Introduction to Acupuncture TechniquesAncient Art to Modern Science

Comparison of East & WestEmpirical Observations over Thousands of YearsScientific Method & Case-Based Medicine

EastWestArt of MedicineHolistic ViewCircular LogicEnergeticTechnology of MedicineMolecular & Organ ViewLinear LogicMechanistic

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

Sun YangAlias BoleVeterinarian Qinmugong period659 B.C. to 621 B.C.Bole Zhen-jingAcupuncture: History

Boles Canon of Veterinary AcupunctureSun Yang

659 to 621 B.C.

Bole Zhenjing

Acupuncture: History1608 Benyuan YuBenheng YuVeterinarian Ming Dynasty1368 to 1644Yuan Heng Liao Ma JiYuan-Hengs Therapeutic Treatise of Horses

Basic Tenets of APBased upon the AP point selectedBased upon the method of stimulationDry needlesElectrical APAquapunctureHemoacupuncture

Based upon the length of stimulation

Low-rate, twisting stimulation of GV26 leads to endorphin response, while high-frequency needling of GV26 leads to epinephrine response

Zhen-jiuNeedles MoxibustionAi-jiu (moxa): moxibustion

Alcohol (huo-jiu)

Herbal moxibustion

Needle + Moxa

Fire-needlingNew AcupunctureBasic Acupuncture Techniques

ArrowheadRoundPressureSharpSwordRound/SharpFineLongLargeNine needles (2,200 years ago)

Arrowhead needleSharp needleSword needleRound needlesharp needleTo drain abscessesTo bleed superficial vessels (TCM Surgical tools) Acupressure (Not penetrate the skin)Round needlesPressure needlesFine or FiliformLong/Large needlesPenetrate the skin at known acupuncture points(commonly known acupuncture)

Dry Needle Acupuncture or Conventional Needling TechniquesDry Needle (White Needle)- -Bai-zhen

Not intentionally bleeding

Most common treatment modality in veterinary and human practice

Filiform needles Sterile needle With tubeWithout tube

Can be applied in most acupoints (GV-1, LI-4)

Can be used any patterns of disease

Acupuncture Needle Diameters in Gauge and Millimeters

GaugeMillimetersApplication400.15 Hand/feet Needle380.16Baby needle360.20340.22Cats, little dogs320.25 All the Small animals (dogs/cats/birds)300.30 Horses, cattle, llamas, pigs280.35Large animals: horses, cattle, elephants

Acupuncture Needle Diameters in Gauge and Millimeters

MillimetersInchesApplication70.25 (Korean Hand Needle)Dogs/cats: around eyes, nose, feet, or sensitive patients130.5Dogs/cats: head, feet, lower limbs, ear, tail, mu ptsHorses: ears/eyes, feet251.0Dogs: back-shu, neck, shoulder, limbsHorses: feet, lower limbs, head, tail401.5Dogs: hip, shoulderHorses: back-shu, mu points, limbs502.0Dogs: hip, cervical hua-tuo-jia-ji for big dogs Horses: back-shu, limbs753.0Horses: hip1004.0Horses: hip

How to needle an acupointPreparationNeedleAnimalPractitioner

Insertion of a needle Pressing handAngleDepthManipulation of a needle

Withdrawal of a needle

How to needle an acupoint: preparationNeedleSterile disposableThe tip should be smooth & sharp as a pine needleHorseSize0.30-0.40 mm (#28-#30)Length13 mm (1/2): in extremities (feet, tail, ear, head)25 mm (1): in lower limbs, head50 mm (2): in the trunk, back75 mm (3): in shoulder, hip100 mm (4): hip

How to needle an acupoint: preparationNeedleSmall animalgenerally thinnernot too thinDog:Size0.25 (#32)Length13 mm (1/2)25 mm (1)50mm (2): large dogCat: Size0.25 (#32)Length13 mm (1/2)

Animal

quiet

relaxed (house call benefit)

Restrained if needed (nose twisted), but not sedation/tranquilized

The site of acupointsnice and clean

How to needle an acupoint: preparation

How to needle an acupoint: preparationPractitioner

Sound plan of acupuncture treatment

Considered as a surgical procedure

others

Pressing Hand

1. Thumbing

2. Pinching

How to needle an acupoint: Insertion12

Pressing Hand

3. Holding

4. Stretching

How to needle an acupoint: Insertion34

How to insert a needle

Jabbing: a quick insertion (Flying technique)0.5 (13 mm)#28 to 30 for horses#30 to 32 for small animals

tube guiding

Twirling: a slow insertionHow to needle an acupoint: Insertion

Angle Perpendicular insertionAngular insertionHorizontal insertion

DepthLocationDe-Qi responseConditionPatientHow to needle an acupoint: Insertion

How to induce De-Qi1. Up-down thrusting2. Left-right twisting3. Flicking4. Scraping

1234

Quantity/dose of needle stimulationIntensityDe-Qi Response IntenseIntermediateMildDuration of stimulationShort: < 5 minLong: >60 minIntermediate: 10 to 30 min

Withdrawal of a needleTwirlingPulling the needle outPressing the point after withdrawalPressing---tonificationNo pressing ---sedation

Practice needling an acupointOrangea layer of papera ball of cottonon selfhealth animalreal case

LI-11Elbow, sore throat, fever, abdominal pain, vomiting, diarrhea, hypertension, seizure, conjunctivitis

PC-6: over the median nerve2 cun above the wristIndication: nausea, vomiting, chest pain

Dry Needle AcupunctureManipulating needles until "DeQi" response

10 to 30 min, manipulated once every 3 to 5 min

Indication: Any diseasesOr starting technique

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

Advantage: 1) More effective2) Less treatments3) Fewer acupoints4) Save labor to manipulate the needles (Classically, the needles should be manipulated every 2 to 3 minutes).5) Objective control of frequency and amplitudeAmplitude (intensity of stimulation): a tolerance levelFrequency:Low level: pain ----> beta endorphin mediatedMedium level: segmental ----> dynorphin mediatedHigh level: internal medicine----> serotonin mediated

Acupuncture Points: 6 to 10 pointsFrequency: 20 Hz,80 to 120 Hz or 200 HzElectrical intensity: gradually goes to the point the patient can tolerateMethods:Pain management a) Bi syndromes (arthritis)b) Soft tissue injuriesc) Disc problemsd) colic/abdominal pain2) Peripheral nerve paralysisa) facialb) radialc) others3) Gastrointestinal conditions: vomiting, diarrhea, constipation, indigestion4) Muscle atrophyIndications:

Contraindications:

1) Weak/deficient patients2) Heart problems3) Seizure/epilepsy4) Tumor

How to Use the Electronic AcupunctoscopeDial the AMPLITUDE and FREQUENCY to zero

Plug the wire leads into sockets 1 to 7 and fasten the clips to the handles of needles

Set the desirable frequencies and wave formslow frequency F1 = 20-30 HzIndication: pain conditionsEndorphin releaseC fiber is sensitive to less than 10 Hz of electrical stimulations20 to 120 Hz stimulates A and A moderate frequency F1 = 80-120 HzEnkalphalin releaseIndications: internal medical conditions (diarrhea etc)

How to Use the Electronic AcupunctoscopeWave Form: depends on how F1 and F2 is set up

Continuing Wave: F1=20-200 and F2=0Indications: pain conditions

Intermittent wave: F1=0 and F2=>0Indications: muscular atrophy

Dense and Disperse (DD) wave: F1=80 and F2 =120Indications: nerve paralysis and internal medical conditions

How to Use the Electronic AcupunctoscopeTurn on the power 3

Gradually increase AMPLITUDE buttons until the patient can tolerateCan increase amplitude a little bit every 5 minutes.

Turn off power to terminate the acupuncture treatment

How to Use the Electronic AcupunctoscopeThe output socket between 4 and 5 is only used for the needleless technique, which acupuncture points are stimulated using the needleless electrode. Fill the cup of electrode with absorbent cotton soaked with saline. Tape the electrode onto the acupuncture points.

Electroacupuncture: how to pair the pointsBilateral connectionPair BL-54 on left side to right BL54 for hip dysplasia;Hua-tuo-jia-ji on the left to right side for disk diseasesBL-21 on the left to right BL-21 for vomitingKID-1 on the left to right KID-1 for rear weakness

Same Channel connection.GV-14 + Bai-hui for disk disease, vestibular dxLI-10 + LI-15 on the same side for shoulder painTip of tail + GV-20 for vestibular dx, disk disease

Local connectionTH-14 + LI-15 on the same side for shoulder painGB-34 + ST-35 on the same side for stifle pain

Same energetic connectionST-36 + GB-34 on the same side for vomiting, rear weaknessST-36 + BL-20 on the same side for SP Qi deficiency

From the top to bottoms for paralysis BL-54 + KID-1 for rear limb paralysisPC-8 + GV-14 for front limb paralysisGB-21 + HT-3 for front limb paralysis

Cover large areasBL-20 on the left + right BL28 for T-L-S IVDD

Normal area to sick areaBL-21 to KID-1 for no deep pain caudal to BL-22ST-5 left to right for right facial paralysisElectroacupuncture: how to pair the points

But, we must pay attention to the following:

The wire (lead) should NOT be connected around the abdominal areas for pregnant moms

The wire (lead) should NOT be connected through the chest if the patient has a pacemaker

The wire (lead) should NOT be connected through the tumor mass

Caution for seizure dogs when using EAElectroacupuncture: how to pair the points

Aquapuncture (point injection)History: Herbal medication for pigs: very challengeInjectable herbal liquid (Angelica Dang Gui)Patient own blood for chronic eye bloodFire Constitution of AnimalsWill not remain stillSome of points not available with dry-needling or EAPoints: Acupoints: except for hemo-acupointsAshi Point

Needle:Dogs/cats: 25-27 gaHorses: 20 to 22 ga

Aquapuncture (point injection)Technique:

Insert needle

After "DeQi" occurs, the injection is given

1-8 points per treatment

Once every 3-7 days, for 3 to 5 times t

Injectable agentsHerbal liquidsAngelica sinesis (Danggui)Carthamus tinctorius (Honghua)Coptis chinensis (Huanglian)Andrographis paniculata (Chuanxinlian)MedicationsSterile water

510% dextrose0.250.5% procaineVitamin B1, B12, or B complexionAntibioticsAnesthetics, sedatives or antirheumaticsBiological products:AntitetanolysinVaccineHomeopathic remedies Patients own blood Aquapuncture (point injection)1 - 15 ml each point for large animals0.1 - 1 ml each point in small animals

Acupuncture point embedding (Implantation)Point injection of a solid substancesThread/catgut/sutureMagnetic beads or pelletsGold bead/wireBiodegradable plastics

UsesDiarrhea in young animalsHip dysplasiaEpilepsyLamenessEye infection

HemoacupunctureAlso called Red NeedleIntentionally puncture a blood vessel to draw blood

Needle: a sharp traditional needle (three edged needle, or wide needle)hypodermic needle#27, 25 for small animals#25, 23, 20 for large animals

Only used for specific points that have a history of hemoacupuncture in TCVM such as Er-jian, Wei-jian, Tai-yang, Xiong-tang

HemoacupunctureIndications: Blood StagnationBlood HeatExcess Heat

Contraindications and cautions: Weak and debilitated animalsQi or/and Blood DeficiencyDehydrated or severely Yin-deficient patientsPregnant animals Patients with potentially zoonotic blood-borne pathogens

Hemoacupuncture can not repeat the same point for a week

Pneumo-acupunctureInject fresh air into an acupointSubcutaneous tissuesLocal ash Point (the worst atrophied spot)Equine: Gong-zi for shoulder atrophyCanine: 5 to 50 cc of air IndicationShoulder atrophyHip atrophyAvoid the head

MoxibustionUsing burning herbs to stimulate acupoints Originates from the Japanese "mogusamoxa" or "moxibustion

Crushed dried leaves of Artemisia argyi (Ai-ye)

Therapeutic effects:dredging meridiansdispelling cold and windreviving Yang for resuscitationpromoting functional activities

Moxa sticks: 20 cm in length and 1.5 cm in diameter

MoxibustionMild moxibustion: 1 to 2 cm distance against the acupoint5 to 10 min. for each point

Circling moxibustion: With a circulating motionFor larger area of rheumatism Pecking moxibustion: With a pecking motiontouches the skin2 to 5 minFor chronic diseases which need stronger stimulation

MoxibustionMoxa cone Moxibustion

Direct Moxibustionup to 5 zhuangs

Indirect Moxibustion a slice of ginger or garlic placed b/w the burning cone and the acupoint. The ginger or garlic slice is about 3 mm thick with some pores

Moxa + Needling

Laser AcupunctureHistoryLater 1970, Laser acupuncture for diarrhea in goats and sheep in Inner Mongolia using CO2 laser at GV-1CO2: no lightCan be very dangerous

5-30 mW Helium-Neon (He-Ne laser): or cold laser

infertility, anti-inflammatory, analgesic, and promotes wound healingcannot penetrate accurately and deeply into most acupuncture points because the light is refracted in the first 1-15 mm of tissueAlmost no effect if less than 5 mW.

Treating superficial acupuncture points in areas of thin integument

Avian: skin is generally very thinLie Que (Lung 7)Jing-well points.

Infrared AcupunctureRadiation heat (moxibustion)

250 W infrared bulb

TDP lamps (Teding Diancipo Pu):Heat a metal plate constructed from numerous mineral substratesDeveloped in Chong-qing, China in the 1980s.

IndicationBi syndromeWound

Caution: avoiding too hot.

Origin: tip of ear

Human auriculotherapyGermany 1950sChinaDiagnosisTreatment

Canine ear pointsDiagnosisTreatment

Auriculotherapy

Other Acupuncture techniquesCupping

Tui-na (massage and chiropractic)

Scalp acupuncture

Microwave acupuncture

How to Approach AP PatientTake history, do exam & make pattern diagnosis

Start with Dry Needles10-15 needles unless strong or weakTreat 15-30 minutes

Follow with B-12 aguapuncture5-8 points

How to Approach AP PatientRe-assess pattern diagnosis

Start with Dry Needles10-15 needles unless strong or weakTreat 15-30 minutes

EA 10 minutes @ 20 Hz10 minutes DD 80-120 Hz5-10 minutes 20 Hz

Follow with B-12 aguapuncture5-8 points

TCM PrayerJust for today, I will let go of my anger.

Just for today, I will let joy in my heart.

I will not worry or be sad.

Just for today, I will embrace life.

I will live without fear, in harmony with myself and the Universe.

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