Wrist-Ankle Acupuncture: An edited Bibliography

Philip AM Rogers MRCVS,
1 Esker Lawns, Lucan, Dublin, Ireland
e-mail: philrogers@tinet.ie

This is an appendix to the paper "Wrist-Ankle Acupuncture - A Simplified Version of Classical Acupuncture" (Rogers 1999).

In preparation for the update of that paper, a search for the profiles [wrist ankle] in Acupuncture Progress gave the following 14 abstracts, published mainly in China between 1984 and 1993 on Wrist-Ankle AP.

PubMed Medline [http://www.ncbi.nlm.nih.gov/PubMed/medline.html] was disappointing; a search there for the profile [acup* AND "wrist-ankle"] gave only one title (Song & Wang 1985) but no abstract.

The abstracts were edited, shortened and the point codes and the language was standardised. Clinical conditions treated, and the relevant references were:

Acute asthma attack Huang 1993
Acute soft tissue sprains and contusions Yang 1986
Acute waist sprains and sciatica Duo 1986, Pan & Yu 1987
Chest / thoracohypochondriac pain Wang et al 1992
Enuresis Song & Wang 1985
facial paralysis Zhao Y 1985
general disorders Qiu & Jiao 1984, Matsuda 1985, Zhao & Chen 1985
Hypertension Wang 1987, Zhang et al 1988
juvenile myopia Zhao YS 1985
renal colic Zhang & Zhang 1987



In view of the fact that Acupuncture Progress claims to have 13000 titles on AP, and Medline has >6873 hits for the profile [acup*] (not including allied methods, such as TENS, moxibustion, massage, tuina etc), a mere 14 hits for the W-A method suggests that it is not widely used, even in China.

This reinforces the conclusion of the main paper, that W-A AP is a very simplified form of AP. However, many authors have claimed significant clinical results from the method.

W-A AP may have practical application in countries in which classically trained acupuncturists are in short supply, but it is unlikely to replace classical AP in treating complex or difficult cases.

References from Acupuncture Progress

(1984) Qiu ML & Jiao GR [An introduction to the study of methods of AP and moxibustion treatment]. Acupunct Res 9(3):188-202. The paper introduces the progress of the study of methods of AP and moxibustion treatment for >30 years since foundation of new China. It discusses especially the clinical applications and study of filiform needles, EAP, acupoint injection therapy, Ear-AP, Head-AP, Wrist-Ankle AP, sound-electric wave AP, laser-AP, microwave-AP and magnetic-AP therapy.

(1985) Matsuda Y [Low frequency EAP treatment of round type skin needle]. Orient Med 1(1):71. Blood pressure measurement and Rydoraku assessment pre-and post-treatment were made in 8 patients refractory to Western medicine. They were treated with self-designed EAP with round skin needle was used on: 1. Ordinary Channel therapy, 2. Wrist-Ankle Ryodoten therapy (W-A AP), 3. Body Ryodoten therapy (abbr. body ESA), 4. Extraordinary Channel therapy. These therapies were used in combination. 6/8 cases were cured and 2 improved. 4 cases of artificial abortion were performed under the round skin needle EAP anaesthesia The patients recovered rapidly, with no side-effects. Low frequency round skin needle EAP was tried, its clinical efficacy and advantages were assured, and the importance of regulating the Channel in treating diseases was confirmed.

(1985) Song BZ & Wang XY Short-term effect in 135 cases of enuresis treated by Wrist-Ankle AP. J Tradit Chin Med 5(1):27-28. 135 cases of enuresis, from 5-25 years old, were treated with Wrist-Ankle AP. X-ray showed spina bifida of vertebra S1 in 2 cases. 1.5" AP needles, 28 gauge, were used. The patient was placed in sitting or lying position. The point selected was Shuangxia 1, at the inner edge of the Achilles tendon 4.5 cm above the highest point of the medial ankle. [This point is very near KI07, the Metal-Tonification point of KI - Rogers]. After 1 course of AP, 82% were cured, 16% improved and 2% failed; total effective rate was 98%. Follow-up in 80 cases after 1 year showed no recurrence. Our method is simple and has no side effects. The patients suffer no sensation of soreness, numbness and distension or pain. The method is therefore more suitable [than other AP techniques] for children.

(1985) Zhao XB & Chen KQ [Brief discussion on some questions of 8 Confluent points]. J Tradit Chin Med 26(11):47-48. The nomenclature of 8 Confluent points, the route of crossing Channel and selection of points were discussed. The author considered that in the research of specific points, such as the 8 Confluent points, further discussion on the theoretical substance in terms of the relationship between Channel vs Channel, Channel vs point, point vs point, point vs Zang Fu organ and referring to pathology and physiology is required. 8 Confluent points have definite effects on certain diseases of the organism. The 8 points are distributed around the wrist and ankle, so all such therapies as Wrist-Ankle AP, "body ring needling", etc. which developed in later years have definite relation with this series of special points. [The Confluent Points are PC06, SP04, SI03, BL62, TH05, GB41, LU07, KI06; of these, only PC06, TH05 and LU07 correspond exactly with W-A points - Rogers]. So, it is necessary to study the 8 points by observing a large amount of clinical cases. On the basis of proving the experiences of the ancients, we could discover the rules, complete the theory, and make contribution to our clinical and teaching works.

(1985) Zhao Y [Facial paralysis treated by Wrist-Ankle AP: Analysis of 69 cases]. J New Chin Med (3):33. Wrist-Ankle points along the Upper 2 region [? W2 = PC Channel - Rogers] were used in 69 patients with facial paralysis. The needle was inserted rapidly at an angle of 30 degrees to the skin, and placed horizontally after insertion. The tip was parallel to the forearm, driven in slowly to a depth of 1.5". The needle was retained 30-40 min. AP was given once/d. 61/69 cases recovered, 6 gained marked effect, 2 improved and 1 had no response.

(1985) Zhao YS [Juvenile myopia treated by injections of placenta extracts at acupoints: Report of 50 cases]. Shaanxi J Chin Tradit Med 6(12):552. Wrist-Ankle Point Upper 1 (in the depression anterior to the base of the 5th metacarpal bone) [W1 = HT Channel - Rogers]; Earpoint Eye; Body point: SP06. 4 points were used in each treatment, and 0.5 ml of placental extract was injected every time. Pt. Eye was selected in every treatment and the other 2 acupoints were alternated 3 times/wk for 5 times/course, with a 4-5 d interval between 2 courses. All 50 cases improved in various degrees.

(1986) Duo JR [Acute waist sprains treated by Wrist-Ankle AP: Report of 29 cases]. Neimenggu Tradit Chin Med 5(4):34-35. The patient was treated lying or sitting. The needle was inserted 2 fingers above the transverse lines of the wrist and ankle. If there was a tender point at the lumbar region, Lower 5.6" [? A5 and A6 = below GB39 and BL60 towards 59 - Rogers] was taken. If the effect was not satisfactory, Upper 6" [W6 = above SI05 - Rogers] of the same or opposite side of the tender point was taken. The handle of the needle was held with 3 fingers (thumb, index, middle finger). The other hand pinched the skin to make it taut. The needle was inserted rapidly through the skin, to run close to the skin surface for 1". The patients felt neither soreness, numbness, distension nor pain, otherwise the insertion was too deep. The needle was not twisted. It was retained for 30 min./d, for 10 d/course. 25/29 cases were cured, 2 cases markedly effective. The total effective rate was 100%.

(1986) Yang ZG [Acute sprains and contusions of soft tissues treated by AP at single point]. Henan Tradit Chin Med (2):14. AP is a highly effective therapy for acute sprain and trauma. Single point AP has the advantages of highly effective and less pain. This paper gives a brief introduction on the treatment of acute sprain and trauma with single point AP including body AP, Hand-AP, fluid AP, Ear-AP, and Wrist-Ankle AP.

(1987) Pan LG & Yu CD [AP in the treatment of waist pain and leg pain: Report of 30 cases]. Fujian J Tradit Chin Med 18(3):42. 30 cases of sciatica (waist and leg pain) were treated by shallow AP at wrist and ankle joints. Needle insertion was shallower (2/3 to 3/4) than general body AP. After needle insertion with mild stimulation, the patient was asked to walk with the needle in situ for 10-15 min. Then the needle was withdrawn. Mild massage was applied at the points with the thumb. 7 treatments = 1 course. All the 30 cases felt comfort, easy sensation and symptoms disappeared or markedly improved.

(1987) Wang YJ [Current status of clinical and experimental study in treating hypertension by AP and moxibustion]. Inf Tradit Chin Med (2):38-40. The author reviews the clinical experiences of treating hypertension with manual AP, plum-blossom needle AP, auricular AP, moxibustion, magnetic acupoint therapy, tuina, EAP, Wrist-Ankle AP, roller needle AP, etc. in China and abroad in recent years. Studies on specificity of acupoints and the findings of laboratory researches were also introduced.

(1987) Zhang XT & Zhang YE [Renal colic treated by Wrist-Ankle AP: Analysis of 50 cases]. Chin Acupunct Moxibust 7(5):16-17. This paper reports 50 cases of renal colic treated by Wrist-Ankle AP. The patient was asked to lie prone. 2 points were used for AP, both 2" above the highest point of the prominence of the medial and lateral malleolus on the same side of renal colic. These were (1) at the centre of the medial aspect (close to the medial edge of the tibia) [A2 = below LV05 - Rogers], and (2) at the centre of the lateral aspect (in the shallow groove between the fibula ridge and adjacent muscle tendon) [A5 = below GB39 - Rogers]. The needle was inserted swiftly, and directed towards the knee joint, 30 degrees to the skin. It was retained for 20-30 min. 82% were cured; total effective rate was 94%.

(1988) Zhang AG; Fang HQ & Deng JR [Non-drug therapy of hypertension]. Jiangsu J Tradit Chin Med 9(10):35-36. Based on literature and author's clinical experiences the methods of non-drug therapies were introduced briefly: 1. AP: including eye AP, nose, Ear, Hand, Foot, Wrist-Ankle AP, liquid injection and intradermal AP. 2. Pushing and holding (massage), acupressure. 3. Others: cupping, magnetic therapy, etc.

(1992) Wang RC; Guo QF & Zhao HL [Thoracohypochondriac pain treated by Wrist-Ankle AP: Analysis of 107 cases]. J Acupunct Moxibust 8(4):32-34. 107 patients with chest pain had shown nothing remarkable on fluoroscopy. As they had responded poorly to several therapies, they were treated by Wrist-Ankle AP. The points were selected at No.1 and No.2 areas, 4-6 cm above the wrist crease [W1, 2 = HT and PC Channels - Rogers] which corresponded with the location of chest pain. After skin sterilisation, a 4-cm needle, 30-32 gauge, was inserted rapidly at an angle of 35 degrees to the skin into the subcutaneous layer. Then the tip was directed toward the affected region for 3-3.5cm. The patients were asked to exercise the wrist. If they complained of discomfort at the needle, the handle was fixed. If patients complained of discomfort due to activity of the wrist, the needle was removed soon after. Otherwise it was retained for 2 hr. Therapy was every 1-2 d for 10 times/course. If there was no effect after 5 sessions, the treatment was stopped. Of 107 cases, 73 were cured, 31 marked improved, 2 improved and 1 exhibited no change. The overall efficacy was 99%.

(1993) Huang HS [Analysis on effect of 154 cases of asthma in attack stage treated with many kinds of AP]. Yunnan J Tradit Chin Med 14(5):25-27. Single Ear-AP for mild asthma: Earpoints Lung, Shenmen, Jiaowozhong(MA-TF) and Fengxi (MA-H) were used with other helper points. If the treatment did not work well, the unilateral single-hand-AP therapy was used in combination. Hand points Feijing, Feixue and Kechuan [? Lung, Cough, Chest, Diaphragm ? - Rogers] were used with other helper points. For moderate asthma, the main points selected were same as the above 2 groups. The needles were inserted with both hands into the bilateral Earpoints and hand points at the same time. Helper points were used in combination. For severe asthma, body AP and both ear-and hand-AP were used in combination. Body points Bailao [Z_30 Jingbailao, Neck Hundred Labour, 2' above GV14, 1' from GV line - Rogers], CV22, CV17 and LI04 were used, with other adjunct points. Wrist-Ankle AP and Chest Area (MS 2) of Scalp-AP was also used at the same time. The points were stimulated for 20 min/d for 5 times/course. 81 cases had marked improvement, 41 improvement and 32 no effect, with the total effective rate being 79%.