Appendix 1

Emergency Acupoint Renzhong (Jenchung, GV26):
A bibliography of 138 edited abstracts (1974-1998)
Philip AM Rogers 1, Roman Skarda 2 & Godfrey Bartlett
See the review Emergency Acupoint Renzhong (Jenchung, GV26): A Review of published Literature and Textbook Sources by Rogers & Skarda (1998)

References

1 Altman S (1997) AP as an emergency treatment. Calif Vet 33, (1), Jan: 6-8. Needle stimulation at GV26 was used to improve resuscitation efforts with intubation, O2-administration, cardiac massage during respiratory arrest and coma in 2 dogs and 3 cats. Needle stimulation at KI01 was used in addition to GV26 in the dogs, one suffering from congestive heart failure, the other from draining fistula after enucleation. Cats arrested during anesthesia (thiamylal, halothane) and surgery abdominal cryptorchidectomy (cat A) and nephrectomy (cat B and C). AP induced a detectable heart beat and spontaneous respiration within 30 sec to 10 min. GV26 and KI01 stimulation were recommended as last-ditch resuscitative attempt in "clinical death" situations in dogs and cats.

2 Andres G (1984) Kuang: Manic disorder. Rev Fr Acup 10(37):11-16. Overexcitement of Jing Shen causes agitated madness (Kuang). Overpowering desire create a violent fire that coagulates liquid into "phlegm" that closes the Shen apertures (holes). Thus appears "rabid dog" vagrancy as depicted in the Kuang ideogram. This paper studies the physiopathological mechanisms behind the Kuang Syndrome and explains its symptoms and treatment using GV26.

3 Anon (1974) Effect of needling the philtrum on haemorrhagic shock in cats. Amer J Chin Med 2 (No 2): 216-217. EAP at GV26 had marked antishock effects in controlled studies of experimental haemorrhagic shock in cats under chloroform + ether anaesthesia. In control- and GV26- cats, bleeding time needed to reduce BP to 50 mm Hg was 15.2+6.1 and 6.9+2.6 min, resp; blood loss needed to induce shock was 2.8+3.9 and 15.8+4.7 ml/kg, resp. Blood letting stopped when BP reached 50 mm Hg. Then some cats in both groups were given blood transfusions, and some were left untransfused. Transfusion volumes needed to keep BP at 80 mm Hg for 1 hour after the end of bloodletting were 32.7+10.3 and 12.7+3.3 ml/kg, resp. The differences between the control values and GV26- cats were significant. Mortality within 3 h in untransfused cats was up to 100% and 25%, resp. EAP at GV26 markedly increased the time, and the volume of arterial bloodletting needed, to induce hypotensive haemorrhagic shock, and markedly reduced the transfusion volume needed to restore BP to 80 mm Hg.. It markedly reduced mortality, in untransfused cats. Deep pentobarbital anaesthesia abolished the anti-shock effect of AP at GV26, suggesting that central neurotransmission mediates the antishock effects of AP.

4 Anon (1982) Effect of EAP on hypotensive rats and its influence on clearance time of colloidal phosphonium in blood. Abstract Amer J Acup 1983;11:74, ex CAP&M 2(Jun):25-26. EAP at GV26 increased the clearance of colloidal phosphonium from blood, suggesting functional enhancement of the R-E system. EAP at GV26 had little effect on BP in normal animals but increased it strongly in animals with ischaemic hypotension.

5 Bao XY et al (1986) Elementary introduction to treatment of cerebral apoplexy (hemiplegia) with acupoints on the head. Abstract Amer J Acup 1986;14:275-276, ex CAP&M 6(Apr):47-48. GV26, GB20 and Scalp acupoints for motor, sensory, visual and speech centres increase brain perfusion and hasten clinical recovery after CVA. Acupoints on the Scalp, such as GV20, GB13, ST08, BL10, Shengxing etc were recommended for the treatment of apoplexy/hemiplegia in "The Canon of Internal Medicine". Stimulation of these points decreases peripheral arterial resistance, relaxes spasm and increases blood flow in the cerebral artery.

6 Baraskov GN, Staroverov AT (1984) Effects of AP on the neuronal mechanism of respiration. In: Theory and Practice of AP (3). Inst of Postgraduate Studies, Leningrad. AP at GV26 had a sympathomimetic effect on the cvsCVS and increased neuronal activity in the respiratory centre in rats, rabbits and cats under halothane anaesthesia. The effect was inhibited by adrenergic beta-blockers (propranolol) and to a lesser extent by alpha-blockers (phentolamine).

7 Chang CL, Lee JC, Tseng CC, Chang YH, Cheng JT (1995) Decrease of anaesthetics activity by EAP on GV26 in rabbits. Neurosci Lett Dec 29 202(1-2):93-96. Dept of Anaesth, Nat Cheng Kung Univ, Tainan City, Taiwan, ROC. They studied the effect of AP at life-saving point GV26 on the depressive action of anaesthetics on the CNS in rabbits. Stimulation with EAP at GV26, which is located at the mid-point on the upper lip, decreased the sleeping time induced by pentobarbital or propofol. However, this action of AP was not modified by naloxone at the doses sufficient to block opiate receptors. Plasma beta-EP was also not markedly changed in rabbits, which received similar electrostimulation. Moreover, pretreatment with pCPA at a dose sufficient to deplete endogenous 5-HT failed to influence the action of EAP. Mediation of endogenous opioids and/or 5-HT in this action of EAP was then ruled out. Prazosin reversed the sleeping time decreasing action of AP in a dose-dependent manner. Also, the action of AP was eliminated in rabbits that received guanethidine icv at a dose that could block NA-ergic nerve terminals. EAP at GV26 can activate NA-ergic neurotransmission in the brain; this reduces the depressive activity of anaesthetics on the CNS. PMID: 8787839, UI: 96379826

8 Chen GS, Erdmann W (1977) Effects of AP on tissue-oxygenation of the rat brain. Comp Med East West Summer 5(2):147-154. AP has been claimed to be effective in restoring consciousness in some comatose patients. Possible mechanisms to explain alleged AP-induced arousal may include vasodilatory effects caused by sympathetic stimulation that leads to an augmentation of cerebral microcirculation and thereby improves oxygen supply to the brain tissue. We studied ten albino rats using PO2 microelectrodes that were inserted into the cortex of the animals. Brain tissue PO2 was recorded continuously before, during, and after AP. Stimulation of certain acupoints (GV26) gave immediate increase of PO2 in the frontal cortex of the rat brain. This effect was reproducible. The effect was comparable to that obtained with increase of inspiratory CO2 known to induce arterial vasodilatation and thus capillary perfusion pressure. The effect was more significant as compared to tissue PO2 increases obtained after increase of inspiratory oxygen concentration from 21% to 100%. AP may cause an increase of brain tissue perfusion, which may be, at least in part, responsible for arousal of unconscious patients. Dilatation of cerebral vascular vessels and improvement of autoregulation in the brain by AP stimulation may also explain the effectiveness of AP in the treatment of migraine headache. PMID: 608334, UI: 78126192

9 Chen GS, Erdmann W (1978) Effects of AP on tissue oxygenation of the rat brain. South Med J Apr 71(4):392-395 and 398. AP has been claimed to be effective in restoring consciousness in some comatose patients. Possible mechanisms to explain alleged AP-induced arousal may include vasodilatory effects caused by sympathetic stimulation, which leads to an augmentation of cerebral microcirculation and thereby improves oxygen supply to the brain tissue. We studied ten albino rats using PO2 microelectrodes that were inserted into the cortex. Brain tissue PO2 was recorded continuously before, during, and after AP. Stimulation of certain acupoints (GV26) gave immediate increase of PO2 in the frontal cortex of the rat brain. This effect was reproducible and was comparable to that obtained with increase of inspiratory CO2 known to induce arterial vasodilatation and thus capillary perfusion pressure. The effect was more significant as compared to tissue PO2 increases obtained after increase in inspiratory oxygen concentration from 21% to 100%. AP may cause increased brain tissue perfusion, which may be, at least in part, responsible for arousal of unconscious patients. PMID: 635615, UI: 78138788

10 Chen QL, Liu HC, Gu F (1987) [Effects of neonatal administration of monosodium glutamate on APA and beta-endorphin-immunoreactive neurones in the rat hypothalamic arcuate nucleus]. Acup Res 12(3):235-238. They studied the relationship between beta-EP -containing neurones and APA in MSG-treated adult rats. They lesioned the neurones in the HAN with MSG in neonatal male rats and used immunocytochemistry to count the beta-EP -containing neurones in the HAN. When compared with EAP effects in control rats, EAP of GV26 and CV24 for 30 min had significantly less analgesic effect in the MSG-treated rats. HAN neurones immunoreactive for beta-EP in MSG-treated rats were decreased by 59%. Beta-EP-containing neurones in the HAN may be involved in APA in rats.

11 Chen YF, Wang YH, Yin QZ (1989) The role of paraventricular nucleus of hypothalamus in APA in rats. East-West Pain Conference (Beijing):59. Recently, VP has been shown to increase the pain threshold. It is not clear whether the HPVN, which is one of the main nuclei that secrete VP in brain and sends fibres to extrahypothalamic nuclei relevant to pain modulation, is involved in APA. We examined the role of HPVN in APA. We studied rats using tail stimulation-vocalisation test to measure the pain threshold. GV26 and CV24 were selected for EAP. Electrical stimulation of the HPVN could increase significantly the pain threshold and enhance the effect of APA. Electrolytic lesion of HPVN could decrease obviously the effect of APA, which could be recovered by AVP injected icv. Pretreatment with AVP-antiserum icv could attenuate the effect of APA. The HPVN may play an important role in pain modulation and in the effect of APA. This role may be mediated by the VP-containing neurones in HPVN.

12 Chen YF, Wang YH, Yin QZ (1991) [The role of paraventricular nucleus of hypothalamus in APA in rats - Article in Chinese]. Chen Tzu Yen Chiu (Acup Res) 16(1):32-38. Dept of Physiology, Suzhou Med Coll. Recently, VP has been shown to increase the pain threshold. It is unclear whether the HPVN, one of the main VP-secreting nuclei in the brain, is involved in APA. We examined the role of HPVN in APA, using rats. The tail-stimulation vocalisation test was used to measure pain threshold. GV26 and CV24 were selected for EAP. Electrostimulation of HPVN significantly increased the pain threshold and enhanced the effect of APA at GV26 and CV24. On the contrary, electrolytic lesion of HPVN clearly decreased the effect of EAPA, which was restored by 300 ng of AVP injected icv. Pretreatment with AVP-antiserum (icv) attenuated the effect of APA. HPVN plays an important role in pain modulation and in the effect of APA. This role may be mediated by VP-containing neurones in HPVN.

13 Chen Z, Qing D, Liu Y, Xie B (1991) [Role of rostral ventrolateral medulla in the GV26-induced pressor response in rabbits - Article in Chinese]. Hua Hsi I Ko Ta Hsueh Hsueh Pao Sep;22(4):387-390. We studied 14 rabbits locally anaesthetised with procaine. Both vagus nerves were cut. The animals were immobilised with gallamine trithiodide and maintained by artificial ventilation. The effects of EAP at GV26 on arterial BP and HR were observed before and after microinjection of kainic acid (KA) into the RVL. EAP at GV26 could elicit a very marked increase in arterial BP, before microinjection of KA into RVL. Bilateral microinjection of KA (0.5 ug, an excitotoxin) into RVL essentially abolished the pressor effect of stimulation of GV26. However, bilateral microinjection of normal saline into RVL showed no effects on the pressor effect of stimulation of GV26. RVL may play a key role in the pressor effect of GV26-stimulation.

14 Chen Z, Qing D, Zheng Y (1990) [Investigation on role of nucleus parabrachialis medialis in GV26-induced respiratory response in rabbits - Article in Chinese]. Hua Hsi I Ko Ta Hsueh Hsueh Pao Mar 21(1):46-49. We studied 27 rabbits, bivagotomized, gallamine triethiodide immobilized and artificially ventilated. The effects of EAP at GV26, NPBM separately, and GV26 and NPBM simultaneously, on Phr were observed before and after electrolytic and chemical lesion of NPBM. SEPs were recorded in NPBM during EAP at GV26. Electrostimulation of the same site of NPBM where the SEPs were recorded induced a respiratory response and changed the effect of EAP at GV26 on respiration. After electrolytic and chemical lesion of NPBM, stimulation of NPBM could no longer evoke the respiratory response and failed to change the GV26-effect on respiration. The NPBM may play a role in the respiratory effects induced by stimulation of GV26, but is not essential to it.

15 Chen Z, Qing D, Zheng Y, Xie B (1991) [Role of nucleus parabrachialis medialis in GV26-induced pressor response in rabbits - Article in Chinese]. Hua Hsi I Ko Ta Hsueh Hsueh Pao Jun 22(2):144-147. 18 rabbits were bivagotomized, gallamine triethiodide immobilized and ventilated artificially. The effects of EAP at GV26 and NPBM, separately and together, on arterial BP and HR were observed before and after electrolytic or chemical lesion of NPBM. EAP at GV26 or NPBM, separately evoked an increase in arterial BP. When both GV26 and NPBM were stimulated, the pressor response to NPBM stimulation influenced that of GV26. After electrolytic or chemical lesion of NPBM, stimulation of NPBM could no longer evoke a pressor response. Transection of the brain stem between NPBM and principal trigeminal nucleus, or lesion of the NPBM, clearly decreased the pressor response evoked by EAP at GV26. The NPBM may play a role in the pressor response of AP at GV26.

16 Cheng GF (1994) [Encephalitis treated by AP]. CAP&M 14(1):37-38. AP was used to treat 43 encephalitic patients, aged from 8 months to 15 years. The disease had been present from 2 days to 3 months. Main points: GB20, LI04, LV03. In the case of unconsciousness, add GV26; fever, add LI11, GV14; dementia, add GV20, Sishencong; aphasia, add CV23; paralysis of the upper limb, add LI11, TH05; paralysis of the lower limb, add GB30, ST36, GB34, GB39. Reducing method was used and needles were not retained generally. In treating conscious patients with comparatively older age, needles were retained for 30-60 min. Treatment was once/d for 5 d/course. A rest interval of 2 d was allowed between courses. Of the 43 cases treated, 35 were cured, 6 improved, 2 unchanged. The total effective rate was 95%.

17 Cheng PY, Zhou GF, Wang LF (1994) [Bone setting and AP for 2009 patients with protrusion of lumbar intervertebral disc]. Shanghai J Acup Moxibust 13(1):22-23. Bone-setting method: When the lumbar intervertebral disc prolapses to the left or the right side, adopt pulling to rotate the straightened waist; stick out the chest with straightened waist to put forth effort; carry the patient with opposing backs. When it prolapses posteriorly, adopt putting forth effort with a thumb where the Qi of the whole body of the operator concentrates. When it prolapses anteriorly, putting forth effort with a palm where the Qi of the whole body of the operator concentrates. AP method: When the disc prolapses to the left or right, select GV26, healthy side of Lumbago spot, HT05, TH05, SI07, strong stimulation. Needles are retained for 40 min. When the disc prolapses anteriorly, select diseased side of Huatojiaji in area L1-L5, SP10, Dingdian, SP12, LV11. EAP a group of these points or some of them alternately. Needles are retained for 30-40 min. When the disc prolapses posteriorly, select BL23, CV06, BL25, BL26, both sides of BL31 to 34), BL54, BL29, etc, 10 points/time. Needles are retained for 30 min, EAP is added. Severe radiating pain of lower limb, add KI01 and prick spots 0.5 cm above the two sides of toenail promptly with a three-edged needle. Such treatment was carried out once every 5 d. Treatment was effective in 1999 cases (99%) and ineffective in 10 cases (1%).

18 Chu ZH (1993) [Treatment of 31 cases of impotence by puncturing points of CV01 combined with CV04]. Journal of Clinical AP and Moxib 9(1):15. AP at GV16, GV20; GV26 and GV04 (moxibustion added) was given; oral-taking Capsule for promoting circulation (auricularia auricula-judae, Hirudo and Radix Notoginseng) was combined. 16 cases of brain atrophy were treated with effective rate 75% and 14 cases of brain blood vessel diseases were treated with effective rate 83%. The therapy promoted brain tissue repair.

19 Clifford DH, Lee DC, Lee MO (1983) Effects of DMSO and AP on the cardiovascular system of dogs. Ann NY Acad Sci 411:84-93. DMSO (100 mg/kg i/v) significantly raised CO, SV, CVP, and decreased HR. AP by electrocautery at GV26 significantly increased CO, SV, HR, MAP, and PP and decreased TPR in dogs under 0.75% halothane anaesthesia. Both DMSO and AP evoked an analgesic effect and enhanced cardiovascular function as exemplified by an increase in CO. PMID: 6576724, UI: 83281296

20 Cui JC (1994) [Treatment of 63 cases of aphasia from apoplexy with AP]. CAP&M 14(2):73-74. GB20, HT05, Jinjin + Yuye were selected as main points. GV26 and PC06 were added for unconsciousness, ST40 was added for thick sputum, SP10 and BL18 were added for stagnation of blood, GV20 and LV03 were needled for asthenia of liver-yang, CV12 and ST36 for deficiency of vital energy, and BL23, KI13 for asthenia of the kidney. The manipulation of lifting, thrusting and twirling was used. Jinjin + Yuye were bled. Besides, WM and TCM were given together. 20 cases were basically cured, 22 cases markedly improved, 14 cases improved and 7 cases unimproved. The effective rate was 89%. The mechanisms of AP treatment of aphasia caused by apoplexy are also discussed.

21 Cui JC, Zhang QY, Li SP (1984) [AP in the treatment of pseudo-bulbar paralysis: Analysis of 48 cases]. Zhejiang J TCM 19(4):156. GB20, CV23, with Helper points GV26, PC06, ST40, SP10, BL17, GV20, LV03. Manipulation. The lifting, thrusting, twisting, and twirling normal reinforcement and reduction method was used. Needle insertion directed obliquely to the laryngeal protuberance, the depth was 1.0-1.5", once/d for 15 d/course. Of the 48 cases, 41 were cured, 3 basically cured, 3 improved, and 1 unchanged.

22 Davies A, Janse J, Reynolds GW (1984) AP in the relief of respiratory arrest. NZ Veterinary Journal, 32, 109-110. Apnoea in sheep was produced by halothane overdose, to compare the effect of AP at GV26, needling the tibial nerve and a control (no treatment). GV26 stimulation, tibial nerve stimulation and no stimulation produced spontaneous breathing in a mean of 16 (0-84), 37 (2-97) and 47 (14-89) sec respectively. Treatment effects GV26 v tibial nerve and GV26 v control were significant at p<.05 and p<.001 respectively. Tibial nerve stimulation had no effect on the initiation of breathing. GV26 may activate a direct neural reflex in the respiratory (inspiratory) centre.

23 Dill SG, Gleed R, Matthews NS, Erb HN, Miller TK (1988) Cardiovascular effects of AP stimulation at GV26 in halothane-anaesthetised ponies. Amer J Vet Res Oct 49(10):1708-1712. Dept of Clinical Sciences, New York State Coll of Vet Med, Cornell Univ, Ithaca 14853. Stimulation of GV26 is used commonly in the Orient to treat shock in human beings and other species. The effects of stimulation of the upper lip on the GV26Tabs.htm - cvsCVS were studied in 7 healthy ponies during 2 episodes of halothane anaesthesia at an interval of 1 week apart. EAP at GV28 and GV26 was used in one episode, moxibustion by electro-probe-cautery at GV28 and "non-point A" in the other. The order of the stimulations was random. During each period of anaesthesia, two "non-acupoints", A and B, were used for control stimulation. Point A was 2 cm dorsal to the mucocutaneous junction of the upper lip, 4 cm left of the midline, and point B was 1 cm caudal to that. Control and AP stimulations were of equal intensity and duration (5 minutes). Relative to the changes in the period of stimulation of the "non-points", neither EAP nor heat- stimulation changed CO, systemic arterial pressure, or HR significantly. PMID: 3189985, UI: 89048579 [Comment: The "non-points" were in the muzzle/nasal area, and may have had a significant effect on the GV26Tabs.htm - cvsCVS, thereby being invalid for comparison of the "active" versus the "control" points].

24 Ding DZ (1988) [Experience in diagnosing and treating schizophrenia]. Zhejiang J TCM 23(4):152-154. Phlegm stagnation: AP is used at BL18, BL21, ST40, LV03, BL15, PC06, HT07, GV16 and GV20 with reducing method. Needles are retained for 3 hours and twisted once every half an hour. Heart confused by phlegm: AP was used with reducing method at BL15, BL13, BL20, GV26, GV20, ST40, PC06, HT05, GV24 => GV23. Heart disturbed by phlegm fire: AP was used by the reducing method at BL15, PC06, BL21, ST40, HT07, BL12 + Earpoints Shenmen, Brain and Stomach. This paper also introduces 10 other types of schizophrenia, all of which are given traditional compound herbs that suit their symptoms at the same time of receiving AP treatment.

25 Fang ZC (1992) [AP therapy and first aid]. Railw Med J 20(4):233. Use of single point for emergency treatment: GV26, KI01, Shixuan, Shierjingxue, GV14, GV16, GV15, GV01, GV20, CV04, ST36, Yintang or PC06. Use of a group of points for emergency treatment: GV25 + PC06 + CV04; LI04 + LV03. AP for treatment of imminent severe diseases according to differentiation of symptoms and signs. 5 successful cases were enclosed.

26 Feng QX, Hua YL, Yang ZM (1988) [Exploration of mechanism of AP at GV26 for emergency case in rabbits]. Jiangsu J TCM 9(12):22-23. Experimentally, AP of GV26 in emergency increased blood sugar, 5-HT GV26Tabs.htm - 5-ht

concentration and CPK activity. These are possibly important anti-shock effects. Further research on the mechanism of anti-shock effect by AP of GV26 in human is necessary.

27 Futaesaku Y, Zhai N, Ono M, Watanabe M, Zhao J, Zhang C, Li L, Shi X (1995) Brain activity of a rat reflects apparently the stimulation of AP: radioautography using 2-deoxyglucose. Cell Mol Biol Noisy le grand Feb 41(1):161-170. Dept of Histol and Analytical Morphol, Sch of Allied Health Sci, Kitasato Univ, Kanagawa, Japan. To confirm a relationship between the CNS and AP, the response was examined in the rat brain using radioautography with tritiated 2-deoxyglucose, after stimulation of some acupoints. 8 groups, of a total of 27 rats were submitted to AP at 6 different acupoints (ST36, GV26, ST25, HT07, PC06, KI01) and control, with or without electric pulses or with anaesthesia respectively, before the injection with isotopic deoxyglucose. 120 cryosections were cut from a freshly frozen brain and exposed on single-coated X-ray films. Compared with the control group, AP at ST36, ST25, HT07 and PC06 enhanced neocortical-, limbic cortical- and thalamic nuclear- activity. AP at GV26 and KI01 depressed the activity on the thalamic nuclei and midbrain. Pentobarbital anaesthesia concealed most activity all over the brain, which hardly responded to any AP stimulus. Brain neuronal activity reflected the signals from AP stimuli and activity changed depending upon each acupoint.

28 Ganzberger K (1997) Traditional animal-resuscitation techniques in Austria. Personal communication. Stimulation of the naso-incisival duct is a traditional way to resuscitate hypoxic newborn calves. Several generations of Austrian farmers and cattle-breeders have used this treatment. They traditionally inserted a matchstick into the naso-incisival duct to induce respiration. The duct is near the same area as GV26.

29 Guan XM, Liu XC, Zhang YW (1989) [Preliminary exploration of mechanism of AP therapy of shock]. Chin Acup & Moxibust 9(1):30-32. Haemorrhagic shock in animals was used as model to observe the effect of AP on BP, the level of catecholamine and oxygen metabolism. Also, the mechanism of the treatment of "Jue-Tue Zheng" was studied. AP at GV26 and CV24 had clear antishock function. AP effectively regulated the level of blood catecholamine. AP raised arterial blood oxygen volume in shocked animals. Shock decreased, and AP increased, the rate of oxygen intake to the lungs. AP decreased the rate of oxygen use in adrenal tissue and increased the oxygen content used in heart and liver tissue.

30 He CY, Zhang LS (1988) [Observation on treatment of 134 cases of allergic rhinitis by massage along Channels]. Chin J Integ Tradit West Med 8(5):304. 134 cases of allergic rhinitis including perennial rhinitis (41 cases) and seasonal rhinitis (93 cases) were treated by massage along the Channels. Index fingers of both hands were used to push the margin of orbit and knead up and down along the bridge of nose repeatedly several times. For nasal discharge as the main symptom, BL02 and BL01 were pushed; for nasal obstruction, Jiabi and Shangxia Yingxiang; for sneezing, GV26 and CV22. Treatment was for 10 min, 1 or 2 times/d for 5 times/course. Of 134 cases treated, 116 were cured, 13 improved and 5 unchanged.

31 Hu YH, Hu DS (1994) [AP in the treatment of chorea minor: Analysis of 30 cases]. CAP&M 14(2):67-68. GV14, GV16, GV20 and GV26 were used as main points; other points were added according to the symptoms as Helper points. After deqi, the manipulation of lifting, thrusting and twirling, was used to make the sensation radiated to the surrounding areas or remote regions. The needles were retained for 10-15 min, or simply withdrawn immediately, while those punctured in the Helper points retained for an hour with 1-2 manipulations. Treatment was once/d. If the patient was not cured after 10 sessions, AP was resumed after 3 d. Of the patients treated, 29 cases were cured after 6-36 sessions, and 1 case was improved with a total effective rate of 97%. A three-year follow up of the cured patients revealed that 3 cases relapsed later but were cured by another session of AP.

32 Hu ZH (1992) [AP and moxibustion treatment for three stages of apoplexy]. Sichuan J TCM 10(6):48-49. Prodromal stage: In addition to expectant treatment, GV20, GB20 and LI11 were needled and manipulated with reducing method, and AP or moxa could be used frequently at ST36. During attack: When the prostration syndrome appeared, emergency treatment was given by moxibustion at CV08 (salt-partitioned), CV06 and CV04 with big moxa cones till the patient's pulse recovered; plus AP at KI01, ST36, CV12 and SP06 with reinforcing method. Emergency treatment of Excess Syndrome of stroke: Bloodletting at Shixuan and puncturing ST06, GV26, GV20, CV24, LI04, ST40 and PC08 with reducing manipulation, and KI01 with reinforcing manipulation. Transformation stage: To treat apoplexy involving Channels and Collaterals: AP at ST36, LI11, GB21, GB30, SP10, SP09, GB34, GB39 and BL60 along and against the direction of Channels, combined with lifting and thrusting the needle and reinforcing method for the healthy side first and with reducing method for the diseased side later. In addition, other points or moxibustion was added based on symptoms.

33 Huang JP (1988) [AP at GV26 in the treatment of hysteric stupor: Report of 21 cases]. Jiangxi J TCM Pharmacol 19(4):38. Short needles are used to repeatedly give strong stimulation on GV26 and LI04 on both sides. The stimulation may be decreased gradually as relief of the symptom appears. All of the 21 cases treated have obtained good effects. Included in the paper are 2 case reports.

34 Huang KH, Rong XD, Cai H (1988) [The effects of EAP at GV26 on brain spontaneous and evoked potentials of the rabbits with haemorrhagic shock]. Acup Res 1988;13(3):205-214. They studied the effects EAP at GV26 on brain spontaneous potentials, SEPs and EEG power spectra in rabbits with haemorrhagic shock . EAP increased BP in haemorrhagic shock and improved brain function to a certain extent. Improvement of EEG by EAP was closely related to the increase of the BP.

35 Huang KH, Zhang XY, Cai H (1992) [Effect of AP on the change in blood sugar in rats with haemorrhagic shock]. CAP&M 12(1):39-42. The contents of blood sugar were significantly increased in surgical control rats at one hour after surgery and in shocked control rats maintained in shock for one hour, p<.05. There was no difference among above two groups and shock-AP group. While shock developed with time, the blood sugar was not continually increased. But the content of blood sugar was still significantly increased after AP, p<.02. The shocked control group differed from the shock-AP group. Shock influenced sugar metabolism, causing initial hyperglycaemia. But after AP at GV26, the glucogenesis and gluconeogenesis were increased, and the time of onset of rebound hypoglycaemia was prolonged.

36 Huang KH, Zhang XY, Cai H (1992) [Observations on the changes of plasma pH and K content and the effect of AP on them in rats with hemorrhagic shock]. Chen Tzu Yen Chiu (Acup Res) 17(2):133-135. Inst of AP and Moxibustion, Chinese Acad of TCM, Beijing, PRC. Effects of AP at GV26 were studied in rats with haemorrhagic shock in relation to changes of pH and K-level of the blood. Experimental rats were assigned at random to 3 groups: Controls undergoing surgery; Controls in haemorrhagic shock; AP in haemorrhagic shock. Blood pH and K-level did not change significantly in the surgical control group (n=15). Haemorrhagic shock, maintained for 1 h, significantly decreased blood pH (n=30, p<.01) and increased K-level (n=26). As the shock time increased, blood pH decreased continually (n=14) and blood K-level increased significantly (n=12), but pH tended to increase again after AP at GV26 for 15 min (n=16), while K-level continued to increase (n=14, p<.05). AP slightly rectified the acidosis in haemorrhagic shock in rats, possibly via modulating the respiratory function and reducing the acidic metabolites in blood. AP did not significantly correct shock-induced hyperkalaemia.

37 Huang W, Huang K, Xu Q, Wang Z, Sun Y, Cai H, Zhang X, Lin J (1995) [Histochemical observation of the effect of EAP on the livers of rats with endotoxic shock - Article in Chinese]. Chen Tzu Yen Chiu 20(3):36-39. Inst of AP and Moxibustion, China Acad of TCM, Beijing. Experimental rats were divided randomly into 3 groups: Control group; Endotoxic shock group (the model of endotoxic shock was induced by i/v injection of E. coli endotoxin, 16 mg/kg); EAP group (GV26 or ST36 was stimulated for 15 min at 1 hr after injection of endotoxin). The rats were decapitated at 75 min after injecting endotoxin. Their livers were taken out for cryostat section, and histochemical observation. Glycogen in the hepatic cells of endotoxic shocked rats was almost completely depleted. The activities of SDH, Mg(++)-ATPase and G-6-Pase and 5'-Nase were decreased; especially the activities of 5'-Nase in the biliary canaliculi and sinusoids were apparently reduced. The content of hepatic glycogen in the EAP group was increased, but some of them were still depleted. The activities of SDH, Mg(++)-ATPase and G-6-Pase were slightly increased as compared with that of the endotoxic shock group. The activity of 5'-Nase increased clearly after EAP. EAP at GV26 or ST36 of rats with endotoxic shock may induce improved hepatic metabolism and promote membrane transport action.

38 Janssens L, Altman S, Rogers PA (1979) Respiratory and cardiac arrest under general anaesthesia: treatment by AP of the nasal philtrum. Vet Rec Sep 22 105(12):273-276. GV26 was needled in 69 cases of respiratory depression or apnoea in dogs and cats during induction or maintenance of general anaesthesia. In all cases, respiration returned to normal or near normal rates within 10-30 sec of insertion of the needle. In seven cases of anaesthetic apnoea with concurrent cardiac arrest and absence of vital signs, the revival rate was 43%. Those, which recovered, required four to 10 min of AP stimulation. In eight cases of collapse due to other causes, the revival rate was 25%. The cases included five sheep in shock after liver biopsy, two cases of haemorrhagic shock (dog, cat) and one terminal collapse in chronic congestive heart failure (dog). PMID: 516310, UI: 80083106

39 Jiang C (1987) [Sciatica treated by AP at GV14, GV20 and GV26]. J TCM Chin Mater Med Jilin (3):17. Needles, 1-1.5", were inserted at GV14, GV20 and GV26. After deqi, reinforcing and reducing manipulation was used. Reinforcing: needles were inserted s/c from the posterior to the anterior along the course of the Channel for three times and withdrawn for one time, with shallow insertion being first and deep insertion being next; they were thrust heavily and lifted slowly for 9 times and retained for 50 min; acupoints are closed quickly while withdrawing needles. Reducing: needles were inserted s/c from the anterior to the posterior against the course of the Channel for 1 time and withdrawn for 3 times, with deep insertion being first and shallow insertion being next; they were lifted heavily and thrust slowly for 9 times with the retention of needle for 45 min, acupoints are enlarged by shaking needles while they are removed.

40 Jiang F, Zhu LX (1988) [The effect of EAP at different points on cardiac pain]. Acup Res 1988:123-126. The nociceptive response of spinal dorsal horn neurone evoked by stimulation of the sympathetic nerve (T2 or T3 ramus) was used as the index of cardiac pain. They studied the inhibitory effects of intercostal nerve stimulation, EAP at PC06, HT03, GB30, KI03, GV26 and non-acupoint at tail of cats on the nociceptive responses of spinal dorsal horn neurones. There was no significant difference between the effect of EAP at all points mentioned above and intercostal nerve stimulation. However, the effect of the non-acupoint was significantly less than that of EAP at the acupoints and intercostal nerve stimulation. After severing of spinal cord at C1 the effects of PC06, HT03, GB30, KI03, especially GV26 were markedly decreased, but the effect of intercostal nerve stimulation was unchanged. There is a difference between the acupoints and non-acupoints in function. Intercostal nerve stimulation inhibited the nociceptive responses of convergent neurones in spinal cord through integration. The effects of the acupoints were produced by descending and segmental inhibition.

41 Jiang XQ, Zhang XS (1988) [Cerebral thrombosis treated by AP combined with hydro-AP: clinical and haemorrheological studies]. Zhejiang J TCM 23(6):279-280. They compared 2 groups of patients (45/group) with cerebral thrombosis. One group was treated with AP + hydro-AP, the other with AP only. AP was given at GV20, GV26, KI01, LI15, LI11, TH05, LI04, GB30, ST36 and GB39. Hydro-AP was used on GV20 and GV23. Herbs: (1 ml injection of Rhizoma Ligustici Chuanxiong) by 6-gauge needle to perform horizontal insertion in a upward movement from GV20 towards GV23 for 1". After deqi, the herbal liquid was injected into each point in turn, once/d for 30 d/course. Of the 45 patients in the group of AP + hydro-AP, 24 were basically cured, 14 had marked effects, 6 were improved and 1 was unchanged. Of the 45 cases in the AP group, 15 were basically cured, 5 had marked effects, 21 were improved and 4 were unchanged.

42 Jiao XM, Yin KJ, Jia CW (1988) [Clinical application of Sun Simiao's "13 Ghost points"]. Shaanxi J Chin Tradit Med 9(5):202-203. In Qian Jin Yao Fang (Thousand Gold Prescriptions), Sun Simiao, a famous doctor of TCM in Tang Dynasty, proposed 13 Guixue (Ghost points) for use in treating manias. They were GV26, LU11, SP01, PC07, BL62, GV16, ST06, CV24, PC08 or PC05, GV23, CV01, LU05 or LI11, and sublingual midline. The authors used these points mainly to treat mental diseases. Of the 13 Ghost Points, the Jing-Well points (LU11, SP01 of the Taiyin Channels) were most effective in mental diseases.

43 Jin SR, Huang ZS (1987) [A study of the specificity of the depressing action of ST36 in visceral pain of conscious cats]. Acup Res 1987;12(1):73-76. The Galvanic Skin Reflex (GSR) induced by splanchnic nerve stimulation was recorded as a measure of visceral pain in conscious cats. The inhibitory effect of AP at ST36 on splanchnic-GSR response was stronger than that evoked by AP at GV26, CV24, LI11 or GV06. APA could not be produced by AP of non-Channel points, such as the root of ear, and some areas of the chest, neck, forehead. But the inhibitory effect was more marked and efficient when both ST36 points were used simultaneously. The difference of analgesic effects produced by AP of ST36 and non-Channel point was statistically significant.

44 Ke XQ (1989) [The rule and thinking of differentiation-treatment of chronic pulmonary heart disease]. Liaoning J TCM 13(2):8-10. Acute stage: Treat to remove the evil and by combining reinforcement and elimination. Treatment according to types of diseases (1) Hanyinshefei (cold drinking to lung): Xiaoqinglong Tang was combined with drugs to relieve heat-phlegm; (2) Tanreyongfei (accumulation of phlegm and heat in lung): Qingqihuatan Tang was used; (3) Yang deficiency and evil remaining: Wenyanghuatan prescription (Warming Yang and resolving phlegm) was used. Treatment according to symptoms and signs: (1) Inflammation: Houttuynia, Chinese holly leaf, or composite of houttuynia was injected; (2) Cough, asthma and phlegm: Keteling, Tankejing and pills of viticis Negundo oil were used. (3) Respiratory failure: a. AP at ST36, GV25, GV26, CV01; b. Point injection Lobeline 3 mg injected at LI11; Huisuling 0.8mg was injected at ST36 or SP06; Xingnaojing 1.2 ml was injected at CV17, LI11, LU01, BL13, ST36; aminophylline 0.5-1ml was injected at LU07, LU01, LI04; 75 composite Chinese angelica solution was injected into BL17. c. Ear AP: Earpoints Brain, Sympathetic, Lung, Subcortex were needled; ear embedding was carried out for 24-48 hours after remission of symptoms and signs. (4) Cardiac failure with blood stasis: Dushen Tang and Shenfu Tang were added.

45 Kong DQ (1992) AP therapy of mental disorder followed by stroke: Report of 33 cases. Shaanxi J Tradit Chin Med 13(11):514. A needle was inserted into GV26 and advanced upward obliquely to about 0.8" in depth and manipulated with heavy "sparrow-pecking" until the patient's eye moistened, or tears came. Another needle was inserted into GV20 and advanced horizontally 2" toward the diseased side. After deqi, the needle was twirled rapidly and in large amplitude for 2 min. The needles were retained for 30 min. Treatment was once/d for 10 d/course. After 1-2 courses, 29 cases were cured and 4 improved.

46 Kumar A, Bihari A (1996) EAP for Resuscitation in Canine. Indian Vet J May 73(5):573-575. Govind Ballabh Pant Univ Agr & Technol, Coll Vet Sci, Dept Surg & Radiol, Pantnagar 263145, Uttar Pradesh, India. The effect of GV26-stimulation was investigated for resuscitation of anaesthetised dogs. 12 dogs, in 2 groups of 6, were given atropine sulphate (0.04 mg/kg, i/m) and thiopentone sodium (30 mg/kg, i/v). Group 1 were controls. Group 2 got EAP (130-`150 Hz, 3-5 V) at GV26 for 15 min, starting 10 min after anaesthesia. After thiopentone administration, they recorded RR, HR and rectal temperature before and at 10, 20, 30, 40 and 60 min, and arterial blood PaCO2 and pH at 15 and 45 min, and noted the duration of anaesthesia and recovery time. Relative to changes in the control dogs, EAP at GV26 significantly (p<.05) increased RR and HR, decreased arterial PaCO2 and pH, and improved respiratory acidosis. It also significantly (p<.05) shortened the duration of anaesthesia from 20.2+1.25 to 8.1+2.42 min and time to complete recovery from 65.5 to 15.5+3.22 min.

47 Kuussaari J (1998) Traditional animal-resuscitation techniques in Finland. Personal communication. To stimulate respiration in newborn calves, cattle farmers in certain Finnish regions traditionally press their fingernails into the septum nasi immediately after birth. The nails press on each side of GV26 in the septum. Currently, many pig farmers in Finland resuscitate neonatal piglets with poor respiration by strong AP at GV26. In Finnish Lapland, the Lapps also have another tradition to revive or resuscitate reindeer in emergencies - they cut the tip of the tail (traditional acupoint Weijian). This is used to induce respiration in apnoeic neonates and to revive adult reindeer that are exhausted from overexertion.

48 Lee DC (1978) Comparison of the cardiovascular effects of AP by various forms of stimulation in dogs during halothane anaesthesia. Amer J Acup 6(3):209-227. AP at GV26 was studied in 7 groups of lightly anesthetized dogs with halothane (0.75%) over a two hour period: Five control dogs, 10 dogs with moxibustion, 7 dogs with digital pressure, 6 dogs with AP with twirling, 5 dogs with EAP, 6 dogs with AP, and 10 dogs with TENS. There was an increase (p=.005) in CO, SV, HR, MAP, and a corresponding decrease in TPR after AP with twirling and moxibustion at GV26. There were no significant changes in any of the above variables and pH, PaCO2, PaO2, and base deficit after other forms of stimulation.

49 Lee DC, Clifford DH, Lee MO, Nelson L (1981) Reversal by AP of cardiovascular depression induced with morphine during halothane anaesthesia in dogs. Can Anaesth Soc J Mar 28(2):129-135. They studied the effects on the GV26Tabs.htm - cvsCVS of morphine sulphate and/or AP by means of electrocautery at GV26 in 35 dogs. To allow controlled ventilation during a two-hour period of monitoring, all dogs were kept under anaesthesia with halothane 0.75% supplemented by succinylcholine i/v. CO, SV, HR, MAP, PP, CVP, TPR, [H+] (pH) PaCO2, PaO2 and base deficit were measured in each dog. Morphine 0.5 mg/kg, given alone as a single bolus, significantly (p<.05) decreased CO, HR, MAP, and significantly increased SV and PP in dogs under halothane anaesthesia. AP by electrocautery alone induced a significant increase in CO, SV, HR, MAP and PP with a significant decrease in TPR after halothane. After i/v injection of morphine, AP at GV26 for 10 min caused a significant increase in CO, HR, MAP and a significant decrease in CVP and GV26Tabs.htm - tprTPR during halothane anaesthesia. The depressant effect of morphine on CO, HR and MAP in dogs under halothane anaesthesia appears to be reversed by AP by electrocautery at GV26. Stimulation of GV26 could be helpful in resuscitating patients whose cvsCVS is depressed by morphine and/or halothane anaesthesia. PMID: 7248823, UI: 81234076

50 Lee DC, Ichiyanagi K, Lee MO, Clifford DH, Morris LE (1979) Can naloxone inhibit the cardiovascular effect of AP? Can Anaesth Soc J Sep 26(5):410-414. 40 dogs were studied during MAC-1 halothane anaesthesia with a chronically implanted electromagnetic flow probe on the ascending aorta. CO, SV, HR, MAP, PP, CVP, TPR, PaO2, pH, PaCO2 and base deficit were determined. Electrocautery moxibustion at GV26 significantly increased (p<.05) CO, SV, HR, MAP and PP and significantly decreased TPR during a period of 120 min observation in dogs under halothane anaesthesia. Moxibustion at GV26 after pretreatment with the narcotic antagonist naloxone (1 mg/kg) significantly increased CO, HR and MAP. Naloxone, which inhibits the analgesic effects of AP, does not inhibit the symphathomimetic effect of AP or moxibustion at GV26 in dogs under light MAC-1 halothane anaesthesia. PMID: 487236, UI: 80022327

51 Lee DC, Lee MO, Clifford DH (1975) Cardiovascular effects of moxibustion at GV26 during halothane anaesthesia in dogs. Amer J Chin Med Jul 3(3):245-261. The effects on the cvsCVS of moxibustion at GV26 in 10 dogs under halothane anaesthesia were compared to 5 dogs under halothane anaesthesia without moxibustion and 5 dogs under halothane anaesthesia in which moxibustion was effected at a neutral or non-AP site. CO, SV, HR, MAP, CVP, TPR, pH, PaCO2, PaO2 and base deficit were measured over a two-hour period. A significant increase in CO and SV and a significant decrease in the TPR were observed in the group that was stimulated by moxibustion at GV26. HR, MAP and PP were significantly increased during the early part of the two-hour period in the same group. The cvsCVS-effects of moxibustion at GV26 which were observed at the end of two hours were also present in two dogs in which measurements were continued for two additional hours. PMID: 1190114, UI: 76059094

52 Lee DC, Lee MO, Clifford DH (1976) Modification of cardiovascular function in dogs by AP: a review. Amer J Chin Med Winter 4(4):333-346. AP at GV26 in dogs under halothane anaesthesia evokes sympathomimetic-like effects on the cvsCVS. This response can be inhibited by pretreatment with propranolol and to a lesser extent with phentolamine. AP at ST09 can reverse severe hypotension and cardiac arrest produced by hypoxia in dogs under halothane anaesthesia. This also was interpreted as a sympathomimetic-like effect. AP at ST36 gave a parasympathomimetic-like effect on the cvsCVS that was inhibited by atropine. AP at LI05 can obtain a parasympatholytic-like effect resembling that produced by atropine in dogs with sinus arrhythmia and pulsus alternans. Publication Types: Review PMID: 793374, UI: 77063045

53 Lee DC, Lee MO, Clifford DH (1980) Comparison of sodium salicylate, morphine sulphate, and AP at GV26 on the cardiovascular system of dogs. Amer J Chin Med Autumn 8(3):245-253. They compared the cvsCVS-effects of administration of Na salicylate (100 mg/kg), administration of morphine sulphate (0.5 mg/kg) and AP by electrocautery at GV26 in dogs under 0.75% halothane anaesthesia. CO, SV, HR, MAP, PP, CVP, TPR, pH, PaCO2, PaO2 and base deficit were measured over a two hour period. Na salicylate significantly increased CO, SV, PP, and CVP and decreased TPR. Morphine sulphate decreased the CO, HR, and MAP significantly while the SV and PP were significantly increased. AP by electrocautery at GV26 significantly increased CO, SV, HR, MAP, and PP and significantly decreased TPR. This model was satisfactory in comparing changes in the cvsCVS evoked by a mild analgesic, sodium salicylate, a potent opiate, morphine sulphate, and AP by electrocautery at GV26. PMID: 7211744, UI: 81157060

54 Lee DC, Lee MO, Clifford DH (1980) Does beta-endorphin modify the sympathomimetic effects of AP during anaesthesia in dogs? Amer J Acup 8:215-222. In other dogs, prepared similarly, EP (epidural injection, 60 ug/kg) had morphinomimetic (parasympathomimetic, cardiodepressive) effects: decreased CO and HR and increased TPR. Electrocautery at GV26 (probe 80 oC, for 10 min) had sympathomimetic (cardiostimulant) effects: increased CO, SV, PP and mean BP and decreased TPR. Electrocautery at a neutral point a few mm beside GV26 had no effect. Electrocautery after EP reversed the parasympathomimetic effect of EP: CO and SV increased and TPR decreased. When naloxone was given after EP, subsequent electrocautery gave a marked increase in CO, HR and BP. AP at GV26 also reversed the cardiodepressive effect of morphine. Naloxone alone increased CO and BP. AP at GV26 after naloxone still gave its sympathomimetic effect. Naloxone blocks the analgesic, cardiovascular and respiratory effects of EP.

55 Lee DC, Lee MO, Clifford DH, Ichiyanagi K (1979) Transcutaneous electrical stimulation: comparison of cardiovascular effects at GV26 for 10 seconds and 10 minutes in dogs. Amer J Acup 7:215-222. Responses of the cvsCVS to stimulation of GV26 were studied in dogs under halothane anaesthesia. Electrocautery (80 oC probe) for 10 min had sympathomimetic effects on the cvsCVS. The effect was more marked than that produced by simple AP, AP with twirling, or EAP. Low frequency TENS (0.5 Hz) for 10 min had similar effects to electrocautery (higher CO, SV and PP and lower mean BP and TPR.

56 Lee DC, Lee MO, Clifford DH, Morris LE (1976) Inhibition of the cardiovascular effects of AP (moxibustion) by propranolol in dogs during halothane anaesthesia. Can Anaesth Soc J May 23(3):307-318. Electrocautery moxibustion at GV26 produces a sympathomimetic effect on the cvsCVS of dogs under halothane anaesthesia (MAC-1). This effect is manifest by significant increase in CO, SV, HR, MAP and PP while TPR is significantly decreased during a two-hour period of observation. Pretreatment with the beta-blocker, propranolol, caused a significant decrease in CO, HR, MAP and PP while TPR was significantly increased. Similar responses were observed when propranolol was given without moxibustion at GV26. PMID: 938968, UI: 76233527

57 Lee DC, Lee MO, Clifford DH, Morris LE (1982) The autonomic effects of AP and analgesic drugs on the cardiovascular system. Amer J Acup 10(1):5-30. The autonomic effects of AP and analgesic drugs on the cvsCVS. AP at GV26 had a sympathomimetic effect in halothane anesthetized (0.75%) and ventilated dogs. Propranolol (0.5 mg/kg i/v), and to a lesser degree phentolamine (0.1 mg/kg i/v), blocked the effects. Atropine (0.2 mg/kg i/v) blocked the parasympathomimetic effect of AP at ST36. They discussed the physiological basis of the analgesic effects of AP on morphinometic agents in the brain, the increase of such substances after AP, and reversibility of natural and synthetic opiates with naloxone. AP at GV26 antagonized the depressant effect of morphine (0.5 mg/kg i/v) and beta-EP (0.06 mg/kg, intraspinal) and resembled the effect of sodium salicylate (100 mg/kg i/v), naloxone (1 mg/kg i/v) and DMSO (100 mg/kg i/v). Stimulation of ST09 reversed cardiac arrest in dogs. AP at LI05 was effective in correcting pulsus alternans and sinus arrhythmia in dogs.

58 Lee DC, Yoon DS, Lee MO, Clifford DH (1977) Some effects of AP at GV26 on cardiovascular dynamics in dogs. Can J Comp Med Oct 41(4):446-454. The effects on the cvsCVS of two types of AP, needling with twirling and moxibustion by electrocautery, at GV26 were studied in dogs with chronically implanted electromagnetic flowmeter probes, during 0.75% halothane anaesthesia with a succinylcholine drip to allow controlled ventilation. CO, SV, HR, MAP, PP, CVP, TPR, acid-base and blood gases were measured over a two hour period. During and after moxibustion by electrocautery at GV26 there was a generally significant increase (p<.05) in CO and SV and an initially significant increase in HR, MAP and PP. TPR decreased significantly initially after electrocautery moxibustion, and after needling with twirling. However, electrocautery moxibustion at GV26 had more significant effects on the dynamics of the cvsCVS in dogs than needling with twirling. PMID: 922560, UI: 78041389

59 Lee MO, Lee DC, Clifford DH (1976) Inhibition of the cardiovascular effects of AP (moxibustion) by phentolamine in dogs during halothane anaesthesia. Amer J Chin Med Summer 4(2):153-161. The effects on the cvsCVS of moxibustion by electrocautery at GV26 and phentolamine (0.1 mg/kg i/v) alone were compared to phentolamine (0.1 mg/kg i/v) prior to moxibustion at GV26 in groups of ten dogs under 0.75% halothane anaesthesia. CO, SV, HR, MAP, CVP, TPR, pH, PaCO2, PaO2 and base deficit were measured over a two hour period. A significant increase (5% level) in CO, SV, HR, MAP, PP and a significant decrease in TPR were observed after moxibustion with electrocautery at GV26 in dogs under halothane anaesthesia. These effects were inhibited by pretreatment with the alpha blocking agent, phentolamine (0.1 mg/kg i/v). The effects on the cvsCVS of phentolamine (0.1 mg/kg i/v) alone were similar to those of dogs in which phentolamine was given before moxibustion. PMID: 937238, UI: 76228723

60 Li CY, Zhu LX, Ji CF (1987) Relative specificity of points in APA. J TCM 7(1):29-34. They compared EAP of ipsilateral GB30, GB02, ST36 and contralateral GB30 and GV26 on the nociceptive responses of spinal dorsal horn neurones evoked by stimulation of the sural nerve in rats. The inhibitory effect of AP at ipsilateral GB30 and GV26 on the nociceptive responses was more significant than that of needling the other points tested. The inhibitory effect of stimulating GB30 of the Foot-Shaoyang channel was similar to that produced by directly stimulating the sural nerve with the same parameter. There is a relative specificity among acupoints in analgesia or treatment of diseases. The sciatic nerve including the afferent fibres from pain source may be the main structure transmitting AP signals arising from GB30. The relative specificity of acupoints probably is closely related to the distribution of nerves.

61 Li CY, Zhu LX, Ji CF (1989) The effect of AP on C-fibre afferent terminal excitability in the spinal cord of cats. East-West Pain Conference (Beijing):26. AP can inhibit the nociceptive response of dorsal horn neurones in cats and rats. In anaesthetised and immobilised cats, we studied whether presynaptic inhibition was involved in the mechanism of APA. The size of the compound antidromic C action potentials of the sural nerve evoked by the stimulation of the spinal cord where the sural nerve terminals enter into was measured as an indicator of C-afferent terminal excitability. They studied the effect of AP on the C-afferent terminal excitability. Not only EAP but also manual AP at GB30, PC06 and GV26 enlarged the antidromic C wave. In spinal animals, the effect of AP at PC06 and GV26 disappeared but at GB30 still remained. AP at GB30, PC06 and GV26 depolarised C-afferent terminals. Presynaptic inhibition may be involved in the mechanism of APA. The results in spinal animals suggest that presynaptic modulation on the transmission of nociceptive information in the spinal cord was involved in the segmental inhibition as well as in the descending inhibition in APA.

62 Li CY, Zhu LX, Ji CF (1990) The effect of AP on the excitability of primary C-afferent terminals. Acup Res 1990;15(4):256-263. The antidromic C-wave of the sural nerve was recorded after the distal part of sural nerve and ipsilateral ventral roots (L5-S1) were cut. The antidromic C-wave was used for reflecting the terminal excitability of primary C-afferent fibres in the spinal cord. It is noted that EAP at GB30 in the segment, PC06 and GV26 in the distal segment all could elicit the increase of the antidromic compound C-waves of the sural nerve, showing the depolarisation of primary C-afferent fibre terminals. After the spinal cord was severed between T10-L2, the effects of EA at PC06 and GV26 were abolished, and the effect of EA at GB30 was reduced. Manual AP also could increase the antidromic C-wave of the sural nerve. Both manual AP and EAP could induce depolarisation of primary C-afferent fibres as long as the intensity of AP stimulation was strong enough. Presynaptic inhibition may be involved in the descending regulation and in the segmental inhibition activated by AP. Presynaptic inhibition may be one of the important mechanisms of APA.

63 Li H, Gao GY, Chen H, Zhang K, Gao Y, Yang M, Xiao G, Guan X (1994) [The study of mechanisms and effects of prophylaxis and cure of EAP against ischaemic injury in brain - Article in Chinese]. Chen Tzu Yen Chiu 19(1):26-28. Dept of Physiology and Biochemistry, Wuhan Postgraduate Med Inst. They studied the influence of EAP at GV26 on experimental acute ischaemic brain injury in 18 rabbits by antidromically blocking the double common carotid arteries. EA, RA and the contents of AI, AII increased; basic arterial pressure and the content of brain LA clearly fell. EAP at GV26 was safe and had a curative effect on brain ischaemia.

64 Li L, Shi XM (1988) [Stakle stroke treated by AP with restoring consciousness for resuscitation needling method: Analysis of 50 cases]. Hunan J TCM 4(2):33-35. AP was used to treat unconsciousness in 33 male and 17 female patients with Stackle stroke. Treatment Principles were: Resuscitation: dredge the Channels and nourish the liver and kidney. AP was used at PC06, GV26 and SP06. Of 50 cases treated, 21 were basically cured, 11 markedly effective, 14 improved, 3 unchanged and 1 died. The total effective rate was 92%. Resuscitation was emphasised in the method, which was consistent with TCM theory.

65 Li RJ (1989) [1268 examples of harelip-needle EAPA in midwifery]. Acup Res 1989;14(1-2):243. EAP model 6805 stimulator was used in 1268 operations: tubal ligation, oophorectomy, caesarean section inside or outside the peritoneum, uterus apoplexy, metorrhexis using hysterectomy left cervix, metrorrhexis recovering the uterus, entra-uterine gestation using one-side hysterosalpingectomy, malignant hydatidiform mold using whole using whole hysterectomy. Harelip-needles were inserted slantwise into two points, the philtrum (anode) and GV26 (cathode). EAP with continuous waves began 15 min before surgery. Sodium luminal 10 mg and atropine 0.5 mg was injected i/m before surgery. Dolantin 50 mg was injected i/v 5 min before cutting the skin. EAP was maintained until the end of surgery with 100 Hz continuous waves. If analgesia was not adequate during surgery haldol (halothane?) and little ketamine was used. This combined anaesthesia counters shock, relaxes the muscles and reduces postoperative pain. 98% of the patients recovered.

66 Li RJ, Li SL (1991) [Experience of application of lip (GV26) EAPA on 97 cases of operation for extrauterine pregnancy rupture]. Acup Res 16(3-4):275. EAP was used at GV26 in cases of operation for extrauterine pregnancy rupture. The needles were connected to an EAP-stimulator (model 6805). Current (continuous wave, up to 100 Hz) was applied 15 min for induction and throughout surgery. 87 cases (90%) were excellent. AP at GV26 had marked antishock effects in 25 cases complicated with shock.

67 Li YF, Li GQ, Xu BQ (1992) [Hemiplegia caused by stroke treated by AP: Report of 365 cases]. Zhejiang J TCM 27(8):345. AP was used at PC06 (both sides) with rapid twisting-rotating for 1 min. Then AP was used at GV26, sparrow-pecking until lacrimation occurred. Then AP was used at SP06 with thrusting-lifting manipulation until the patient's limbs jerked 3 times. Needles were not retained. Helper points: LI15, LI11, LI10, TH04, TH03, LI04, SP10, GB31, GB34, ST40, LV03, BL62, KI03. Needles were retained for 30 min. at 5-6 points, treated alternately, once/d for 14 d/course, with an interval of 7 d between courses. Of 365 cases treated, 146 were cured, 139 well improved, 73 improved, and 7 unchanged.

68 Li ZM (1992) [Some gynecopathy treated by AP therapy of xingnaokaiqiao). Tianjin J TCM (6):37-38. Premenstrual tension: A needle was inserted obliquely into GV26 and manipulated with sparrow-pecking method till tears came out. The needles inserted in GV20 and Sishencong were manipulated with reducing method, and those in SP06, PC06, LV03 manipulated with reinforcing method. CV06 was needled with uniform reinforcing-reducing manipulation and with the needle retained for 20 min. The treatment was given from d 15 before menstrual onset until d 2 after the end of menstruation. Menopausal syndrome: The needle insertion of PC06 and GV26 was same as mentioned above. Needled BL23 straight to the depth of 2", KI03 straight to the depth of 1.5-2", and BL18 obliquely with the needle tip toward the posterior middle line. All the needles were manipulated with reinforcing method. Needled SP06 with uniform reinforcing-reducing manipulation. Treatment was every 1-2 d for 10 times/course. Postpartum shock: PC06 and CV03 were needled with reducing manipulation, GV26 was needled with sparrow-pecking manoeuvre. Shixuan was used for bloodletting. Once conscious, the patient was advised to take Modified Shaofu Zhuyu Decoction. General postpartum pain: GB20, LI11, PC06, GV26, GB34, SP10, ST36, LI04 and BL17-BL23 were needled with reducing manipulation..

69 Lin JH (1985) AP demonstration in sows: resuscitation and reproductive disorders. Acup Res Quart (Taiwan), 9, 41-43. AP at GV26 and Shangen (midline, in the first fold above the snout) was used to treat shock and apnoea in sows. Most cases recovered within minutes.

70 Liu GT (1988) [Lumbago treated by AP combined with exercise therapy: Report of 65 cases]. Shandong J TCM 7(3):14. Lumbar pain due to cold-dampness: GV26 in lumbar pain and SI03 in Foot-Taiyang Channel lumbar pain. Helper points were BL20, bilateral ST36. Lumbar pain due to blood stasis: GV26. Helper points were Ashi point at local stasis region, BL23 in long period of lumbar sprain. Lumbar pain due to kidney deficiency: BL23, ST36; Helper points GV26, bilateral SI03. Manipulation. The patient was in standing position, AP on GV26 first, and SI03 later. Reducing method was used in severe pain, plain reinforcing and reducing method in mild cases, reinforcing method in intractable cases. Treatment was once/d. The patient moved his (her) body during AP. Reinforcing method was used at ST36, BL20 and BL23 + moxa on needle handle for 5-10 min. The needle retained for 20 min, once/d. For cases of blood stasis, cupping therapy was used after triangular needle puncturing to bleed. Result. The total effective rate was 96%.

71 Liu JL et al (1983) Effect of GV26 on the circulation system. Abstract Amer J Acup 1984;12:76, ex CAP&M 3(Aug):44-47. AP at GV26 increased CO and decreased TPR in animals. AP at GV26 dilated and congested the arteries of the cerebral pia mater and raised the temperature of the ear. Stimulation of GV26 had little effect on BP in normal animals but increased it strongly in animals with haemorrhagic shock.

72 Liu JL et al (1984) Effect of AP on catecholamine histochemistry in the adrenal medulla of rabbits in haemorrhagic shock. Abstract Amer J Acup 1985;13:172-174, ex CAP&M 4(Oct):30-34. GV26 an antishock effect, decreased mortality and increased the catecholamine levels in adrenal medulla, preventing their depletion in haemorrhagic shock in rabbits.

73 Liu JL et al (1986) Histochemical observation on the effect of AP at GV26 in the adrenal cortex of rabbits in haemorrhagic shock. Abstract Amer J Acup 1986;14:276, ex CAP&M 6(Apr):33-35. GV26 improved the functional activity of the cortical cells, as assessed by histochemical changes in lipid and cholesterol in the zona fasciculata of the adrenal cortex in rabbits.

74 Lou AL, Zuo HM, Lu ZB (1987) [Experimental study on effect of AP of ST36 on abdominal disorders]. WFAS 1st Conf (Eng) 170-172. The "Compendium of AP and Moxibustion" gave ST36 as a main point to treat abdominal disorders. They studied the central mechanism of the regulatory effect of AP at ST36 on vomiting and regurgitation using electrophysiological techniques and H-deoxyglucose autoradiography in dogs and rats. AP at ST36 inhibited vomiting and regurgitation induced by gastric traction. NRM, its opiate receptors, and GV26Tabs.htm - 5-ht

5-HT in brain mediated these inhibitory effects. The inhibitory effect of ST36 was stronger than that of PC06, or GV26, or CV24. AP signals via dorsal funiculus to the higher brain centres may play an important role in the inhibitory effect of AP on vomiting and regurgitation. ENK may mediate the transmission of AP signals from ST36 to the thalamus. They proposed that AP at ST36 inhibits vomiting and regurgitation via a central neurocircuit.

75 Lu WY, Liu L (1988) [Effects of AP at GV26 on experimentally-induced disorder of respiratory rhythm]. Acup Res 13(2):124-129. Apnoea and disorder of respiratory rhythm were induced in rabbits by mechanical lesioning of the dorsomedial region of, or a microinjection of Lidocaine into, the facial nucleus. EAP at GV26 evoked the start of respiration and recovery of rhythm. The dorsomedial region of the facial nucleus may play an important role in respiratory rhythm, and EAP at GV26 evokes regulation of experimentally induced disorder of respiratory rhythm. However, EAP at other facial points did not induce the effect. Also the effect of AP at GV26 was abolished by blocking the infraorbital branch of the trigeminal nerve, indicating that nerve as the afferent pathway of the respiratory effect induced by AP of GV26.

76 Lu YZ (1993) [Postpartum uroschesis treated with the AP of GV26: Report of 91 cases]. New J Tradit Chin Med 25(4):31-32. GV26 was needled (32 gauge, 1" long) to a depth of 0.5", "sparrow-pecking" until the patient's eyes became moist, or tears came. The needle was not retained. After 1-3 sessions, 88 cases were cured and 3 failed to respond. The latter were cured later by incorporating moxibustion at CV04, CV02 and AP at GV26.

77 Luo L, Lu SQ, Liu ZQ (1996) [Clinical Experience on Rescue of Acute Myocardial Infarction Complicated by Severe Arrhythmia with AP Resuscitation and Cardiac Pacing]. CAP&M 16(7):1-3. Arrhythmia of Adams-Strokes syndrome induced by cardiac arrest, atrioventricular block or others is one of main causes of death in AMI. In our hospital, we used AP at GV26, PC04, SP06, CV17, GB20 to improve HR. As the HR increased, endocardial pacing was performed immediately. AP increased the success rate of rescue of patients from imminent and AMI. Data of 21 cases were summarised. AP is of value in resuscitation for patients with arrhythmia before or during AMI.

78 Luo L, Lu SQ, Tong GL (1992) [A comparative study on AP, drugs and sideration for atrial fibrillation conversion]. Shanghai J Acup Moxibust 11(3):9-10. To compare their clinical effects, and study the clinical significance and theoretical basis of AP for cardioversion, they used AP, drugs or sideration to treat 62 cases of AF. Group 1 got AP with suitable stimulation and special needle manipulations at GV26, PC06, PC04, PC07. Groups 2 and 3 got sideration and medicine in the routine traditional way. The successful rates of AP, sideration and drugs were separately 75, 80 and 76% and there were no significant differences between the treatments. AP treatment of AF was safe, simple and had no side effect. AP is especially suitable to old patients, and may be used as the first preference to treat AF.

79 Ma FC (1993) [Application of CV04 for emergency]. CAP&M 13(1):23-24. Big moxa cones (or moxa sticks) were used at CV04 in emergency treatment. Moxa was used for several Ying (1 Ying = 28.8 min) until the effect was obtained. AP at GV26, KI01, PC06 and moxa at GV20 were supplemented as necessary. In particular cases, oral herbal medicine or i/v drip was added for satisfactory effects. Typical cases were described.

80 Ma XC (1994) [Acute lumbar sprain treated with the AP of violent trauma point: Report of 213 cases]. Chin J Orthop Traumatol 7(2):21. The "Violent trauma point" is a white granule, slightly larger than a grain of rice, situated at the midpoint of the frenulum of the upper lip, near GV28. After routine sterilisation, this point and its periphery was stabbed with a three-edged needle to let out small amounts of blood. Then, GV26 was used. After sterilisation, it was needled obliquely upwards to a depth of 0.5". The needle was twisted and rotated and retain it for 20 min. In this period, the patient was asked to move/pivot/bend his (her) waist. Only one treatment was given. Of the 213 cases treated, 178 were cured (85%), 27 improved (13%), and 5 unchanged (2%). The total effective rate was 98%.

81 Ma YY (1993) [Wang Mingzhang's experience of AP treatment of madness]. Liaoning J TCM 20(7):40-41. To treat each of 10 patients with mental illness, 5 doctors, using 26-28 gauge needles (1", 4 and 1.5" long) punctured GV26, Hubian (both) and SP06 (both) simultaneously. The needles were manipulated synchronously with reducing method at GV26 and Hubian and with reinforcing method at SP06. After deqi, the needles were simultaneously twirled for 1-2 min, retained for 1 min and then twirled again. The procedure was repeated 3 times. When the patient fell asleep the needles were withdrawn. Madness syndrome: stronger stimulation was given; Depressive psychosis: moderate stimulation given, with the needle retained for 5-10 min. Treatment was once/week in patients with a short duration of disease, every 2 d in those with long duration of disease and once/week after controlling the state of disease. After 3-5 sessions, of the 10 cases, 7 were markedly improved and 3 were improved.

82 Meng ZP (1988) [AP in the treatment of sequels of Japanese B encephalitis: Report of 30 cases]. Zhejiang J TCM 23(8):378. Basic points were GV26, PC06 bilateral, Sishencong, SP06 on the affected side and ST36 on the affected side. Swallowing difficulty: add TH17 on both sides. Aphasia: add CV23. Paralysis of upper limbs: add LI15 and Bizhong. Paralysis of lower limbs: add BL40 and GB34. Needles were first inserted 0.5-1.0" into PC06 on both sides; reducing method was used by lifting, thrusting, twisting and twirling for 30 sec, without retaining the needles. Then GV26 was needled obliquely for 0.3", with reducing method by sparrow-pecking for 30 sec without retaining the needle. Then ST36 and SP06 were needled perpendicularly for 0.5-1", by reinforcing method by lifting, thrusting, twisting and twirling. Normal reinforcement and normal reduction was taken for other points and needles were retained for 15 min after deqi. Treatment was once/d, for 10 d/course. Of 30 cases treated, 16 were cured, 9 had marked effects, 3 were improved and 2 were unchanged.

83 Mu J (1985) Influence of adrenergic antagonist and naloxone on the anti-allergic shock effect of EAP in mice. Abstract Amer J Acup 1986;14:176, ex AETRIJ 10:163-167. EAP at GV26 + CV24 was effective in shock induced by injection of bovine serum in mice. Phentolamine or propranolol injection before EAP partially blocked the effect but practolol, naloxone or depletion of pituitary EPs had no effect on the anti-allergic effect of EAP. The anti-anaphylactic effect of EAP may have different mechanisms from the analgesic and cardiac effects.

84 Nie HY, Nie MZ (1987) [AP therapy of infantile convulsions: Report of 84 cases]. Shanghai J Acup Moxibust 6(2):20. Children with convulsions were treated with AP in 3 specific groups. Points for the three groups were selected according to the symptoms. (1) Acute onset of convulsion: AP at Shixuan, Yintang, GV26, LI11 and LV03 with reducing manipulation. (2) Chronic convulsion: AP at CV12, CV04, ST36, LV13 and Yintang with mild reinforcing and reducing manipulation. (3) Chronic convulsion due to splenic disorder: AP at BL18, BL20, GV20, CV08 and ST36 with potent reducing manipulation. Group (1): Of 31 cases treated, 26 were cured, 4 improved, and 1 unchanged. Group (2): Of 29 cases treated, 22 were cured, 5 improved, and 2 unchanged. Group (3) Of 24 cases treated, 18 were cured, 4 improved and 2 unchanged.

85 Nie XF, Zhou AJ (1990) Aetiology of cardiac arrest and apnoea caused by AP at TH17: case report. Hubei J TCM (5):39. A male, aged 26 years, had pain, soreness and distension of left eye pupil. Left TH17 was needled toward the opposite side to a depth of 2"; the needle was retained. Right TH17 was punctured 2" deep. The patient became nauseated and vomited. He suddenly lost consciousness and developed apnoea and cardiac arrest. The patient was placed in supine position for immediate emergency treatment. Pressure on GV26 and PC06 for 1 min, restored his heart beat, and consciousness gradually returned. Moxibustion was used at GV20 and hyperosmotic glucose solution was given i/v. The patient recovered after half an hour. A needle inserted 2" deep at TH17 may puncture the vagus and cause vagal stimulation, which causes inhibition of heart beat, constriction of the coronary artery, fall in BP and shock. Spasm of bronchial smooth muscles may induce respiratory difficulty even asphyxia. Increased gastrointestinal peristalsis may induce nausea and vomiting. This case was probably caused by vagal shock.

86 Pan YY, Zhu HC, Tang ZS (1991) Observation on alteration of blood flow in carotid artery after AP at GV26. Shanghai Med J 14(2):70-72. They used a Doppler ultrasonic flowmeter to monitor changes in systemic BP, HR and carotid arterial blood flow after AP at GV26 in 31 patients under general anaesthesia. After AP of GV26, the mean diastolic velocity of blood flow in common carotic artery increased remarkably, while the pulsatile index and resistance index decreased significantly, until 1 min after needle removal. There was no obvious change in the velocity of systolic blood flow, MAP and HR. AP of GV26 changed the modality of carotid blood pulsation and reduced vascular resistance. These effects favour cerebral blood perfusion, hence the resuscitation effects evoked by AP at GV26.

87 Pothmann R (1987) Acute anticonvulsive action of acustimulation in children. WFAS 1st Conf (Eng):101-102. 62 cerebral convulsions of children between 2 and 14 years were managed by strong stimulation of the nasal philtrum at GV26. 91% of cases ceased fitting and regained consciousness within 30 s. Treatment of convulsion-types other than Grand Mal was not successful. AP at LU11 alone had only a 50% success in 10 cases. Compared to conventional therapy e.g. with rectal use of chloral hydrate, acupressure gave a faster response, without sedative or other side effects like respiratory arrest. AP may inhibit lateral or recurrent nervous pathways and restore consciousness from cerebral convulsions by excitatory stimulation of the reticular formation of brainstem. The lower efficacy of LU11 may be explained by loss of impulse rate along the longer pathway to the brain. AP at GV26 or LU11 had enough therapeutic reliability to stop acute cerebral Grand Mal convulsions. AP usually was effective within 30 s. It is recommended to try AP at GV26 + LU11, while pharmacological medication is being prepared for rectal instillation or i/v injection. Rectal medication takes at least 15 min to reach maximum effect. Even i/v injection takes some time to be fully effective.

88 Qiu ML, Sheng CR, Li ZR (1984) [Changes in rheoencephalogram and haemorrheology in patients with apoplexy before and after AP therapy]. Jiangsu J TCM 5(3):52-56. Acute stage: GV26, GV20, Shixuan, KI01. Convalescence: LI15, LI11, LI10, LI04, GB30, GB34, SP06, ST36, GB39, LV03. Treatment was once/d at 4-5 points from the above list. The needle were retained for 30 min, and manipulated once during the needle retaining. After every 5 d, a 2-d rest was needed. Reducing technique was given in acute stage, while tonifying technique or even manipulation, in the convalescence. Of 30 cases treated, 16 recovered, 9 were greatly improved, 3 improved and 2 unchanged. The total effective rate was 93%. Rheoencephalogram: Of 30 cases treated, 5 turned to normal, 7 improved, and 15 changed. Haemorrheological indices: The viscosity of whole blood, haematocrit and equation value K of ESR decreased clearly after treatment (p<.01).

89 Qiu ML, Sheng CR, Li ZR (1984) [Observations on the effect of AP on the change of rheoencephalogram and haemodynamics of patients with apoplexy]. Proceedings of 2nd Natl Symp Acup-Moxib & Acup-Anaesth (Beijing):17-18. We studied the effect of AP on the change of rheoencephalogram haemodynamics, blood lipids and lipoprotein electrophoresis of 34 cases of apoplexy (involving cerebral capillary embolism 27, apoplexy 7). Points used were: Acute stage: GV26, GV20, Shixuan, Shierjingxue, KI01. Convalescent stage for sequels of paralysis of upper limbs: LI15, LI11, LI10, TH05, LI04 etc. Convalescent stage for sequels of paralysis of lower limbs: GB30, ST31, GB34, SP06, ST36, GB39, LV03 etc. Some patients had treatment based on differentiation of Syndromes. 4-5 points were used once/d for 5 d/course, retaining needles for 30 min, and manipulating again during needle retention. A 2-d rest interval was allowed between each 5 d series. One month of treatment was taken as a course. Reducing method was used for the acute stage and an even or reinforcing method to the affected side was used for the convalescent stage or sequels. Mean time to elimination of clinical symptoms was 6.8 (range 3-15) d. Mean time to improvement of muscular activity was 11 (range 3-30) d. Total effective rate was 93%. AP improved the condition of consistency, viscosity and aggregation of blood to a great or certain extent; AP promoted the blood flow to the brain, thus consolidating the blood circulation to eliminate blood stasis This helped greatly to adjust the Yin and Yang of the patients and to hasten their recovery. AP improved the elasticity and tonicity of brain vessels, and dilated them. It promoted blood flow, invigorated the blood and brain perfusion, raised the fractional pressure of oxygen and the supply of nutrients to the brain. Thus, AP assisted compromised brain function and enhanced the recovery of damaged brain tissue.

90 Rogers PAM (1977) Revival in shock, respiratory failure and narcotic overdose by AP at GV26. Vet Rec 101, 215. Doctors of TCM use strong AP stimulation at GV26 to revive people and animals in shock, respiratory failure and narcotic overdose. A rat became apnoeic in the recovery-box after neurosurgeons had implanted permanent indwelling brain-electrodes and a jugular catheter under general anaesthesia. As the rat's heartbeat was strong, the surgeons interrupted a similar operation in a second rat to ventilate the first one with a rubber bulb over the nose and mouth for some minutes and give chest-massage. They failed to reverse the apnoea, accepted defeat, ended the attempt at resuscitation and recommenced surgery in the second rat. Noticing an unused brain-electrode on the table, I used it to needle GV26 strongly as a last resort in the discarded rat. The rat coughed and began spontaneous breathing within seconds. Recovery was uneventful. When other methods fail, colleagues should try this simple aid to resuscitation.

91 Rogers PAM (1994). Amalgamated Data: Top Ten Points for Major Body Functions, Organs & Parts <http://users.med.auth.gr/~karanik/english/vet/reytop10.htm>. Based on frequency of citation, the top four points for digestive, gastrointestinal disorders were ST36, PC06, BL21 and CV12.

92 Rogers PAM (1994) Notes for the Chapter "Immunologic Effects of Acupuncture". In: Veterinary Acupuncture: Ancient Art to Modern Medicine. American Veterinary Publications Inc., 5782 Thornwood Dr., Goletta, CA93117. Ed: AM Schoen. pp243-. GV26 is the best-known revival point. KI01, over plantar digital nerve, in the notch between the proximal heads of metatarsal bones 2-3, has similar effects to GV26 in shock. PC06, over median nerve, 1/6 of the distance between the palmar wrist crease and the elbow, has potent action on circulatory and cardiac function. It is added if needed. Many other points, such as HT09, PC09, ST09, ST36, can stimulate recovery from shock. However, the most often used are GV26, KI01 and PC06. A combination of GV26 (or KI01) with PC06 is useful in coma or unconsciousness with cardiac failure.

93 Schoen AM (1990) Electrocardiographic recording during dry needle stimulation of GV26 following cardiac arrest (a case report). International Journal of Vet AP 1: 21-23. AP at GV26 was given for several minutes to resuscitate a 9 year old German Shepherd. A splenic hemangiosarcoma had been removed under general anesthesia 24 hours earlier. AP initiated respiration and converted cardiac standstill (asystole) into sinus rhythm after previous CPR for 5 min, including i/v injection of 3 ml of epinephrine, 40 meq/L of sodium bicarbonate, and Lactated Ringer's solution, had not been effective. The sympathomimetic effects of GV26 stimulation on recorded EKG are shown. Sinus rhythm could only be maintained by continued needle manipulation. After removal of the needle, the dog arrested again and died. Metastasis into the heart was suspected.

94 Shen JF, Ye MF, Wei J (1988) Haemorrheological study on the effect of AP in treating cerebral infarction. J TCM (Eng) 8(3):167-172. Clinical therapeutic effect in 75 cases of acute cerebral infarction treated by AP and VNRT was compared with cases treated symptomatically. Three groups of in-patients were divided into AP group, VNRT group and symptomatic group. Points were GV26, SP09, ST40, GB09, KI01 and BL01. According to the patient's condition and syndrome differentiation, other points were: Mainly for limb paralysis: GV20, LI15, LI11, TH05, LI04, GB30, ST31, GB34, ST36, GB39; Mainly for central facial paralysis: ST04, ST06; Mainly for motor aphasia: CV23, HT05. The rate of basic recovery and marked improvement was: AP 73%, VNRT 70%, symptomatic therapy 33%. Overall rate of improvement was: AP 87%; VNRT 83%; symptomatic therapy 47%.

95 Shi XM (1989) [Apoplexy treated by AP with restoring consciousness needling method: Analysis and experimental study of 2336 cases]. Tianjin TCM (6):2-7, 44. Main Points: GV26, SP06. Helper Points: HT01, LU05, BL40. Dysphagia: add GB20, TH17 and GB12. Clenched fingers: LI04 inserted towards LI03. Dysphasia: bleed Jinjin + Yuye. Of 2336 cases treated 1281 were cured, 542 notably effective, 453 improved, 18 unchanged, and 42 died. The cure rate was 59%. The effective rate was 97%. Average duration of treatment, 35 d. This therapy improved rheoencephalogram, EEG, and microcirculation of patients suffering from apoplexy. It can correct harmful pathologic states such as hyperviscosity, hyperaggregation, or hypercoagulability; it can increase high density lipoprotein, decrease the accumulation of cholesterol in tissues and improve cerebral blood supply. Both the dry and the wet weight of patients' thrombi were lighter apparently. Besides, AP of PC06, GV26, and GB20 may prolong the survival time of mice significantly. This therapy may inhibit experimental thrombosis in rats.

96 Shi XM, Li J, Yan L (1992) [Clinical study on apoplexy treated by AP]. Shanghai J Acup Moxibust 11(4):4-7. Main points: PC06 (reducing), GV26 (sparrow-pecking), SP06 (reinforcing). Helper points: HT01, BL40, LU05 (all reducing). Dysphagia: add GB20, TH17, GB12. Grasping fixedly: add LI04. Dysphasia: add Jinjin + Yuye (blood-letting). Treatment was twice/d for 10 d/course. 2523 cases of initial onset and 684 cases of multiple onsets received such treatment for 3-5 courses. Results of these two groups (initial v multiple onset) respectively were: 1489 and 322 cases cured, 568 and 175 clearly improved, 440 and 164 improved, 6 and 7 unchanged and 20 and 16 died. The effective rates were 99 and 97% respectively. There were significant differences between both cure rates and effective rates of these two groups (p<.01). The cure rate of cerebral infarction was apparently higher than that of cerebral haemorrhage in the initial onset group (p<.05). In both groups, the cure rates <10 d of onset were evidently higher than those >11 d (p<.05 or p<.01).

97 Shi ZX, Tan MZ (1987) Analysis of therapeutic effect on AP treatment in 500 cases of schizophrenia. WFAS 1st Conf (Eng):118-119, and J CAP&M [Eng] 1(3-4):75-79. AP was used to treat 500 cases of schizophrenia. The patients were divided into three groups. Mania (181 cases): GV14, GV18, GV26 and CV15, SI03 => PC08, or from PC05 => TH06, or from LI04 => PC08, or from LV03 => KI01. GV24, LI11 and ST36 are commonly used too, in the reducing method. Depression (140 cases): Heart Channel obstructed by phlegm as a pathogenic factor: CV14, CV17, CV24, PC07, ST40, PC08 and KI01. Qi stagnancy of the liver: CV12, GV20, PC05 => TH06, LV03 => KI01 or LI04 => PC08. The reinforcing method was used. Delusion (179 cases): CV12, CV17, GV24, HT07, SP06 or PC06 and SP04, with reinforcing method. AP was done once/d for 20 d/course. Of the 500 cases, 275 (55%) were cured, 84 (17%) were markedly improved, 83 (17%) were improved and 58 (12%) were unchanged.

98 Skarda R (1998) Anaesthesia Case of the Month. JAVMA 1999; 214(1):37-39. AP at GV26 was used to resuscitate 2 caesarean-born kittens. Previous attempts at CPR for 15-20 min included manual stimulation of the kittens, airway suction, oxygen administration, external thoracic and cardiac compressions, heat supply by an infrared light, and sublingual administration of one to two drops of Doxapram hydrochloride solution (Dopram, Elkins Sinns Inc., 20 mg/ml). These attempts had failed to restore respiration and cardiovascular function in these kittens. GV26 was pricked strongly to a depth of 2-4 mm using a 25-gauge, 5/8" monoject needle. AP began 15 and 35 min, respectively after termination of unsuccessful CPR. The AP-resuscitation needed 20 and 30 min in these cases. The procedure was videotaped in one kitten. A third caesarean-born kitten, given similar CPR and no GV26 stimulation, could not be resuscitated. The dam and surviving 2 kittens were in good health the day after surgery and were released from hospital.

99 Song ZZ (1991) [Motion AP in the treatment of 1000 patients with acute soft tissue injuries in lumbar region]. Proc Intnl Congr of TCM (Beijing) 134-135. Motion AP was used to treat 1000 cases of acute soft tissue injuries in the lumbar region. Distant points were used to treat in line with the principle that differentiation of syndromes and the affected Channels were incorporated. Injury of supraspinal and interspinal ligaments was differentiated as the disorder of Governor Vessel and GV26 was used. Injury of lumbodorsal muscular fascia was differentiate as disorder of Foot-Taiyang Channel and SI06 was used. Coincident injury of sacrospinal muscle and lumbogluteal muscular fascia was differentiated as disorder of both Foot-Taiyang and Shaoyang Channels, and Yaotong was used. Coincident injury of interspinal ligament and lumbodorsal muscular fascia was differentiated as disorder of both Du and Foot-Taiyang Channels, and GV26 and SI06 were used together. At deqi, the patient was asked to move the waist while the needle was being manipulated. The movement increased into the large amplitude as anterio-posterior flexion and extension, lateral flexion. The needle was retained for 15 min during which the manipulation was conducted twice. The total effective rate was 98%. 100 cases with similar conditions were selected at random as the control group and they were treated with the conventional AP. The total effective rate was 82%. The difference between the two groups was significant (p<.05).

100 Still J (1988) A comparison of the respiratory stimulant effects of AP at GV26 with noradrenaline in thiopental-induced apnoea in dogs. Scand J Acup & Electrother, 3, 129-136 and Research in Veterinary AP. Monograph printed by BeVAS ( Belgian Veterinary AP Soc). AP of GV26 was 88% effective in treating anaesthetic apnoea within 10-30 sec in dogs. NA i/v was 75% effective but needling a non-acupoint (just lateral and superior to the nostril) was only 40% effective.

101 Still J, Konrad J (1985) The use of AP for resuscitation of animals. Veterinarni Medicina, 30, 493-500. AP was used in 243 cases of anaesthetic (especially thiopentone) apnoea in 17 species of domestic and zoo animals and birds. GV26 was needled and pressed (acupressure). KI01, HT09, PC09 were used occasionally. The success rate was 93% in zoo animals, 100% in healthy dogs and 77% in diseased dogs.

102 Tong SX (1988) [Acute waist sprain treated by AP combined with cupping therapy and acupoint injection: Report of 350 cases]. CAP&M 8(5):18-19. AP + cupping and acupoint injection was used to treat 350 cases of acute lumbar sprain. Of 350 cases treated, 98 were cured and the remainder improved; the total effective rate was 100%. Treatment protocol was to puncture GV03, SI03 and TH03 and simultaneously to make the patient sway the waist back and forth, for 3-5 min. Then GV26 was punctured with manipulating techniques to sweat the patient all over; then bleed BL40; then AP at BL24, using reducing method with lifting thrusting and rotating of the needle is provided, and cupping is combined after needling.

103 Tseng CC, Chang CL, Lee JC, Chen TY, Cheng JT (1997) Attenuation of the catecholamine responses by EAP on GV26 acupoint during postoperative recovery period in humans. Neurosci Lett Jun 13 228(3):187-190. cctmay@mail.ncku.edu.tw Dept of Anesth, Med Coll, National Cheng Kung Univ, Tainan, Taiwan, ROC. GV26 was stimulated by EAP in 10 patients, and by placebo treatment in 10 controls, immediately after termination of inhalation for 15 min. During the postoperative recovery period, plasma catecholamine (CA) levels were assessed before (0) and 15 and 30 min after treatment. The time from cessation of inhalation to the first eye opening and to extubation did not differ between groups. The plasma catecholamine levels increased by 30% from 0 to 15 min in the control group but decreased by 6% in the EAP group. The levels at 30 min were approximately the same as at time 0. The change in catecholamine levels from 0 to 15 min was significantly lower (p<.02) in the EAP groups than the control group. Publication Types: Clinical trial PMID: 9218639, UI: 97361678

104 Gonzalez BB, Sumano HL, Ocampo LC (1982) Levels of acetylcholine in the medulla oblongata of rats treated with Doxapram or AP at GV26. Rev Veterinaria Mexico 13:119-124. Pentobarbital-anaesthetised rats were allocated to one of 3 groups of 8 rats. Group A rats were controls. Group B received manual AP at GV26. Group C received Doxapram. Doxapram i/m has powerful effects in resuscitation in cases of respiratory arrest under general anaesthesia. The levels of ACh in the medulla oblongata were measured. The effect of GV26 on the respiratory centre involved increased levels of ACh in the medulla. Doxapram did not have this effect, thus other mechanisms may be involved in Doxapram effects.

105 Wang S, Wu ST, Shi XM (1994) [Dynamic observation on the left heart function of cerebral infarction patients by applying the needling method of "Restoring consciousness and inducing resuscitation"]. J Clin Acup Moxib 10(3):26-29. Main points to restore consciousness and induce resuscitation were PC06, GV26 and SP06. These were selected to observe the dynamic changes of the function of left ventricle on patients with cerebral infarction. AP increased CO, EF, FS and MESR, and strengthened the function of the left ventricle, which is significant to maintain a constant blood flow in the brain. Variation of the group with traditional AP method was slight.

106 Wang SY, Xu ZY, Chen SY (1988) [The clinical study on abdominal tuboligation under APA]. Acup Res 13(3):189-193. Abdominal tuboligation under APA was carried out in 23554 cases, the aim being to study different selections of points, stimulation condition, the duration of induction and supplementary medicines. Stimulation of GV26, CV24 and BL32 gave a better result compared with other point groups: SP06, BL32; or GV26, CV24; or Earpoint Lung, Shenmen, Uterus, Endocrine; or Earpoint Lung, Shenmen, Uterus, Endocrine and paraincision. An induction time of 5-10 min was optimum for abdominal tuboligation under APA. APA can be used for abdominal tuboligation without the help of any supplementary medicines, but premedication of an optimal dose of dolantin can elevate the efficiency of AP in the patients with mental stress and a lower pain threshold.

107 Wang Z, Huang W, Xu Q, Huang K, Cai H, Zhang X (1996) [The effect of EAP on the adrenal gland of endotoxic shocked rats - Article in Chinese]. Chen Tzu Yen Chiu 21(1):73-75. Inst of AP and Moxibustion, China Academy of TCM, Beijing. This paper records quantitative histochemical changes induced by EAP on glycogen and SDH in the adrenal gland of endotoxic-shocked rats. EAP at GV26 or ST36 of endotoxic shocked animal can improve adrenocortical function and achieve recovery to a certain extent. PMID: 9387362, UI: 98048608

108 Wang ZL (1987) [Fainting during AP and its prevention and treatment]. CAP&M 7(2):22-23. Causes, symptoms, prevention and treatment of fainting during AP are discussed. The patient should assume the correct posture. Fewer points, and milder stimulation and manipulation, should be used in patients having AP for the first time. If fainting occurs, remove needles, keep patient warm, and give a glass of water. In serious situations, needle GV26, PC09, PC06 etc. First aid may be given, if needed.

109 Wu JG (1987) [Intervertebral disk displacement treated by AP, massage and Chinese herbal drugs: Report of 22 cases]. Jiangxi J TCM Pharmacol 18(6):35. Points for patients in early stage: GV26, SI03, Ashi points were selected by reducing method. Moxa was used for 1-2 min after needle insertion on SI03 and Ashi points. For patients in late stages: BL23 and ST36 were selected by reinforcing method. Moxa was used for 2-3 min after insertion of the needle. Manipulation. 1. Method of extension of hip and extremity; 2. Oblique plate method; 3. Lifting extremity and lumbar pressing method; 4. Spasm relaxation method; and 5. Restoring and treating injured soft tissues. Herbal drugs were used mainly to tonify the kidney and supplement bone marrow and regenerate bone. Of the 22 cases treated, 18 were markedly improved and 3 were improved and 1 discontinued therapy.

110 Wu JW (1986) [Apoplexy treated by AP: Analysis of 78 cases]. J New Chin Med 18(5):35-36. Syndrome differentiation and point selecting of affected side: Upper limb paralysis: LI17, LI13, PC03, SI08, LI11 => HT03, Hubian => SI03. Lower limb paralysis: GB30, Tengzhong, BL39, BL40, GB34 => SP09, external Yinlian. Unconscious of idiotic smiling: GV26, GB14. Central facial paralysis: TH17, GB12, lower earlobe. Stiff tongue or aphasia: CV23, External CV23. Faecal incontinence: GV01, CV01. Urinary incontinence: CV03, KI06. 1-2 points were selected each time for every syndrome, treated alternatively. Reducing manipulation was used, no retaining, or retained only for 20 min. When supplemented with EAP, retaining the needle was used, once every 1-2 d. The rate of cure and marked improvement was 67%, the total effective rate was 96%.

111 Wu Y, Shen Q, Zhang QQ (1992) [The effect of AP on high oxygen pressure-induced convulsion and its relationship to the brain GABA level in mice]. Chen Tzu Yen Chiu 17(2):104-109. Inst of Navigation Med, Nantong Med Coll, Jiangsu. This paper reports the effect of AP at GV26 and CV24 on high oxygen pressure-induced convulsion in mice. The convulsion was accompanied by decreased levels of GABA in brain. EAP for 15 min before exposure to hyperoxic chamber increased the latency of convulsions, alleviated the symptoms of seizures, and increased brain levels of GABA remarkably. Giving Vitamin B6 enhanced the effect of AP on convulsions and increased brain GABA level. The latency of convulsions was well correlated with the GABA level of the brain (r=.987). AP can elevate endogenous GABA levels in the brain and prevent the hyperbaric-oxygen-induced the decrease in the brain GABA level. Therefore, AP protects effect against oxygen convulsions. Vitamin B6 may facilitate the effect of AP by improving the GABA metabolism in the brain. The effect of AP against oxygen convulsions may be closely related to the increase in the brain GABA levels.

112 Wu YL et al (1984) Relationship between central cholinergic activity and pressor effect of EAP: 2: In hypotension. Abstract Amer J Acup 1984;12:383-384, ex CAP&M 4(Jun):34-37. EAP at GV26 in rats increased BP in hypovolaemic hypotension. The effect was increased by cholinergic stimulation (by ACh) or by inhibiting cholinesterase activity (physostigmine) and blocked by blocking ACh synthesis (by Hc3). The pressor effect of EAP is probably mediated by the cholinergic (parasympathetic) system. Naloxone also had a pressor effect in hypotension, abolished by Hc3, suggesting that there is a link between the cholinergic and opiate systems in BP regulation.

113 Xia YQ et al (1986) AP effect on dehydrogenase in the myocardia of rabbits under haemorrhagic shock. Abstract Amer J Acup 1986;14:165, ex CAP&M 6(Feb):41-43. GV26 increased the activity of SDH and LDH in myocardial muscle in rabbits and protected against damage to myocardial cells.

114 Xia YQ, Wen S (1988) [The effects of AP at GV26 on myocardial glycogen and phosphorylase in haemorrhagic shock]. Acup Res 13(4):354-357. Effects of AP on myocardial glycogen and phosphorylase were observed with a histochemical method in rabbits with haemorrhagic shock. Sham operation had a slight effect on myocardial glycogen content and phosphorylase activity. The myocardial glycogen content and phosphorylase activity decreased significantly in rabbits with haemorrhagic shock as compared with the normal rabbits and they were markedly increased to near the normal level by AP at GV26. AP at GV26 activates the metabolism of the myocardium in rabbits with haemorrhagic shock and elevates the energetic supply for the myocardium.

115 Xie YK, Zhou L, Liu LG (1987) [Roles of the caudal brain stem in the modulation and inhibition of the gastric motility by AP GV26]. Acup Res 12(3):202-206. Contractile activity of antrum was recorded by strain gauge for observing effects of stimulation of the caudal brain stem on the gastric antral motility and their roles in the inhibition of antral contraction caused by AP of GV26. Stimulation of raphe nuclei in the medulla increased antral contraction. Stimulation of ventrolateral medulla inhibited both frequency and amplitude of antral motility. The ventrolateral medulla may mediate the inhibition of gastric antral motor activity elicited by AP of GV26, because their lesion abolished the AP inhibition.

116 Xue CC, Xie HS, Ruan QC (1987) [Electric AP convulsive therapy]. CAP&M 7(3):44-45. They compared electric AP convulsive therapy (EACT) and electroconvulsive therapy (ECT) to treat 150 schizophrenic patients. EACT is a modification of ECT in which stimulating currents are passed through AP needle electrodes inserted in midline positions. When the electrodes were placed at GV20 and GV26, the current needed to elicit a convulsion in EACT was only 3.6% of that for ECT. The efficacy of EACT was better, the somatic and visceral reactions milder, and the incidence of spinal fracture and changes in EEG and in memory were less than in ECT. The clinical efficacy of ECT depends on changes in midline brain structures.

117 Yang YD (1986) [AP therapy in emergencies of paediatrics]. Yunnan J TCM 7(4):29-30. Acute Infantile Convulsion: GV26, GV14, the arm Jing-Well points, or Shixuan, LI04, LV03, PC06, SI03. Apply reducing method and twist needles for 10 s without retaining needles. Infantile Dyspepsia: a. Sifeng, ST36, b. ST25, CV04, BL25. Apply prompt pricking at Sifeng and reducing method for other points by twisting needles for 1 min. Mumps: TH17, ST06, TH05, TH02, LI04. Apply reducing method and retain needles for 10-15 min. Whooping Cough: CV22, Dingchuan, Sifeng, LI04, ST40, BL12, BL13. Apply reducing method by twisting needles for 1 min and prompt prick at Sifeng and do cupping at BL12 and BL13.

118 Zeng BS (1992) [Hemiplegia caused by stroke treated by AP combined with traditional Chinese drugs: Report of 46 cases]. Zhejiang J TCM 27(8):344-345. AP was used to treat 46 people with hemiplegia. Points used were: Initial stage of apoplexy: GV20, GV26, PC06, KI01. Paralysis of upper limb: add LI15, LI11 => HT03, LI04 => SI03, TH05 => PC06. Paralysis of lower limb: add GB30, GB34 => SP09, ST36, ST40, GB39. Deviation of eye and mouth: add GB20, ST06 => ST04, GV26. LI04. Aphasia: add GB20, CV23, KI01, HT05, GV26. Hypertension: add LI11, KI01, ST36. Weakness of the waist and knees: AP and moxa at BL23 and ST36 with moxa on both sides. Each time, 3-5 points were selected. After deqi, EAP was used. Needles were retained for 20-40 min. Chinese drugs: 1) Hyperactivity of Liver Yang due to Yin deficiency of Liver-Kidney: modified Jian Ling Decoction. 2) Blockage of Collaterals by Wind-Phlegm due to Phlegm-Heat and sthenic syndrome of Hollow Organs: modified Decoction for Eliminating Phlegm. 3) Unconsciousness: Calculus Bovis Bolus for Resurrection. 4) Obstruction of Collaterals by Phlegm-Blood due to Qi deficiency and Blood stasis: Decoction for Invigorating Yang. Of 46 cases treated, 15 were cured, 20 clearly improved, 8 improved, and 3 unchanged.

119 Zhai L, Wen SE, Huang WM (1989) [Research on energy metabolism enzyme in liver of the rabbit during haemorrhagic shock and effect of AP at GV26 by quantitative histochemistry - Article in Chinese]. Chen Tzu Yen Chiu 14(4):431-434. The energy crisis has been considered to act an important role during shock recent years. Liver can supply energy substrate when body is in an emergency condition. GV26 is a very important point to treat "Jue-Zheng" (including shock) in TCM theory. We divided 36 male rabbits into 3 groups randomly: Normal control group; AP group; Non-AP group. The normal control was anaesthetised only with sodium pentobarbital (35 mg/kg). The AP and non-AP groups were operated while conscious with method of improving Wiggers (1950). After bleeding 20 ml/kg, these animals were in shock. During experimental haemorrhagic shock, group 2 received AP at GV26 and group 3 did not. Samples of liver were excised and stained using enzyme histochemical method. Two dehydrogenases (SDH and LDH) in hepatocytes were observed. Among the three groups, SDH and LDH activity were weakest (p<.01 and p<.05) in the non-AP group. Activity in the AP group was stronger than in the non-AP group and was near that of the normal control group. AP at GV26 increased the activity of hepatic SDH and LDH in haemorrhagic shock. GV26 can evoke useful antishock effects.

120 Zhai WS, Wang JM (1992) [Observation on 60 cases of epilepsy treated with "Xing Nao Kai Qiao Zhen Fa"]. Zhejiang J TCM 27(10):445. With the patient supine, AP at GV20 was used first. After deqi, needles were twirled for 1 min. Then GV26 was sparrow-pecked, until his (her) eyes moisten. Then PC08 on both sides, thrust-lifting and twirling to produce a discharging sensation; then KI01 on both sides, needled swiftly, and twist-rotated quickly until there was a feverish and distending sensation in the sole. Lastly, AP was used at PC06 on both sides, with twirling for 1 min after deqi. The needle was retained for 1 hour, manipulated once every 20 min. Of the 60 cases treated, 9 were cured, 18 clearly improved, 30 improved and 3 unchanged.

121 Zhai YD (1988) [Stroke treated by AP with "restoring consciousness for resuscitation" needling method: Report of 279 cases]. CAP&M 8(5):10-11. AP was used to treat wind-stroke patients, needling by the method of "Restoring Consciousness for Resuscitation". Of the 279 cases treated, 61% were cured and 98% were improved. Main points were GV26, PC06 and SP06. Helper points were HT01, LU05 and BL40. Treatment was twice/d for 10 d/course. Mean duration of treatment was 53 d. It is important to use the reduction by lifting and thrusting the needles to cause the punctured limbs to jerk 3 times.

122 Zhang CD (1989) [Clinical observation on 150 cases with shock treated by AP]. CAP&M 9(4):22. The article reported 150 cases with shock treated by AP at GV26, KI01, LI04, PC06, ST36, GV20, combined with LU06, LU07, CV12, HT07, etc. After insertion, needles were rotated, twisted, lifted and trusted strongly once at 5 min intervals during 30 min of needle retention. Of 150 cases treated, 96 cases (64%) were obviously improved. The total effective rate was 93%.

123 Zhang DC (1991) [The clinical analysis of thyroid operation with APA]. Acup Res 1991;16(3-4):262-263. EAP at 2-3 Hz was used in for analgesia in thyroid surgery on 106 patients (55 male, 51 female), aged 19-61 years old. Most (89%) were 20-60 years old. Four point combinations were used. (1) LI04 + PC06 (81 cases, 78% of which were excellent and good). (2) LI04 + LI18 (4 cases, 75% of which were excellent and good). (3) Earpoint: Shenmen => Sympathetic and Spleen => Lung, (9 cases, 100% of which were excellent and good). (4) GV26 + LI04, (12 cases, 100% of which were excellent and good). None of 106 cases failed. After deqi, EAP was used. Induction time was generally > 20-30 min. Current intensity was increased gradually to the tolerance of the patient. Of 106 cases, 81 (76%) were excellent, 23 (22%) good and 2 (2%) fair. No side effects were found.

124 Zhang FR (1988) [Hysterical aphasia treated by AP: A case report]. Sichuan TCM (1):46. A male, aged 35, suffered from aphasia for 6 months. AP at GV26 gave a strong stimulation by successive rotation for 5 min. Then PC08 and KI01 were punctured with large amplitude of rotation, lifting and inserting of the needle for 5 min. The patient could respond to calling at that time. Strong stimulation was used for another 5 min and the needles were retained for 15 min. During the period of needle retention, the patient could speak fluently.

125 Zhang H, Zhang M, Liu L (1989) Effect of pain in the change of respiration induced by stimulation GV26. East-West Pain Conference (Beijing):103. Stimulating GV26 changes respiratory activity in rabbits. This effect is mediated through nucleus of trigeminal spinal tract which is relevant to pain and other somatic senses. We used 7 anaesthetised 1.5-2kg rabbits to study whether the respiratory effect of stimulating GV26 is caused by pain. Phr and RR were recorded. EAP at GV26 (10 mS pulse, 20 Hz, 0.4-4 mA, duration 3-5 s) gave an 83+16% increase in the amplitude of Phr, and a 31+6% decrease in RR. The experiment was repeated 8 min after i/v injection of morphine (5.0-6.6mg/kg), a dose sufficient to abolish pain reactions. GV26 stimulation could still induce a 43+8% increase in the amplitude of Phr and 20+6% decrease in RR. The influence of stimulating GV26 on respiration is not necessarily due to the pain produced by the stimulation.

126 Zhang JM (1987) [Acute waist sprain treated by massage combined with AP: Analysis of 60 cases]. Xinjiang TCM (2):40-41. AP was used to treat 60 cases of acute waist sprain of 1-7 d duration. Points used were: Injury in the middle of the lumbar spine: LI19 => GV26, using a 1" needle to insert horizontally from the left LI19, penetrating left LI19 => GV26 => right LI19. Twirling manipulation was used once every 10 min for 3 times. Injury to both sides of the lumbar spine: BL02 or BL01 at each side. Helper points in both types: Ashi in lumbar region, or Shangdou of hand AP, by the reducing method by twirling the needle. Of the 60 cases treated, 17 (28%) were cured by applying AP and Tuina once only and 35 (58%) were cured after 3 sessions. The effective rate after 3 sessions was 87%.

127 Zhang M, Zhang H, Liu L (1990) [The study of effect of pain in the change of respiration by stimulating GV26 - Article in Chinese]. Chen Tzu Yen Chiu (Acup Res) 15(2):147-149; and Zhang H, Zhang M, Liu L (1989) Effect of pain in the change of respiration induced by stimulation of GV26. Proceedings of the East-West Pain Conference, (Beijing):103. Department of Physiology, Shandong Med Univ, Jinan, PRC. Stimulation of GV26 starts respiratory activity in apnoeic rabbits. The AP signals transmit to the nucleus of the trigeminal spinal tract, and go to influence the respiratory nucleus. The afferent signals include those of pain and other somatic senses. We studied whether the effects of GV26-stimulation are caused by pain or another stimulus. Amplitude of Phr and RR of 7 anaesthetised rabbits, 1.5-2.0 kg, were recorded. EAP at GV26 (10 ms pulse, 20 Hz, 0.4-4 mA, duration 3-5 s). EAP at GV26, evoked an 83+16% increase in Phr, and a 31+6% decrease in RR. Morphine was then injected into the rabbits (5 mg/kg, a dose sufficient to abolish pain reactions). After 8 min, the Phr had decreased by 22+9% and the RR had decreased by 16+6%. Under the effects of morphine, EAP at GV26 still evoked a 43+8% increase in the Phr amplitude but a 20+6% decrease in RR. The effects of AP at GV26 in stimulating the respiratory centre are not totally, or necessarily due to the pain produced by EAP. Other sensory signals may be involved.

128 Zhang SJ (1993) [Manic-depressive epilepsy treated by AP: Report of 106 cases]. Yunnan J TCM 14(3):33. Points selected: HT07, PC07, PC06, GV26, GV16, CV17, CV15, LV03 and KI03. A reinforcing or reducing method was used according to the deficiency or excess type of syndrome differentiation. The first treatment was given on the onset of the disease, 3-5 points/session, once/d for 7 d/course. Satisfactory effect was obtained in all 106 cases.

129 Zhang SL (1990) Tooth extraction under the anaesthesia induced by injection of Ear acupoints: Report of 174 cases. Shanghai J Acup Moxibust 9(1):back cover. Patients in sitting position with the head slightly backward. After routine sterilisation of the diseased tooth, and Earpoints Tooth (Ear lobe) and Anterior Lobe, 1 ml water was injected into the 2 points of affected side, the tooth was extraced. There were no reports of pain sensation during tooth extraction or other side-reaction. Pricking GV26 for 1-2 min was necessary in individual cases which fainted due to needle reaction.

130 Zhang XL (1988) [Emergencies in children treated with AP]. Henan TCM 8(4):36-38. Case 1. A 23-d female baby with high fever (42 oC), convulsion and coma, was treated with AP at GV26, Yintang, GV25, bilateral LI04 and KI01. The points were punctured without needle retention, blotting on Shixuan. Body temperature decreased to 38.7 oC. Case 2. A 2.5-year girl with purulent tonsillitis was treated at bilateral LI04, LI11, LU11, ST44. The points were punctured to bleed them. 4 treatments was carried over one night, the body temperature decreased to 37.8 degrees C. Case 3. A 2-year female baby, ill due to overeating and high fever, was treated at bilateral Sifeng, ST36, ST37, ST39, Lineiting. Needling was shallow, and several drops of blood were squeezed from ST36 and Sifeng. Body temperature fell to normal 0.5 hour after treatment.

131 Zhao CX (1987) AP treatment of hypotension. J TCM 7(3):229-230. TCM does not use the term hypotension though its manifestations (vertigo, headache and fainting) are recognised. Main points: GV20, CV06, ST36, PC06. Helper points: Sishencong, BP Point (2" from vertebrae C6 and C7 on each side). Alternate points for symptom-complexes: Insomnia and palpitation: HT07; Poor appetite: CV12 and BL20; Sexual dysfunction or incontinence of urine: BL23, CV04 and SP06; Emergency cases of syncope: GV26, PC09, ST36 and PC06 together with moxibustion of CV06. Reinforcing technique was used in all cases. AP was given every 1-2 d for 10 times/course, with intervals of 2 or 3 d between courses. Needles were retained for 20 min each time.

132 Zheng Y, Xu ML, Yang SR (1989) [Mechanisms of effects of EAP at GV26 on phrenic-nerve discharge in rabbits - Article in Chinese]. Hua Hsi I Ko Ta Hsueh Hsueh Pao Dec 20(4):384-388. We studied urethane anaesthetised, bivagotomized, flaxedil paralysed and artificially ventilated rabbits. The effects of EAP at GV26 on Phr were not due to alteration of BP. The effects were abolished by bilateral section of infraorbital nerves, were similar to those of stimulation of the central end of the infraorbital nerve, and were not qualitatively changed by mid-colliculi decerebration. The responses of the bulbar respiratory related neurons were coordinated with those of the phrenic nerve to EAP at GV26 - the responses of almost all of the inspiratory neurons were consistent with phrenic responses and those of the most of the expiratory neurons were contrary to them. The effects of EAP at GV26 on Phr result from a nervous reflex. Its afferent is the infraorbital nerve and the higher centres are not essential for it. Bulbar respiratory related neurons may play an important part in it.

133 Zhou L (1987) [The study of regulatory function of AP on stomach and its mechanism]. WFAS 1st Conf (Eng):174-175. We studied the effect of AP, and its mechanism, on gastric secretion and function in dogs. AP at ST36, BL20 and PC06 significantly increased gastric secretion of bicarbonate and sodium. As these effects were completely blocked by atropine and lidocaine, gastric secretion may involve a somatic afferent-visceral reflex mechanism in which a cholinergic nerve plays a role. AP of GV26 significantly inhibited gastric motor activity. The NRL of the VLM may mediate the inhibition of gastric antral motor activity elicited by AP of GV26.

134 Zhou L, Liu LG, Chen HL (1987) [The effect of AP GV26 on gastric antral motility and its relation to peripheral 5-hydroxytryptamine]. Acup Res 1987;12(2):130-138. They studied the effect of AP of GV26 on antral motility, changes of GV26Tabs.htm - 5-ht

5-HT content in whole blood and fluorohistochemical changes of 5-HT in the enterochromaffin cells (EC cell) of antral mucosa in dogs. AP on GV26 inhibited markedly the gastric antral motor activity. During the inhibition of antral contraction induced by AP of GV26 5-HT in whole blood decreased significantly. The amount of fluorescent EC cells and the fluorescent intensity of 5-HT in the increased storage and decreased release of 5-HT in EC cells during the AP. 5-HT may be involved in the inhibition of AP on the gastric contraction.

135 Zhou L, Liu LG, Xie YK (1988) [Effects of AP on gastric motility in dogs and its mechanism]. Chin J Digestion 8(1):30-32. The influence of AP at GV26 on gastric movement and its relationship between gastrin secretion and the NRL of the VLM was studied in dogs. Gastric movement was measured with a stress conductor recorder. AP at GV26 markedly inhibited gastric movement, serum gastrin content decreased, the number of antral G-cells increased, and the fluorescein intensity of gastric also increased. AP at GV26 increased the storage of gastrin and decreased its release. The inhibitory effect of AP at GV26 on gastric movement may be related with gastrin secretion, and also related to the GV26Tabs.htm - nrlNRL of the VLM.

136 Zhou L, Zhou WY, Liu LG (1988) [The regulatory function of AP on gastric motility and it's relation to gastrin peptide: Radioimmunoassay and immunohistochemical studies]. Acup Res 1988;13(2):130-134. Contractile activity of stomach was recorded on a strain gauge to observe the effects of AP at GV26 on gastric motility and its relation to gastrin peptide in dogs. AP of GV26 inhibited gastric motor activity. During the AP the gastrin level in plasma decreased significantly with simultaneous decrease in the contractile activity. The amount of immunofluorescent G cell and the immunofluorescent intensity of antrum were both increased in dog under the AP. This result may be related to an increase of storage and a decrease of release of gastrin in G cell during the AP.

137 Zhu CX, Li SX, Ma GH (1989) [Experimental study on the relative speciality of GV26 with blood flow in the common carotid artery as the indicator of response]. Chin Acup & Moxibust 9(2):29-33. A square-wave electromagnetic blood flow meter (MF27) and kymograph (RM86) were used to measure blood flow in 30 conscious rabbits. They compared the ability of AP at GV26, ST36, LI04 and Earpoint Ear-Apex to increase blood flow in the carotid artery. AP at GV26 increased carotid flow in all 30 cases. LI04 increased flow in 16 cases, but had no effect in 14. ST36 increased flow in 11 cases, decreased it in 2, and had no effect in 17. AP at "Ear Apex" increased flow in 6 cases, decreased it in 1, and had no effect in 23. AP at GV26 was much more effective in increasing blood flow in the common carotid artery of rabbits than was AP at ST36, LI04, or Ear Apex.

138 Zhu LX, Li CY, Ji CF (1988) [Presynaptic inhibition in APA]. Acup Res 1988:108-112. They studied the role of presynaptic inhibition in APA using the fifth negative wave of dorsal root potential (DRP-V) as the index of depolarisation of the primary afferent. Stimulation of ST36 and GB34 induced the DRP-V of neighbour rootlet. Strong stimulation of PC06 and GV26 also induced depolarisation of the primary afferent terminals at remote segment, expressed by augmenting the DRP-V. Topical administration of bicuculline reduced the augmentation of DRP-V caused by AP-stimulation. Thus GABA probably was involved in AP-induced primary afferent depolarisation. Depolarisation of primary afferents induced by stimulation on acupoints may play an important role in APA.