Post on 04-Jun-2018
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Introduction to AcupunctureTechniques
Ancient Art to Modern
Science
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Comparison of East & West
Empirical
Observations overThousands of Years
Scientific Method &
Case-BasedMedicine
East West
Art of Medicine
Holistic View Circular Logic Energetic
Technology ofMedicine
Molecular & OrganView
Linear Logic
Mechanistic
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Science versus Art
Over the last 10
years, there has been
no change in mean
life expectancy inhuman beings, dog or
cats
There is an increase
in incidence of
inflammatory
diseases and cancerover our ability to
detect the conditions
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Sun YangAlias Bole
Veterinarian
Qinmugong period
659 B.C. to 621 B.C.
Bole Zhen-j ing
Acupuncture: History
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Boles Canon of Veterinary
Acupuncture
Sun Yang
659 to 621 B.C.
Bole Zhenjing
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Acupuncture: History
1608
Benyuan Yu
Benheng Yu Veterinarian
Ming Dynasty
1368 to 1644
Yuan Heng Liao Ma Ji
Yuan-Hengs Therapeutic Treatise of Horses
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Basic Tenets of AP
Based upon the AP
point selected
Based upon the
method of stimulation Dry needles
Electrical AP
Aquapuncture
Hemoacupuncture
Based upon thelength of stimulation
Low-rate, twistingstimulation of GV26 leadsto endorphin response,while high-frequencyneedling of GV26 leads to
epinephrine response
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Zhen-jiu
Needles
Moxibustion
Bones needles: 3,000 years ago
Metal needles: 2,200 years ago
Gold/silver needles
Bamboo needles
Stone needles: 8,000 years ago
Fine needles
Ai-jiu (moxa): moxibustion
Alcohol (huo-jiu)
Herbal moxibustion
Needle + Moxa
Fire-needling
New Acupuncture
Basic Acupuncture Techniques
Electro-acupuncture
Embedding
Injectable AP
Laser therapy
Magnetic therapy
Infrared therapy (TDP)
aquapuncture &
pneumo-AP
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Arrowhead needle
Sharp needle
Sword needleRound needle
sharp needle
To drain abscesses
To bleed superficial vessels(TCM Surgical tools)
Acupressure (Not penetrate the skin)Round needlesPressure needles
Fine or FiliformLong/Large needles
Penetrate the skin at known acupuncture points(commonly known acupuncture)
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Gauge Millimeters Application40 0.15 Hand/feet Needle
38 0.16
Baby needle36 0.20
34 0.22 Cats, little dogs
32 0.25 All the Small animals (dogs/cats/birds)
30 0.30 Horses, cattle, llamas, pigs
28 0.35 Large animals: horses, cattle, elephants
Acupuncture Needle Diameters in Gauge
and Millimeters
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Millimeters Inches Application
7 0.25 (Korean
Hand Needle)
Dogs/cats: around eyes, nose, feet, or sensitive
patients
13 0.5 Dogs/cats: head, feet, lower limbs, ear, tail, mu pts
Horses: ears/eyes, feet
25 1.0 Dogs: back-shu, neck, shoulder, limbs
Horses: feet, lower limbs, head, tail
40 1.5 Dogs: hip, shoulder
Horses: back-shu, mu points, limbs50 2.0 Dogs: hip, cervical hua-tuo-jia-ji for big dogs
Horses: back-shu, limbs
75 3.0 Horses: hip
100 4.0 Horses: hip
Acupuncture Needle Diameters in Gauge
and Millimeters
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How to needle an acupoint
Preparation
Needle
Animal
Practitioner
Insertion of a needle
Pressing hand
Angle Depth
Manipulation of a needle
Withdrawal of a needle
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How to needle an acupoint:
preparation
Needle Sterile disposable
The tip should be smooth & sharp as a
pine needle
Horse Size
0.30-0.40 mm (#28-#30)
Length
13 mm (1/2): in extremities (feet, tail, ear,
head)
25 mm (1): in lower limbs, head
50 mm (2): in the trunk, back
75 mm (3): in shoulder, hip
100 mm (4): hip
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How to needle an acupoint: preparation
Needle
Small animal
generally thinner
not too thin
Dog:
Size
0.25 (#32)
Length
13 mm (1/2)
25 mm (1)
50mm (2): large dog
Cat:
Size
0.25 (#32)
Length
13 mm (1/2)
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Animal
quiet
relaxed (house call benefit)
Restrained if needed (nose
twisted), but not
sedation/tranquilized
The site of acupoints
nice and clean
How to needle an acupoint:
preparation
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How to needle an acupoint:
preparation
Practitioner
Sound plan of
acupuncture treatment
Considered as a
surgical procedure
others
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Pressing Hand
1. Thumbing
2. Pinching
How to needle an acupoint:
Insertion
1
2
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Pressing Hand
3. Holding
4. Stretching
How to needle an acupoint:
Insertion
3
4
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How to insert a needle
Jabbing: a quick insertion (Flying technique)
0.5(13 mm)
#28 to 30 for horses
#30 to 32 for small animals
tube guiding
Twirling: a slow insertion
How to needle an acupoint:
Insertion
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Angle Perpendicular
insertion
Angular insertion
Horizontal insertion
Depth
Location
De-Qi response
Condition
Patient
How to needle an acupoint:
Insertion
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How to induce De-Qi
1. Up-down
thrusting
2. Left-right twisting
3. Flicking
4. Scraping
1
2
3 4
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Quantity/dose of needle stimulation
Intensity De-Qi Response
Intense
Intermediate Mild
Duration of stimulation
Short: < 5 min Long: >60 min
Intermediate: 10 to 30 min
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Withdrawal of a needle
Twirling
Pulling the needle out
Pressing the point after withdrawal Pressing---tonification
No pressing ---sedation
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Practice needling an acupoint
Orange a layer of
paper
a ball of cotton on self
health animal
real case
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LI-11
Elbow, sore throat, fever,
abdominal pain, vomiting,
diarrhea, hypertension,
seizure, conjunctivitis
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PC-6: over the median nerve 2 cun above the wrist
Indication: nausea, vomiting,
chest pain
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Dry Needle Acupuncture
Manipulating needles until "De-Qi"
response
10 to 30 min, manipulated once every 3 to
5 min
Indication: Any diseases
Or starting technique
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Electro-acupuncture techniques
History
After electro-acupuncture (EA) analgesia was found
effectively to perform a surgery in China in the early
1970's, EA has been widely used in TCM practice.
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Advantage:
1) More effective
2) Less treatments
3) Fewer acupoints
4) Save labor to manipulate the needles (Classically, theneedles should be manipulated every 2 to 3 minutes).
5) Objective control of frequency and amplitude
Amplitude (intensity of stimulation): a tolerance level
Frequency:
Low level: pain ----> beta endorphin mediated
Medium level: segmental ----> dynorphin mediated
High level: internal medicine----> serotonin mediated
Dynorphins
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Acupuncture Points: 6 to 10 points
Frequency: 20 Hz, 80 to 120 Hz or 200 Hz
Electrical intensity: gradually goes to the point
the patient can tolerate
Methods:
1) Pain management
a) Bi syndromes (arthritis)
b) Soft tissue injuries
c) Disc problems
d) colic/abdominal pain
2) Peripheral nerve paralysis
a) facial
b) radialc) others
3) Gastrointestinal conditions: vomiting,
diarrhea, constipation, indigestion
4) Muscle atrophy
Indications:
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Contraindications:
1) Weak/deficient patients
2) Heart problems
3) Seizure/epilepsy 4) Tumor
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How to Use the Electronic
Acupunctoscope
Dial 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 forms
low frequency F1 = 20-30 Hz
Indication: pain conditions
Endorphin release
C fiber is sensitive to less than 10 Hz of electrical stimulations
20 to 120 Hz stimulates A and A
moderate frequency F1 = 80-120 Hz
Enkalphalin release
Indications: internal medical conditions (diarrhea etc)
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How to Use the Electronic
Acupunctoscope
Wave Form: depends on how F1 and
F2 is set up
Continuing Wave: F1=20-200 and F2=0
Indications: pain conditions
Intermittent wave: F1=0 and F2=>0
Indications: muscular atrophy
Dense and Disperse (DD) wave: F1=80 andF2 =120
Indications: nerve paralysis and internal
medical conditions
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How to Use the Electronic
Acupunctoscope
Turn on the power 3
Gradually increase
AMPLITUDE buttons until the
patient can tolerate Can increase amplitude a little bit
every 5 minutes.
Turn off power to terminate the
acupuncture treatment
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How to Use the Electronic
Acupunctoscope
The output socket between 4 and 5 is only used for
the needleless technique, which acupuncture points are
stimulated using the needleless electrode. Fill the cup of
electrode with absorbent cotton soaked with saline. Tape
the electrode onto the acupuncture points.
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Electro-acupuncture: how to pair the
points Bilateral connection
Pair BL-54 on left side to right BL54 for hip dysplasia; Hua-tuo-jia-ji on the left to right side for disk diseases
BL-21 on the left to right BL-21 for vomiting
KID-1 on the left to right KID-1 for rear weakness
Same Channel connection. GV-14 + Bai-hui for disk disease, vestibular dx
LI-10 + LI-15 on the same side for shoulder pain
Tip of tail + GV-20 for vestibular dx, disk disease
Local connection TH-14 + LI-15 on the same side for shoulder pain GB-34 + ST-35 on the same side for stifle pain
Same energetic connection ST-36 + GB-34 on the same side for vomiting, rear weakness
ST-36 + BL-20 on the same side for SP Qi deficiency
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From the top to bottoms for paralysis BL-54 + KID-1 for rear limb paralysis
PC-8 + GV-14 for front limb paralysis
GB-21 + HT-3 for front limb paralysis
Cover large areas
BL-20 on the left + right BL28 for T-L-S IVDD
Normal area to sick area
BL-21 to KID-1 for no deep pain caudal to BL-22
ST-5 left to right for right facial paralysis
Electro-acupuncture: how to pair the
points
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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 thetumor mass
Caution for seizure dogs when using EA
Electro-acupuncture: how to pair the
points
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Aquapuncture (point injection)
History:
Herbal medication for pigs:
very challenge
Injectable herbal liquid
(Angelica Dang Gui)
Patient own blood for
chronic eye blood
Fire Constitution of Animals
Will not remain still
Some of points notavailable with dry-needling
or EA
Points:
Acupoints: except for
hemo-acupoints
A-shi Point
Needle:
Dogs/cats: 25-27 ga
Horses: 20 to 22 ga
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Aquapuncture (point injection)
Technique:
Insert needle
After "De-Qi" occurs,
the injection is given
1-8 points per
treatment
Once every 3-7 days,
for 3 to 5 times t
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Injectable agents Herbal liquids
Angelica sinesis
(Dang-gui)
Carthamus tinctorius
(Hong-hua)
Coptis chinensis
(Huang-lian)
Andrographis
paniculata
(Chuan-xin-lian)
Medications
Sterile water
5-10% dextrose
0.25-0.5% procaine
Vitamin B1, B12, or B
complexion
Antibiotics
Anesthetics, sedatives
or anti-rheumatics
Biological products:
Antitetanolysin
Vaccine
Homeopathic remedies
Patients own blood
Aquapuncture (point injection)
1 - 15 ml each point for large animals
0.1 - 1 ml each point in small animals
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Acupuncture point embedding
(Implantation)
Point injection of a solid
substances Thread/catgut/suture
Magnetic beads or pellets
Gold bead/wire Biodegradable plastics
Uses
Diarrhea in young animals
Hip dysplasia
Epilepsy
Lameness
Eye infection
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Hemoacupuncture
Also called Red Needle
Intentionally puncture a blood vessel to draw blood
Needle:
a sharp traditional needle (three edged needle, or wide needle)
hypodermic needle
#27, 25 for small animals
#25, 23, 20 for large animals
Only used for specific points that have a history of
hemoacupuncture in TCVM such as Er-jian,Wei-jian,
Tai-yang, Xiong-tang
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Hemoacupuncture
Indications: Blood Stagnation
Blood Heat
Excess Heat
Contraindications and cautions:
Weak and debilitated animals
Qior/and Blood Deficiency
Dehydrated or severely Yin-deficient patients
Pregnant animals Patients with potentially zoonotic blood-borne pathogens
Hemoacupuncture can not repeat the same point for a
week
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Pneumo-acupuncture
Inject fresh air into an acupoint
Subcutaneous tissues
Local ash Point (the worst atrophied spot)
Equine: Gong-zi for shoulder atrophy
Canine: 5 to 50 cc of air
Indication
Shoulder atrophy Hip atrophy
Avoid the head
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Moxibustion
Using burning herbs to stimulate acupoints Originates from the Japanese "mogusa
moxa" or "moxibustion
Crushed dried leaves of Artemisia argyi (Ai-ye)
Therapeutic effects:
dredging meridians
dispelling cold and wind
reviving Yang for resuscitation promoting functional activities
Moxa sticks: 20 cm in length and 1.5 cm in diameter
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Moxibustion
Mild moxibustion: 1 to 2 cm distance against the acupoint
5 to 10 min. for each point
Circling moxibustion:
With a circulating motion
For larger area of rheumatism
Pecking moxibustion:
With a pecking motion touches the skin
2 to 5 min
For chronic diseases which need stronger stimulation
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Moxibustion
Moxa cone Moxibustion
Direct Moxibustion
up 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 withsome pores
Moxa + Needling
L A t
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Laser Acupuncture History
Later 1970, Laser acupuncture for diarrhea in goats and sheep in
Inner Mongolia using CO2 laser at GV-1 CO2: no light
Can be very dangerous
5-30 mW Helium-Neon (He-Ne laser): or cold laser
infertility, anti-inflammatory, analgesic, and promotes woundhealing
cannot penetrate accurately and deeply into most acupuncturepoints because the light is refracted in the first 1-15 mm of tissue
Almost no effect if less than 5 mW.
Treating superficial acupuncture points in areas of thinintegument
Avian: skin is generally very thin
Lie Que(Lung 7)
Jing-well points.
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Infrared Acupuncture
Radiation heat (moxibustion)
250 W infrared bulb
TDP lamps (Teding Diancipo Pu):
Heat a metal plate constructed from numerousmineral substrates
Developed in Chong-qing, China in the 1980s.
Indication Bi syndrome Wound
Caution: avoiding too hot.
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Origin: tip of ear
Human auriculotherapy
Germany 1950s China
Diagnosis
Treatment
Canine ear points
Diagnosis
Treatment
Auriculotherapy
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Other Acupuncture techniques
Cupping
Tui-na (massage and
chiropractic)
Scalp acupuncture
Microwaveacupuncture
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How to Approach AP Patient
Take history, do exam &
make pattern diagnosis
Start with Dry Needles
10-15 needles unlessstrong or weak
Treat 15-30 minutes
Follow with B-12
aguapuncture
5-8 points
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How to Approach AP Patient
Re-assess pattern diagnosis
Start with Dry Needles
10-15 needles unless strong
or weak
Treat 15-30 minutes
EA
10 minutes @ 20 Hz
10 minutes DD 80-120 Hz
5-10 minutes 20 Hz
Follow with B-12 aguapuncture
5-8 points
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TCM Prayer
Just for today, I will let go of my anger.
Just for today, I will let joy in my heart.
I will not worry or be sad.
Just for today, I will embrace life.
I will live without fear, in harmony with myselfand the Universe.