictures as people know them today only came into (understanding that the particle is part of the wave being with the invention of the laser – the most pure and the wave moves the particle); is it Yin or Yang and coherent light wave that can be generated (at this (understanding that Yin is within Yang and Yang is time). within Yin). If you were standing on the shore watching Second, each and every case should be the pattern from your rock, the collision of the waves treated as its own research case. If a practitioner would create a dynamic interplay of interwoven approaches an animal with a symptom pattern thinking pattern that would spread across the pond. This in a Newtonian ‘if I do this point, then this effect is a holograph being created. In the early 1800’s, will occur’, then quantum probability states that this pattern was mathematically described by sometimes this is probably true. So a practitioner Baron Jean Fourier (2) so this pattern of changing who is struggling with the paradigm shift should not information from a space-time coordinate system to be disheartened if no response to a needle occurs a total spectrum system (properties of the original (although clients are likely to be). Instead, the image are spread throughout the system) is called a experiment (treatment) may need to be performed Fourier transformation. Important for us to know again or one should reformulate the question of as acupuncture practitioners is that the Fourier how to treat (and inform the client of that too). In transformation can move in both directions: space- the author’s experience, figuring out how to ask the time, two-dimensional information can be represented question (eg. how to I get this dang lameness to go as a multi-dimensional image and a multi-dimensional away with this needle?) a different way, usually with image can be transformed back into two-dimensional owner participation, has led to insights into new information. We shall see with current research on packets of acupuncture information…learning in a neural webs that this is exactly how it is thought that quantum paradigm. And when we are moving into the nervous system may function – it can flip back an age where ancient acupuncture authors are starting and forth between transforming space-time coordinate to sound like modern quantum physicists and modern systems into holographic ones and vice versa. quantum physicists are starting to sound like ancient authors, then you know which paradigm must be used. First, let’s go through how a visual holograph similar to those on credit cards is created with laser THE HOLOGRAM – CREATING A THREE light. First a recording medium (each type of wave DIMENSIONAL IMAGE: must have its own type of recording medium) is A hologram is a multi-dimensional used to capture two different beams of laser light representation (re-presentation) of a multi-dimensional originating from the same source. The beam is split object created by wave interference patterns6,7. An into two with one bouncing off of the object of interest interference pattern is created when the crests and and then onto a special plate; the second is bounced troughs of waves containing particles of light or sound through mirrors and a diffusing lens (which unfocuses collide into each other, thereby creating a pattern the light but does not change its wavelength) before of wave cancellations and enhancements; the most colliding with the first beam on the same plate (much common example of this is pattern of waves that like a wave from one rock hitting its own bounced would occur if a stone were dropped into still water of back wave). The interference pattern (or Fourier a pond with a beach and submerged logs. Coherent transformation) looks like a bunch of circles and lines. waves would be the original ones in the same phases
61 THE POINT A PUBLICATION OF THE INTERNATIONAL VETERINARY ACUPUNCTURE SOCIETY VOL.35 / NO. 4 November 2012 though a kidney looks and functions differently from a heart, it still contains the genetic information to create a heart. This also is the link between local and non-local causality; changing a pattern in one area (as we often do by generating information- containing pressure waves in water-laden tissue with needle insertion) in theory should be able change the larger pattern of the hologram. While this theory for acupuncture has yet to be completely validated with research, the discovery of the necessary items for creating bio-holographs have been found with the discovery of stable water clusters, the presence of interference patterns, and sound wave and electrical propagation along meridians. And there is certainly enough body of anecdotal proof for local vs non-local needle cause-and-effect that has accumulated over thousands of years.
Figure 1: Creating a hologram (from Talbot M, The As mentioned before, holographic Holographic Universe, 1991)6 representations (images) can be created with Creating the hologram is only the first half of the more than just light waves. In the modern world, story. The multi-dimensional image as we have come acupuncture practitioners may not be aware of other to recognize is actually created by shining a different validations of holographic approaches in other fields. laser onto the recording of the object. Re-expose the Electron and acoustic holography using electrical recording of the original information to new packets of and sound waves already have been validated and energy and the three-dimensional holographic image are developing commercial applications. The Nobel is created. Key to the holograph is that because the Prize-winning physicist who discovered holographs, original image was created by light that was scattered Dennis Gabor, invented electron holography to in a range of directions, the image too can be viewed improve the resolution of transmission electron 9 10 from different angles, ie from multiple dimensions microscopes. Reid (and replicated by Schwartz, 11 (perspectives or views). The other unique feature Suchdev & Russek ) showed that electrons could of a hologram is that even if the recording material carry information that could cause changes in the containing the image is divided into smaller and structure of albumin crystal. This is applicable smaller parts, each part will still be able to reconstruct to the acupuncturist since one proven way that the entire recorded image. (6, 7) acupuncture works is through electrical conductance within meridians, ie. movement of electrons through So what does this mean to the veterinary the body. In maintaining our duality approach, acupuncturist? In theory, any wave should be able to the electrons would be considered the Yin to the
produce a holographic image…an original image of movement of the current Yang. interference patterns that if exposed to a similar wave at a later date, will still produce a representation of the Acoustic holography is used to record sound original picture. If an organism, its organs, its cells, its waves (pressure waves) distant from the sources using molecules are essentially patterns of wave and particle particle and pressure transducers as the recording 12 energy, then that organism is a holograph reflecting plate. This allows back tracking of individual reflections, where “every place is a reflection of every acoustic events (images) to determine location, other.” 8 Therefore, states and properties that are frequency and strength. Essentially the image created present in one place, can be present in other places. of the sound pressure waves allows local targeting An example of this can be seen in the genetic DNA of a non-local event. Currently this is being used material of genes (and probably in the RNA material commercially in the studio for audio rendition and in of mitochondria but no one every looks at that); even the manufacturing of cars and airplanes. Since there 62 THE POINT A PUBLICATION OF THE INTERNATIONAL VETERINARY ACUPUNCTURE SOCIETY VOL.35 / NO. 4 November 2012 is research showing that acupuncture meridians are process. Initially they may seem too esoteric to be of sound propagators (14) acoustic holography implies importance to the practitioner, but a deeper look may (and may be a way to prove) that local events that show otherwise. create pressure waves in an acupuncture meridian (such as strumming or twisting an acupuncture Acupuncture research shows that while needle) may propagate and create an effect in a place no specific anatomic structures can be found by distant from the local event of needle placement or microscopy, there are significant electrical and optical manipulation. differences between classic meridian locations and the tissue nearby. Meridians have been shown to have And what about in a biological organism lower impedance to electrical conduction, conduct context? Quantum & Manhattan project physicist varied frequencies differently, are more transparent to David Bohm, working with neurophysiologist Karl infrared light (longitudinally only, not transversely) Pribram, proposed a holographic and dual quantum and selectively attract hydrogen and calcium ions.(15) theory for the workings of the brain. (2) In the Holonomic Brain Theory, the function of the brain We were gaining insight on what a meridian is proposed to have a similar duality as light…both did (it’s Yang), but not what a meridian was (it’s Yin), particles of information that are transmitted and until some important research on water. Even though stored as waves of local electrical field potentials most of our world, both internal and external, is made in finely fibered neural dendrite ‘webs’. Pribram, a up of water, physicist will be the first to admit that noted neuroscientist from working at Stanford (and they don’t really understand it. In the late 1990’s, now Georgetown) has been working for decades Lo (et al), a theoretical particle physicist from the on research that is showing that some of the brain University of Chicago (and then California Institute functions in ‘windowed’ Fourier transformations. of Technology) discovered that water can undergo Windowed in that the information ‘representations’ certain changes that creates a state where crystals are present only in patches of fine-fibered dendrites. (or clusters as they are now being called) are stable Each dendrite and each region of the neural web stores at room and body temperatures (15-18). Additional critical information of how its environment is viewed research has shown that water in this state also has as packets of wave oscillations. When it’s time for altered surface tension (19) and can affect function multidimensional image to be made, each web sends of immune cells. (20) These polarized water clusters its information as a perceptual patch that must be display different electrical characteristics than water assembled globally to create an image of the whole in other non-polarized states (21). Lo has postulated system. So it turns out that information that the brain that acupuncture meridians are made up of these views through vision, hearing, touch and memory water clusters – essentially meridians are full of is collected, stored and re-created much like how a Yin substance (22). Even new research in microbial radio-telescope works for an astronomer. (2,3,13) Here is biofilms and their importance to bacterial communities a well-researched example of a quantum approach to a is looking at the importance of water structures may biological system…and this is just the beginning. play. (23)
QUANTUM BIOPHYSICS & ACUPUNCTURE: Research done by numerous labs has also WATER CLUSTERS & LIQUID COLLAGEN demonstrated that all the cells of a living organism CRYSTALS are interconnected by connective tissue and that Two recent important research findings, related this connective tissue was in a meso (or mid) state in biophysics, related but done independently may between solid and liquid. These crystals (or clusters?) point to new horizons in the understanding of the were found to be polarized as well as responsive to duality function of acupuncture; interestingly, they electrical, mechanical, pH and ionic stimuli. (24, 25) have their basis in water – the Yin aspect of the body. This mesostate connective tissue was composed of While from a practical aspect this research will not stable water clusters oriented in helices interspersed help a practitioner select specific points to treat a within an ordered matrix of collagen fibers. Ho particular disease, these studies will help the serious proposed that the acupuncture system is co-aligned practitioner in his or her understanding of the disease with this ordered matrix of structured water clusters
63 THE POINT A PUBLICATION OF THE INTERNATIONAL VETERINARY ACUPUNCTURE SOCIETY VOL.35 / NO. 4 November 2012 and collagen fibers in a way that allows for the TC(V)M physical exam such as the pulse, the tongue rapid semi-conduction of protons. Proton jump and point palpation were developed over years of conduction has been demonstrated to (26-30) She states, observation. The agrarian Chinese society, so much “actual conducting channels may bear a more subtle in tune with the natural cycles, gathered enough relationship to the orientation of the collagen fibers, as comparative data of space-time causation versus conductivity depends predominantly on the layer(s) of subtle body symptoms and signs, combined with bound water on the surface of the collagen molecules documentation of response to point manipulation, rather than the collagens themselves.” (29) She goes that essentially what TCM teaches is probabilities of on to say that, “…this would be consistent with the predicting the response to the wave form created by observed increase in conductivity of collagen as needle manipulation in the meridian. hydration increases to a level well beyond the bound water fraction.” Additionally, the collagen fibers in The pulse is the most effective tool for a the proposed meridian ‘structure’ may be responsible practitioner to evaluate the state of the quantum Yin for daqi, or the tissue grab of the needle; it has been of the body. Amber stated in 1966 “The Chinese shown that a mechanical locking occurs when the method, removed from the atomistic practices of collagen fibers sticking to the needle are wound modern, Western medicine, geared its reading of the around a rotated needle. This mechanical locking pulse to the organismic theory of the total man, to deforms the involved tissue. In a holographic way the two types of energy [here the author is referring through either the connective tissue matrix or the fine to previously mentioned theories of Yin and Yang] fiber neural web, these deformed and activated cells …In their readings of the pulse they interpreted the can transmit information to other parts of the system. electrical field forces of the body and the cosmos.” (31) (32) And Lu states, “The physiological activities of the human are carried out by the Yin Fluid and Yang Qi of QUANTUM YIN: the human body. Yin Fluid is a collective term for all So now this gets us to where we really want of the Yin substances of the body such as Body Fluid, to be…acupuncture. From the beginning of our Blood and Essence. They are so called because they training, practitioners of TCVM are exposed to the are all liquid substances. As Yang Qi is movable and blending duality concepts of Yin and Yang and the invisible in nature and Yin Fluid is still and substantial balance between the two determines the difference in nature, they have different influences on Pulsation.” between health and disease. “Disease is described as (34) ‘a breakdown in the equilibrium of Yin (vital essence) But acupuncture is about doing…about and Yang (vital function) in the body.” (32) As simple improving quality of life for an individual in a phase as this foundational concept is, it often provides that is not one of balanced homeostasis. Combining marked disquiet and confusion among Western the theories showing that acupuncture meridians practitioners trained in well-defined categories of may be comprised of water clusters and collagen reductionist medical thinking. Circular thinking of fibers that are responsive to both electrical, ionic and symptoms or patterns that have no beginning nor mechanical response demonstrates that there are many end, and where symptomology patterns do not have ways for the holographic system to be manipulated. discrete boundaries and often blend into each other, As acupuncturists we are taught that Qi is generated is a concept foreign to current Western philosophy from both Yin and Yang. Qi has been described as much less to Western medicine. This has led to energy, oxygen function, as something unseeable and partitioning of modern acupuncture into its own intangible. Ho and Lo have both proposed that qi is duality. Those discomforted by and unable to grasp a quantum coherent energy. If that is true then our the entangled and dynamic nature of Yin and Yang goal as acupuncturists is to stimulate that organism to have created acupuncture methodologies that try to generate the coherent wave. ignore traditional Chinese precepts, to the loss of acupuncture’s ability to maximize healing change in The ancient Chinese were practical people and an organism. recognized the need to practice a system of medicine that worked, no matter how mystical its explanation. The categorization of the various parts of the Therefore, when one looks at the individual point 64 THE POINT A PUBLICATION OF THE INTERNATIONAL VETERINARY ACUPUNCTURE SOCIETY VOL.35 / NO. 4 November 2012 function descriptions, it is obvious that most points 6. Talbot M, The Holographic Universe. New York, are involved with Fluids, Blood or Yin and some NY: Harper Collins, 1991. with Qi. Very few are described as stimulating Yang 7. Nave R, Holography, http://hyperphysics.phy-astr. (we tend to support Yang more with chemical herbal gsu.edu/Hbase/optmod /holog.html formulas). Fortunately for those of us living in the 8. Braden G, The Divine Matrix: Bridging Time, real world of barn aisles and clinic floors, the ancients Space, Miracles and Belief. Carlsbad, CA: Hay Chinese developed an inverse Fourier system where House, Inc.: 2007. manipulating a quantum, holographic system could 9. Ponce FA, Cai J, Stevens M, Profiling the be translated into a time-space coordinated system electrostatic field and charge distributions using of meridians and points. When an ancient Chinese electron holography. Proc Advanced workshop medical mystic starts to sound like a modern quantum on TEM in Materials and Geological Sciences. physicist and when a modern quantum physicist starts Pan American Advanced Studies Institute: to sound like an ancient Chinese medical mystic, then Transmission Electron Microscopy in Materials you realize that maybe it wasn’t mysticism to begin Science. http://ciasem.com/2006. with. Maybe the ancient Chinese healers had a better 10. Reid BL, The ability of an electric current to carry knowledge of the way the world functioned right information for crystal growth patterns. J Bio from the start – just in different words. It has taken Physics. 29(2):33-35, 1987. over 2000 years for the world of Western science to 11. Schwartz GER, Suchdev P, Russek LGS. Ability rediscover and integrate that language of quantum of an electric current to carry information for healing, but it is happening. It’s all just one big circle. crystal growth patterns: implications for systemic memory. Honors thesis, Dept Biochem, Univ Ariz. (A final note on Evidence-Based Medicine In: The Living Energy Universe. Charlottesville, or Evidence-Based Practice: there is quite a bit VA: Hampton Roads Publishing Co., 1999. of confusion in the veterinary world as to what 12. http://www.acoustic-holography.com/ exactly EBM/P is. The initial basic precepts by its 13. Schempp W. Cortical linking neural network developer, Dr. David Sackett, of providing guidance models and quantum holographic neural to practitioners in evaluating evidence has been technology. In: Pibram KH, ed. Rethinking Neural high-jacked by individuals with agendas that are not Networks: Quantum Fields and Biological Data. always friendly to inclusive integrative medicine. London, UK: Psychological Press. 1993. Veterinarians are strongly encouraged to go to the 14. The reader is referred to (1), Appendix A, which source and teach themselves about what really is one of the most complete and comprehensive constitutes EBM/P rather than being spoon-fed by compilations of acupuncture research up to 2004. those that may have altered the original information. 15. Lo SY. Anomalous state of ice. Mod Phys Let B The best tutorial that I have found that presents 1996; 10:909-919. EBM/P with its original intention is one offered online 16. Lo SY, Lo A, Li AC et al. Physical properties by Duke University. It can be accessed at: http://www. of water with IE structures. Mod Phys Let B hsl.unc.edu/services/tutorials/ebm/index.htm.) 1996(10):921-930. 17. Lo SY. Survey of IE clusters. In: Lo SY, Bonavida REFERENCES: B, Proc of First Int Symp on Physical, Chemical 1. Lo A, Forward, In: Lo SY, The Biophysics Basis and Biological Properties of Stable Water for Acupuncture and Health. Pasadena, CA: 2004. (IE) Clusters. River Edge, New Jersey: World 2. Pribram K, Holonomic Brain Theory. Scientific. 1997: 3-47. Scholarpedia, 2(5):2735, 2007. 18. Wong CY, Lo SY Possible mechanism of 3. Pibram KH. Brain and Perception: Holonomy formation and stability of anomalous states of and Structure in Figural Processing. London, UK: water. In: Lo SY & Bonavida B (eds). Proc of First Psychology Press. 1991. International Symposium on Physical, Chemical 4. Holzner S. Quantum Physics for Dummies. and Biological Properties of Stable Water (IE™) Hoboken, NJ: John Wiley & Sons, 2009. Clusters. River Edge, NJ: World Scientific. 1997: 5. McMahon D, String Theory Demystified. New 48-64. York, NY: McGraw Hill Professional, 2009. 19. Christian SD, Scamehorn JF, Tabatabai A et al.
65 THE POINT A PUBLICATION OF THE INTERNATIONAL VETERINARY ACUPUNCTURE SOCIETY VOL.35 / NO. 4 November 2012 Surface, solution and liquid properties of IE water. Am J Phyiol Cell Physiol, 2005; 288: C747-C756. In: Lo SY & Bonavida B (eds). Proc of First 32. Liu Y, The Essential Book of Traditional Chinese International Symposium on Physical, Chemical Medicine, Vol 1: Theory. New York, NY: and Biological Properties of Stable Water (IE™) Columbia University Press, 1988. Clusters. River Edge, NJ: World Scientific. 1997: 33. Amber R, Babey-Brooke AM. The Pulse in 135-148. Occident and Orient: It’s Philosophy and Practice 20. Bonavida B, Gan XH. Induction and regulation in Holistic Diagnosis and Treatment. New York, of human peripheral blood TH1-TH2 derived NY: Aurora. 1966 cytokines by IE water preparations and synergy 34. Lu Y. Pulse Diagnosis. Jinan, China: Shandong with mitogens. In: Lo SY & Bonavida B (eds). Science and Technology Press. 1996. Proc of First International Symposium on Physical, Chemical and Biological Properties of Stable REFERENCE READING (INFLUENTIAL TO Water (IE™) Clusters. River Edge, NJ: World BUT NOT DIRECTLY REFERENCED IN THIS Scientific. 1997: 167-183. PAPER) 21. Lo SY, Li WC, Huang SH. Water clusters in life. 1. Austin M, Acupuncture Therapy, 2nd Ed. New Med Hypoth, 2000; 54(6): 948-953 York, NY: ASI, 1972. 22. Lo SY. Meridians in acupuncture and infrared 2. Becker RO. Cross Currents: the Perils of imaging. Med Hypoth, 2002: 58(1): 72-76. Electropollution; the Promise of Electromedicine. 23. Costerton JW. The Biofilm Primer. Berlin, Los Angeles, CA: JT Tarcher. 1990. Germany: Springer. 2010. 3. Becker RO, Selden G. The Body Electric: 24. Leiken S, Parsegian VA, Rau DC et al. Hydration Electromagnetism and the Foundation of Life. forces. Ann Rev Phys Chem. 1993; 44:369-395. New York, NY: Quill William Morrow. 1985 25. Leiken S, Rau DC, Parsegian VA. Temperature- 4. Chen DC, Xuan GW. The Clinical Practice of favoured assembly of collagen is driven by Chinese Medicine: Lupus Erythematosus. Beijing, hydrophilic not hydrophobic interactions. PRC: People’s Medical Publishing House. 2007. Structural Biology. 1995: 205-210. 5. Dossey L. Reinventing Medicine. New York, NY: 26. Ho MW, Saunders PT. Liquid crystalline HarperCollins. 1999. mesophases in living organisms. In: Ho MW, Popp 6. Ellis A, Wiseman N et al. Fundamentals of FA & Warnke U (eds), Bioelectrodynamics and Chinese Acupuncture. Taos, NM: Paradigm Pub. Biocommunication. Singapore: World Scientific. 2004. 1994. 7. Greene B. The Hidden Reality: Parallel Universes 27. Ho MW, Haffegee J, Newton R et al. Organisms and the Hidden Reality of the Cosmos. New York, as polyphasic liquid crystals. Bioelectrochemistry NY: Vintage Books. 2011. and Bioenergetics. 1996; 41:81-91. 8. Greene B. The Fabric of the Cosmos: Space, Time 28. Ho MW, Zhou YM, Haffegee J et al. The liquid and the Texture of Reality. New York, NY: Vintage crystalline organism and biological water. Proc Books, 2005. Gordon Research Conf Interfacial Water & Cell 9. Greene B. The Elegant Universe: Superstrings, Biology. London, UK: Int Science in Society. Hidden Dimensions, and the Quest for the 2004. Ultimate Theory. New York, NY: W.W. Norton & 29. Ho MW, Knight DP. The acupuncture system Co. 1999. and the liquid crystalline collagen fibres of the 10. Han JS. Opioid and antiopioid peptides: a model connective tissues liquid crystalline meridians. of Yin-Yang balance in acupuncture mechanisms IVAS Proc 31st Int Cong on Vet Acup; 2005: 65-79. of pain modulation. In: Stux G, Hammershlag 30. Ho MW. Acupuncture, coherent energy and liquid R (eds). Clinical Acupuncture: Scientific Basis. crystalline meridians. IVAS Proc 31st Int Cong on Berlin, Germany: Springer. 2001 Vet Acup; 2005: 81-94. 11. Kendall DE. The Dao of Chinese Medicine: 31. Langevin HM, Bouffard NA, Badger GJ et al. Understanding an Ancient Healing Art. New York, Dynamic fibroblast cytoskeletal response to NY: Oxford University Press. 2002. subcutaneous tissue stretch ex vivo and in vivo. 12. Maciocia G. The Channels of Acupuncture:
66 THE POINT A PUBLICATION OF THE INTERNATIONAL VETERINARY ACUPUNCTURE SOCIETY VOL.35 / NO. 4 November 2012 Clinical Use of the Secondary Channels and Eight 17. Vieth I. The Yellow Emperor’s Classic of Internal Extraordinary Vessels. Philadelphia, PA: Elsevier. Medicine. Berkeley, CA: University of California 2006. Press. 1972. 13. Maciocia G. Foundations of Chinese Medicine: 18. Zukav G. The Dancing Wu Li Masters: an A Comprehensive Text for Acupuncturists and Overview of the New Physics. New York, NY: Herbalists. New York, NY: Churchill Livingstone. Quill William Morrow. 1979. 1989. 14. Pert CB. Molecules of Emotion: The Science Behind Mind-Body Medicine. New York, NY: Scribner. 1997. 15. Schwartz GER, Russek LGS. The Living Energy Universe. Charlottesville, VA: Hampton Roads Publishing Co., 1999. 16. Tam T. Lao Tzu Dao De Jing: Chapters 1-12. Boston, MA: Oriental Culture Institute Press. 1994. Market Place
ARIZONA The Pet Memorial Program at IVAS provides a For Sale: Holistic Veterinary Practice, Arizona. Dream way of communicating to your client or friend that practice & dream town! Sunny, moderate elevation & you know they are grieving, and that you care about climate, wonderful community, open space. Currently this significant loss in their lives. Many people are acupuncture, herbs and manipulations. Office peace- touched that their veterinarian or friend took the ful, many windows, trees. Unhurried 60-90 minute time to let them know how much they sympathize appts. Well established referrals w/local conventional by remembering their pet in this special way. It helps vets. Thriving growth & terrific net profit! Established them start the healing process and gives veterinarians 10 yrs. Practice & real estate. Training option. Please and friends a warm feeling of satisfaction that they contact:[email protected] or (928) 420- helped someone during this difficult time. Set up a 5926. Pet Memorial Account through IVAS. Simply make a donation deposit of any amount to be held for Veterinary Acupuncture Tri-Fold Brochures future memoriam use. When a client’s or friend’s are available for download on the IVAS website. pet dies, simply contact us at IVAS with the owner’s There is a place for you to enter your business name and address and the name of the pet, along information. Then you may print them yourself, or with the amount of donation. We mail a personalized have them printed professionally. sympathy card to the client letting them know you have remembered their pet with a contribution. The donation amount is not included in the card. Contact [email protected] for more information.
International Veterinary Acupuncture Society
67 THE POINT A PUBLICATION OF THE INTERNATIONAL VETERINARY ACUPUNCTURE SOCIETY VOL.35 / NO. 4 November 2012
JOIN US FOR THIS SPECIAL TWODAY VETERINARY WORKSHOP! The Use of Ishizaka, Mishizaka and Huatuojiaji Points in the IVAS Approved Treatment of Back Pain, Myofascial Pain & Specific Protocols for for Neurological & Other Conditions in the Horse & Dog Credits
with Dr. Kevin May, DVM, in Vancouver, BC - March ,
This event is part of COMS - Be sure to check out our other courses and treat yourself to a weekend of learning!
Join Dr. Kevin May, DVM, as he shares a number of clinically useful techniques for TCM/Acupuncture Veterinarians. This hands-on, two-day work shop will cover a variety of topics and review a number of acupuncture points that will allow veterinary practitioners to: Diagnose and treat Temporomandibular Joint and Myofascial Pain Syndrome Treat back pain in the reluctant patient Use acupuncture in the treatment of neurological problems Use acupuncture in the treatment of animal reproduction problems Plus so much more! The workshop will focus on equine and canine patients, but the skills developed can be applied to all animals.
For more information and to register online, please visit www.easterncurrents.ca/coms
REGISTER BY PHONE T: F: SEMINARS EASTERNCURRENTS.CA
NOW AVAILABLE! LEARN FROM THE COMFORT OF YOUR HOME OR OFFICE Online Learning with Bruce Ferguson, DVM
Recorded at our 2011 TCM Symposium in Vancouver, Dr. Bruce Ferguson’s workshop on Approved The Balance Method for Pain with New Points and TCM Food Therapeutics for Animals for 14.25 is now available online at www.eclearning.org IVAS CE Credits In this recorded workshop, Dr. Ferguson shares his clinical applications of acupuncture and dietary therapy for animals. The first 4 sections focus on the Wei (Atrophy) and Bi (Painful Obstruction) acupuncture module of Traditional Chinese Veterinary Medicine (TCVM). He outlines strategies for positive clinical outcomes and conducts a quick review of the basics of Dr. Richard Tan’s Balance Method and 5 acupuncture subsystems. Then, he introduces new distal point placement and function which he has developed for small quadrupeds. With these points understood, he introduces the concept of Dynamic Balance and its use in clinical practice. Lastly, he uses live patient cases to diagnose and treat using the techniques and methods introduced in this module. The last 4 sections delve into TCVM food therapy. Finally, Dr. Ferguson shares the Zang-Fu and Eight Principle concept for food therapeutics and its application in practice.
Visit us online at www.eclearning.org for more information!
QUESTIONS? GIVE US A SHOUT 1 800 667 6866 OR 604 263 5042 WWW.ECLEARNING.ORG
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69 2013 - 2014 IVAS CERTIFICATION COURSE IN BASIC VETERINARY ACUPUNCTURE San Antonio, Texas
Session I Session II October 23-27, 2013 November 20-24, 2013
Session III Session IV January 22-26, 2014 February 26-March 2, 2014
Mentored Internships Exams April 2-3, 2014 April 5-6, 2014
THE INTERNATIONAL VETERINARY ACUPUNCTURE SOCIETY 1730 South College Avenue, Suite 301 ~ Fort Collins, CO 80525 ~ USA PH: +(970) 266-0666 FAX +(970) 266-0777 www.ivas.org