Philip A.M. Rogers MRCVS


Alltree_J (1993) Physiotherapy and AP: practice in the UK. Complementary Therapies in Med Jan 1(1)34-41. A descriptive study of practice of chartered physiotherapists using AP in the UK was conducted by postal questionnaire. A 77% response rate was achieved. Two patterns of practice emerged from the study: respondents who had undertaken long AP courses were more likely (p <.001) to use pulse diagnosis, tongue diagnosis and Five Phase Theory when compared with those who had not. They placed more importance on traditional diagnosis (p <.001) and less on Western diagnosis (p=.004). The commonest methods for selecting AP points used by all respondents included a knowledge of Channels, prescriptions and tender points. These different patterns of practice could be used as a basis for treatment schedules to facilitate future research. AP was rarely used in isolation, most frequently being combined with exercises and manual therapy. Stress, gastrointestinal conditions, gynaecological conditions, headache, migraine and neck pain were among conditions perceived to respond well to AP and are recommended as future areas for research.

Andersson_S (1992) [A new survey of AP: with more training, AP can be used as a therapeutic complement]. Lakartidningen 4 Mar 89(10):785-792. Fysiologiska Inst, Goteborgs Univ, Sweden.

Andersson_S (1993) The functional background in AP effects. Scand J Rehab Med Suppl 29:31-60. Dept of Physiology, Univ of Goteborg, Sweden.

Anon (1990) Needles about! The art of AP. Br Dent J Dec 169(11):378. The ancient art of AP is becoming more and more popular, and cost-factors prompt practitioners to reconsider the benefits of a medical technique that is safe, simple and cheap. The British Med AP Society put their case at a press conference in October.

Anon_JTCM (1992) The detailed articles of the Plan for the Proficiency Examination for Int AP & Moxibustion Professionals (for Trial Implementation): Chinese Int Examination Centre for AP & Moxibustion. JTCM Mar 12(1):76-80.

Baldry_P (1993) Comp Med: The Practice of AP Needs Tighter Safeguards. BMJ Jul 31 307(6899):326-326; Comment on: BMJ 1993 4 Sep 307(6904):624.

Beal_MW1 (1992) AP and related treatment modalities: Part I: Theoretical background. J Nurse Midwifery Jul-Aug 37(4):254-259. Yale Univ School of Nursing, New Haven, CT 06536-0740. An introduction to the therapeutic applications, history, and theory of AP and several related treatment modalities is presented. The practices of AP, moxibustion, acupressure, and shiatsu are described. The underlying concept of treatment of imbalances of Qi (life energy), is presented along with the flow of Qi in Channels (pathways), and the theories of Yin and Yang, Five Phases, and Eight Principle Patterns.

Bennet_R (1990) [AP and scientific point of view: there are no short cuts to health]. Lakartidningen 25 Jul 87(30-31):2418. In Swedish.

Birkeflet_O (1992) [AP for nurses?]. Sykepl Fag 7 Dec 80(6):3-7.

Cier_JF1 (1990) [AP]. Bull Acad Natl Med Oct 174(7):1041-1044. In French.

Cier_JF2 (1991) [Definition of AP]. Bull Acad Natl Med Nov 175(8):1295-1298. In French.

Cignolini_A (1990) Problems of teaching and diffusion of Chinese AP in Europe. JTCM Mar 10(1):9-12.

Csiszar_R (1993) Basics of AP in the oral cavity: oral AP. Fogorv Sz Jul 86(7):233-238. Magyar Oralakupunktura Orvosok Tarsasaga, Budapest. In Professor Gleditsch's TCM doctrines, Qi Channels encircle and connect the mouth-cavity and its nearby areas. Appropriate knowledge of Channel points is decisive in diagnosing disorders of the mouth-cavity. Persons working on the mouth-cavity have an increasing responsibility to recognise and correctly interpret the connections between mucous membrane disorders and disorders in remote organs and Channel-organ systems.

Dorr_K (1992) Critical analysis of veterinary literature (until 1990) concerning diagnostic or therapeutic use of AP in cattle. Doctoral Thesis, Tierarztliche Hochschule Hannover. In German; Summary in English. Includes bibliographical references (pp114-132).

Friesjung_R (1994) Ear-AP Treatment in Vet Med. Tierarztl Umsch Feb 49(2):78. Werrastr 1, D 30519 Hannover, Germany.

Fu_S (1990) Present situation of Chinese AP and moxibustion education and its prospective strategy. JTCM Mar 10(1):3-5.

Gadsby_JG (1993) Kirlian photography diagnosis: a recent study. Complementary Ther in Med Oct 1(4):179-184. Leicester AP Services, 47 Milton Crescent, Leicester LE4 0PA, UK. This article examines the development and diagnostic applications of Kirlian photography analysis. A case study is presented which examines 100 Kirlian photographs within a complementary therapy practice. The results of this investigation aim to strengthen the knowledge base of Kirlian photography diagnosis with orthodox and complementary therapies in medicine.

Ge_S (1990) Treatment of alopecia areata with AP. JTCM Sep 10(3):199-200. Dept of AP, Shen Yang Hospital, PLA Air Force, PRC.

Gofman_SS (1991) [The treatment of occupational fluorosis by AP reflexotherapy]. Gig Tr Prof Zabol 11:40-42. The article contains the electrodiagnostic data on 26 Ear-points in 24 fluorosis-affected patients. It was established that the greatest electrical polarity asymmetry was found in points 13, 25, 28, 31, 54, 37, 39 and 40. Palpation of the Ear- and body- points also showed unfavourable conditions in the respective painful point of the organ. Basing on the results of the AP procedures, needle therapies of 80 occupational fluorosis cases were performed. The therapeutic patterns elaborated by the author were also proposed, which proved perfect results at different stages of the disease.

Gu_JC; Zhang LM (1992) AP and moxibustion in primary health care in rural China [letter]. World Health Forum 13(1):51.

Hao_LC (1987) AP and moxibustion for farm animals. Feeding a billion: frontiers of Chinese agriculture. Sylvan Wittwer [et al]. East Lansing: Michigan State Univ Press, 405-413.

Holmdahl-MH (1993) AP: contacts between East and West: Experience and science. Scand J Rehab Med Suppl 29:19-29. Dept of Anaesthesiology, Univ Hospital, Uppsala, Sweden.

Hu_Ra1 (1990) [Basic research on auricular AP]. Chung-Hsi-I-Chieh-Ho-Tsa-Chih Jun 10(6):379-382.

Illarionov_VI; Kosoverov EO (1994) [The evaluation and interpretation of the thermal AP test]. Vopr Kurortol Fizioter Lech Fiz Kult Mar-Apr 2:27-28. In Russian.

Johnson_IS (1993) Complementary Med: AP Has Weak Scientific Foundations. BMJ Sep 4 307(6904):624. Leicestershire Hospice, Leicester LE2 4HD, UK.

Kaptchuk T (1996) Some Thoughts on Efficacy Beyond the Placebo Effect. Adapted from WWW. Originally printed in the Anglo-Dutch Inst for Oriental Med Magazine. [Ted Kaptchuk OMD, Assoc Director, Centre for Alt Med Research at Harvard Med Sch. He is the author of "The Web That Has No Weaver": WebMaster].

One of the most often asked questions concerning complementary and Alt Med interventions is whether they are anything more than placebo effects. This question could more accurately be stated as follows: are any positive effects produced by an unconventional Med intervention greater than the effects of a sham intervention in a randomized clinical trail (RCT)?.

The question whether an intervention has greater effectiveness than a placebo was asked for the first time in the Med literature before World War II. It became a common question with the systematic introduction of the randomized controlled trial after World War II. Only from the early 1960s, with the phocomelia produced by thalidomide, did the comparison of an intervention with placebo become the defining and legally necessary question for scientific Med and Govt regulatory agencies. The bioMed concept of efficacy underwent a gradual and subtle shift. The question of efficacy evolved from demonstrable clinical effects and gradually become an issue of a demarcation line defined by a placebo intervention in a clinical trial.

There are many approaches to this question and many issues are still being debated. The main approach to this question is the perspective of fastidious efficacy, a name coined by Alvan Feinstein. Assuming that clinical outcome "is equal to its active effect plus its placebo effect", the fastidious approach takes an additive/subtractive approach for defining the boundary line of efficacy. The assumption of fastidious efficacy, embedded in the adoption of the RCT, both creates the question of what is beyond the placebo and supplies the answer with its "blinded-placebo-controlled" approach. Its answer is quantitative and precise and has the objectification that a chemomechanistic biology requires. Whether this information accurately portrays clinical Med is problematic as the method assumes that real and non-specific effects are stable, separable, linear and relatively constant during a clinical trial.

Most reviewers of AP's efficacy using this perspective tend to be either slightly positive or inconclusive. Unfortunately, most clinical trials upon which these opinions are based have major flaws. For example, it is unclear whether the quality of AP, the quality of therapist and the length of time for a reasonable expectation of outcome were adequately taken into account when these randomized clinical trials were performed. A second approach towards approaching this question is the perspective of pragmatic efficacy, a term created by Schwartz and Lellouch. This model of randomized clinical trials assumes that various non-specific effects are interactive among themselves and among any real effects and that is, therefore, difficult to make a clear distinction between real and placebo. The pragmatic approach blurs the real-placebo dichotomy embedded in the question, generates a less scientifically-satisfactory answer but may be of greater clinical relevance. The growth of the outcomes research movement is consistent with this pragmatic efficacy perspective. I am unaware of any genuine pragmatic trials where the practitioner can practice without any restraints on "optimal" treatment for AP. Many hybrid-pragmatic trials attempted to compare AP to another real treatment, but all other factors (including use of "Cookbook AP") were "standardised", so that it is not "optimal" AP. (Optimal AP must be adapted to the individual needs of the patient at that time). Well done pragmatic trials in other complementary fields such as manipulative therapy are very positive and more "expert" pragmatic trials in AP are needed.

A third approach to the question is what Tambiah calls "performance efficacy." This approach is cultural and anthropological and accepts symbols, belief, suggestion, expectation and persuasion as central to illness and health. This approach avoids any reliance on objectivity, controls and measurement. The contrived environment of an experiment might be the only clearly labelled sham from this perspective. This approach raises the question of who decides what is a sham. Performance efficacy is grounded in the language of solidarity, holism and unity; it is immune to the distancing and neutrality requirement of randomization, blinding and p values. This method generates clear answers about the experience of a self-selected, biased, individual person and has nothing to do with generalizability and replicability.

This approach turns the question of what is beyond the placebo on its head; instead, it asks: who decides whether a therapy is merely sham or more than sham? Patient satisfaction surveys of Comp Med point to the possibility that one answer to what is beyond the placebo is that sham intervention is defined in the eyes of the beholder, who may or may not recognize the scientific method as the final arbitrator. Generally speaking, patient survey of satisfaction with Alt Med is very high, always in the range of 80%.

There are few published surveys of patients' satisfaction with AP, as compared with TCM, but I suspect the satisfaction rate is equally high. The performance perspective also raises fundamental questions as to whether or not randomization introduces significant bias; whether informed consent itself is a potent non-specific effect and whether patient preference itself can have decisive clinical effects.

Beecher, HK. The powerful placebo. JAMA 159 (1955) 17:1602-1955.
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Meade TW, S Dyer, W Browne et al. 1995. Randomized comparison of chiropractic and hospital outpatient management for low back pain results from extended follow up. BMJ 311:349-51.
Patel M, F Butzqiller, F Paccaud et al. 1989. A meta-analysis of AP for chronic pain. International J Epidemiology 18; 4:900-904.
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Klazsik_G (1992) [AP in primary care (letter)]. Orv_Hetil 21 Jun 133(25):1587. In Hungarian.

Knottenbelt_JD (1993) Perspectives in AP. S Afr Med J Apr 83(4):241-242. Groote Schuur Hospital, Cape Town, S Africa.

Kornev_MA; Pugach PV; Aleksandrov SI (1991) [Anatomo-topographical characteristics of various AP points in children]. Arkh Anat Gistol Embriol Jan 100(1):85-88. To ensure the safety of AP therapy for children, a layer-by-layer study was made of tissue topography up to the limits of needle depth at important AP points in young children. Peculiarities of the following points were described: GV20, TH05, PC06, SP09, SP06, LI04, ST36, HT07 and GB34.

Kudriavtsev_A; Vlasik T (1994) Gentle and strong AP: a short review of the two main approaches to treatment. Inst of Clinical Cardiol, Acad of Med Science, Moscow, Russia. AJCM 22(3-4):221-233. Secondary Qi pathways have been known for centuries. Although AP at their points can be very effective in many diseases, AP therapy, surprisingly, is used very seldom. In this article we present some methods allowing the relief of these pathways in their most limited sites. Such approaches are referred to as gentle AP which intends to clear Qi Channels. Also, methods of working with principal Channels using the Five Xing (Phase) points are presented. These methods, considering energy imbalance at a level of the whole organism, are called strong AP because of their strong influence on the Energy of the body.

Landa_NM; Makarenkova GA (1990) [The work experience of a paediatric office of AP in a polyclinic]. Med Sestra Aug 49(8):14-17. In Russian.

Lidicka_M (1990) [Possibilities of using AP in pediatrics]. Cesk Pediatr Feb 45(2):110-111. Okresni ustav narodniho zdravi, Praha. In Czech.

Limanskii_IuP (1990) [The hypothesis of AP points as polymodal receptors of the ecoceptive sensitivity system]. Fiziol Zh Jul-Aug 36(4):115-121. Hypothesis is proposed that the human brain has the sensory system (ecoceptive sensory system) which responds to changes of the Earth EMFs (EEFs) and meteorologic factors (MFs). AP points are activated easily by adequate somatosensory stimuli (mechanical, temperature) and EMFs (EAP, magneto-AP). They can act as polymodal receptors of the ecoceptive sensory system. The sensory endings of AP points are excited by sharp changes of EEFs and MFs. Through neuronal brain stem structures, especially through hypothalamus, stimulation of the AP points starts the adaptive mechanisms intended to compensate for deviations in the functional systems of the brain, provoked by prolonged environmental influences, such as exposure to EEFs and unsettled weather.

Lisenyuk_VP; Samosyuk IZ; Yakupov RA (1993) Computerized AP medical system. AETRIJ Apr-Jun 18(2):97-101. Dept of Neuropathol and Reflexotherapy Kiev State Sch for Post-Graduate Studies of Physicians, Ukraine. Long-term experience of AP applications at 9 specialized centres, and analysis of over 30000 cases have allowed development of original algorithms for prescribing AP therapy on the principles of balancing Channel Qi, functional indicators and specific effects of AP points, anatomical location, segmental sensory innervation of pathological foci, and optimal combination of body-AP points with the micro-AP systems. This served as the basis for the creation of computer software to increase the efficiency of AP treatment used by a wide range of practitioners.

Lu_S (1992) AP treatment of soft tissue injury. JTCM Sep 12(3):228-232. Beijing College of AP, Moxibustion, Orthopaedics and Traumatology, PRC.

Lu_S (1991) Scalp AP therapy and its clinical application. JTCM Dec 11(4):272-280. Dept of AP and Moxibustion, Beijing College of AP, Moxibustion, Orthopaedics and Traumatology, PRC.

Ma_Y; Liu W (1994) Studies on Xie (Reducing) and Bu (Reinforcing) manipulation of AP during the past 4 years. JTCM Sep 14(3):226-232. Inst of AP and Moxibustion, China Acad of TCM, Beijing, PRC.

Ma_Y; Wang C (1992) Clinical application of point-through-point AP. JTCM Jun 12(2):154-157. Dept of AP and Moxibustion, Hospital of Shandong College of TCM, Jinan, PRC.

Marcus_P (1991) AP treatment for industry. Occup Health (Lond) Nov 43(11):341-344. The general public has become increasingly interested in a variety of "alternative" therapies. These can range from the well-established to the downright eccentric. One of those which has the most scientific research to support it is AP. Dr Paul Marcus explains what AP treatment is, what medical conditions it is best used for and the importance of using medically qualified acupuncturists.

Mendelson_G (1991) Laser-AP [letter]. Med J Aust 3 Jun 154(11):779.

Moldovan_CI2 (1996) Low Energy Laser-AP: A Novel Model of Enegetic Interaction. Corneliu I Moldovan MD DSc, Bucharest AP & Homeopathy Centre, 4-6 Visarion Street, Bucharest 1, ROMANIA; Tel: +40-1-650.42.44; Fax: +40312.95.45. Adapted from WWW. The scope and the purpose of this work are to provide the description of Low Energy Laser (LEL) light interaction with the skin electric charges, mainly registered at AP loci. A novel spatial electrostatic imaging technique that allows the visualization of the surface load distribution using static discharges upon a nematic liquid (LCTV) transducer, has been developed. Significant modification pattern of skin electric activity after laser irradiation has been monitored at 16 AP points location, by digital electrometry and digital photopletismography. These patterns allow to detect and measure the alteration of the spatial distribution of the electrostatic loads generated by the electret behaviour of the derma as well as the surface electric potentials and the dermal microcirculation. LEL acts at the AP cutaneous gate by: Dipole polarization depending mainly on the laser wavelength and time of exposure. Micro-electric potentials' generation by electric charges transfer, depending on the dermal microcirculation that is laser-activated. Electrostatic induction depending on the laser source frequency. Bio-effects of laser irradiation depend on the optical (scattering-absorption) and the thermal properties of the tissue. These tissue-specific parameters control the wavelength-dependent depth of penetration and the tissue effect. This study indicates the electrostatic mechanisms that involved AP points may play a major role in the Laser-AP Bio-effects.

Multykh_VE; Samsygin VIu (199.) [Experience with the use of AP by mobile health units]. Anesteziol Reanimatol Mar-Apr 2:58-59. In Russian.

Nagai_T (1990) [The situation of AP in Germanic countries]. Kitasato Arch Exp Med Dec 63(4):33-42. Dept of Haematology and Genetics, Fac of Hygiene, Kitasato Univ, Kanagawa, Japan.

Norheim_AJ (1993) [Attitudes to AP: a questionnaire study among medical students in Tromso]. Tidsskr Nor Laegeforen Mar 113(9):1055-1057. Medisinstudiet FagomrÕdet medisin, Universitetet i Tromso, Norway. In February 1992, 80% of the medical students at Tromso Univ filled in a questionnaire concerning attitudes to AP. 63% of the students would recommend AP when the diagnosis was migraine, while 14% of the students would support a patient who tried AP as cancer therapy. 86% of the students thought that placebo could account for 25-50% of the effect of AP. Most of the students wanted more scientific documentation, although 75% said that AP already was, or at least should be, part of the ordinary health care system. The main result of this study was a generally positive attitude towards AP. The students want to learn the method, and they will recommend AP for their future patients.

O'Neill-A (1994) Danger and safety in medicines. Social Science and Med Feb 38(4):497-507. Dept Health Adm Educ, Lincoln School Health Sci, La Trobe Univ, Carlton South 3053, Victoria, Australia. Inaugural-Dissertation / Tierarztliche Hochschule Hannover; 1988 [no. 41]. Convictions about established medical safety and the danger of alternative remedies and practitioners are discussed in this article. While most alternative medicines continue to be denounced as unscientific and unsafe, government reviews have concluded that chiropractic and osteopathy and (more recently) AP should be registered occupations and that qualifying courses of tertiary education should be instituted in Australia. This paradoxical result follows the widespread adoption of AP and spinal manipulation by established practitioners of medicine and physiotherapy. The practices become intrinsically dangerous as their efficacy is accepted. Consequently, the argument is that only established practitioners are safe enough to use them. But alternative groups can use the established announcement of danger to represent the desirability of official action to protect the public. The article concludes with a review of the idea that therapies become dangerous as they are introduced.

Omura_Y (1994) Accurate localization of organ representation areas on the feet & hands using the bi-digital O-ring test resonance phenomenon: its clinical implication in diagnosis & treatment: Part I. AETRIJ Jun-Sep 19(2-3):153-190. Heart Disease Research Foundation, New York. Accuracy of the widely used organ representation areas, currently used in different schools of foot and hand reflexology was evaluated using Bi-Digital O-Ring test resonance phenomenon. Our previous study indicated that mapping organ representation areas of the tongue using Bi-Digital O-Ring Test resonance phenomenon between 2 identical substances often provided more reliable clinical information for both diagnosis and treatment than the 2 widely used, but crude, traditional schools of Chinese tongue diagnosis. This same method was applied for the mapping of the organ representation areas on the feet and hands. We succeeded in mapping the following areas on human feet: 1. Middle (3rd) toe on the sole side represents the following starting from the tip: a.Head; b.Face with eye, ear, nose, and mouth (1st Digit); c.Neck and organs within the neck (narrow space between 1st crease after the 1st digit and crease at the junction of the beginning of the sole); 2. 2nd and 4th toe represent upper extremities, the beginning tip being fingers and hands. The crease at the base of these toes represents the shoulder. The 2nd toe represents right upper extremity, and the 4th toe represents left upper extremity; 3. 1st and 5th toes in both the right and left feet represent lower extremities with the tip being the toes and soles of feet. The crease at the base of these toes represents the inguinal area. The 1st toe of each foot represents right lower extremity, and 5th toe represents left lower extremity. The sole of the foot is divided into the following 3 distinctive sections: 1. Upper (1st) section represents organs in the chest cavity including 2 thymus glands, trachea, 2 lungs, with the heart between them, and with the oesophagus appearing as a narrow band outside of the lung near and below the 1st and 2nd toe depending upon the individual. Chest section occupies the first 20-33% (on a relatively long foot) of the entire sole. The boundary between the chest and gastrointestinal system can be estimated by extending the length of the entire toe or up to 25% longer to the sole, but it can be accurately determined using a diaphragm tissue microscope slide as a reference control substance. 2. Middle (2nd) section represents GastroIntestinal system, including lower end of the oesophagus, liver, stomach, spleen, gallbladder, pancreas, duodenum, jejunum, ileum, appendix, colon, and anus.

Orlova_MV (1991) [Kinetics of human blood ceruloplasmin properties under the effect of microcurrents at AP points (letter)]. Biofizika Jul_Aug 36(4):732-733. In Russian.

Price_JR (1994) The placebo effect: Use outside trials may be unethical [letter]. BMJ 10 Sep 309(6955):667.

Resch_KL; Ernst E (1995) [Proving the effectiveness of complementary therapy: Analysis of the literature exemplified by AP]. Fortschr Med Feb 113(5):49-53. Post-graduate Med Sch, Univ of Exeter, UK. At present, AP may be considered one of the most popular forms of complementary medicine worldwide. However, in relation to the number of reviews on the subject, comparatively few controlled clinical trials have been reported. An analysis of all the controlled clinical trials listed in MEDLINE between 1987 and March 1994 (n=39) that met certain basic requirements revealed that they addressed a wide variety of diseases and/or symptoms with no major focus (apart from the symptom of pain, which of course is highly complex in nature). In agreement with the findings of other meta-analyses, most of the more recent papers are still of indifferent quality. Besides the inherent problem that the term AP subsumes within itself a substantial number of different techniques (and even philosophies), an obvious methodological deficit can be observed. Many groups seem to attach too little importance to choosing an appropriate control model, although seminal papers addressing this problem were already published in the early eighties. Similar remarks apply to inadequacies in study design, which should be at least single-blind. These findings may help to explain why the effectiveness of AP has still not been definitively shown.

Robinson_C (1990) Getting started in AP [news]. Aust Vet J Oct 67(10):423.

Rothman_KJ; Michels KB (1994) The continuing unethical use of placebo controls. NEJM 11 Aug 331(6):394-398. Boston Univ School of Public Health, MA 02118.

Rothschild_R; Quitkin FM (1992) Review of the use of pattern analysis to differentiate true drug and placebo responses. Psychother Psychosom 58(3-4):170-177. Dept of Psychiatry, Columbia Univ, New York, NY, USA. Placebo response in patients assigned active drug is a troubling source of variance in antidepressant studies. This paper summarizes a series of studies utilizing pattern analysis to distinguish between placebo and true drug responses. Analysis of the persistence, speed, and timing of onset of patients' improvement during antidepressant therapy reveals distinct patterns of response which are likely to be attributable to placebo and true drug effects. While true drug effects seem to be characterized by a 2-week delay in onset followed by persistent improvement, placebo effects seem to be characterized by abrupt, transient improvement. Gradual responses on placebo may be due to spontaneous remission. The heuristic and clinical implications of pattern analysis are discussed.

Rubens_D; Gyurkovics D; Hornacek K (1996) The cultural production of Biotherapy: psychic healing and the natural Med movement in Slovakia. Dept of Anthropology, State Univ of New York at Buffalo. Adapted from WWW. Despite powerful opposition, natural Med (NM) has found a toe-hold in the state-run bioMed system in the Slovak Republic. The Med-leader of the NM movement aims to use his ministerial post as NM "supreme expert" and his interlocking NM clinical and research facilities to achieve a complex, unified health care system under control of Med doctors. This health care model simultaneously reinforces bioMed hegemony and moves classical Med from the centre by substituting a bioenergetic paradigm. Among other diagnostic and healing modalities, NM includes AP, herbal therapy, bee therapy, reflexology and iridology. However, its paradigm is biotherapy, the focus of this paper. Biotherapy is a form of psychic healing or therapeutic touch. It is based on bioenergetic and information-processing principles. Conceptually, biotherapy unifies psyche, soma and energy dimensions of the human body and places the human in an extended transpersonal social, physical and cosmological environment. Biotherapy is a reconstruction of a folk healing tradition in more scientific and medical terms, whose appropriation simultaneously secularized and re-consecrated this tradition by re-locating its practice from lay healers to Med doctors, from the once-religious realm to the now-venerated scientific realm, from deviant-science to normal-science. As part of the creation of an academic secular parapsychology in the former Soviet Bloc in the late 1960s, the reconfiguration of psychic healing into biotherapy illustrates the use of the privileged discourse of science for a cultural production that seems to have both supported and subverted the regime.

Sensabaugh_SM (1986) Acupuncture for veterinary technicians. Vet Tech Nov-Dec 7(10):434-436, 438-439.

Shang_C (1993) Bioelectrochemical oscillations in signal transduction and AP: an emerging paradigm. AJCM 21(1):91-101. Renal Unit, Massachusetts General Hospital, Charlestown 02129, USA. Several converging points from recent research on cellular signal transduction, pattern formation, bioelectromagnetism and AP are reviewed. An organism is not only a system of molecules and cells, but also a system of oscillations. Bioelectrochemical oscillations are generally important in morphogenesis and physiology. They precede the morphological changes in development or pathology. Converging discoveries and hypotheses in different fields, and a perspective on their potential application in bioMed are also discussed in this article.

Shul'ga_AP; Gus'kov SV (1990) [Effect of prolonged magnetic AP on computer operators during shift work]. Fiziol Cheloveka Sep-Oct 16(5):142-146.

Smith_C (1992) AP: an ancient treatment modality under scientific scrutiny [news]. JAVMA 1 Nov 201(9):1321-1325.

Smith_FW Jr (1992) Neurophysiological basis of AP. Cardiopet Inc., Floral Park, New York. Probl Vet Med Mar 4(1):34-52. Research has shown that the benefits of AP are real. AP effects are due to local effects, stimulation of neuroendocrine systems, and modulation of the body's electromagnetic (EM) energy. The exact mechanisms activated depend on point selection, type of stimulation, and probably time of day. The effectiveness of the treatment will depend on the disease entity treated and the skill and knowledge of the acupuncturist. Knowledge should include both the fundamental principles of Chinese medicine and the more recent scientific understanding of AP's physiologic basis.

Stefanatos_J (1990) Bioenergetic medicine: homeopathy and acupuncture for animals. American Holistic Veterinary Medical Association, 83pp.

Sternfeld_M; Finkelstein Y; Eliraz A; Hod I (1990) Cell membrane activities and regeneration mechanisms as therapy mediators in moxibustion and AP treatments: theoretical considerations. Med Hypotheses Mar 31(3):227-231. Kaplan Hospital, Pulmonary Unit, Rehovot, Israel. AP needling or moxibustion, the major modalities of physical TCM, include mini-destruction of tissue or increased permeability of cell membrane. Both action potential activities and the release of cellular metabolites responsible for regeneration occurs. These phenomena are eventually abolished by local and systemic inhibitory elements being metabolites or neurogenic. The inhibitory effect induced by the AP and moxibustion and directed to the manipulation site of these modalities may affect other anatomical sites and reduce or prevent neoplastic growth and neuromuscular or cardiac membrane activity disturbances.

Stulbaum_AW (1992) The scientific rationale, clinical practice, and future of AP in the US [letter]. AETRIJ Jul-Sep 17(3):229-231.

Tang_D (1991) [Experimental AP-study and its role in AP education: suggestion offering the course of experimental AP in AP education]. Chen Tzu Yen Chiu 16(1):76-78, 68. Dept of AP and Moxibustion, Tianjin Coll of TCM, PRC. Experimental AP-study (EAS) is a new subject which probes the Channel and principle of AP with the help of modern scientific technique and experimental method. In Channel research, the basic responsibility of EAS is to expand the essence of the Channel. For nearly 50 yr, the research has concentrated mainly on detection of the Channels, the phenomena of Channels and the relationship between Channel-points and viscera, etc. In the research on the principle of AP, EAS has accumulated many data to prove the therapeutic effect of AP. Many factors influence the effect of AP. Thus, it is a basic task for EAS to programme the experimental procedure according to the principles of diagnosis and treatment based on an overall analysis of symptoms and signs, so that the best circuits can be chosen. At its best, EAS has significance in three important areas in the training of modern specialists in AP: 1. It can help students to get a deeper understanding on the thought of traditional AP and realize the advantage of AP, thus, encourage their faith on this medical means. 2. It can enrich the contents of AP medicine and broaden the outlook of students, because it introduces modern science and experimental methods into traditional theory. 3. It can train students' ability in scientific research through strengthening the practicability of AP. Therefore, its active significance in AP education has been accepted by AP specialists in our country. More and more colleges of TCM offer this subject, which is welcomed widely.

Troshin_OV (1993) [The functional properties of the cochlear-vestibular AP points of the external auditory canal]. Fiziol Zh Im I M Sechenova Mar 79(3):47-53. Ear-AP points inside the ear were studied in 60 healthy subjects. The points were found to have obvious advantages as compared with the commonly accepted Earpoints.

Ueki_S; Iwai Liao Y; Han KS; Higashi Y (1995) Histological study of the circulatory system of human dental pulp from individuals under local anaesthesia and EAP-analgesia. Okajimas Folia Anat Jpn Mar 71(6):335-343. Dept of Orthodontics, Osaka Dental Univ, Japan. Dental pulp from patients under AP-analgesia (APA) or local infiltration analgesia was studied using transmission electron microscopy (TEM). Vessels in the dental pulp of patients who received infiltration anaesthesia were constricted, congested, static and thrombotic, making it difficult to differentiate lymphatic circulation. However, dental pulp from AP-patients showed normal arterioles, capillaries, and venules, as well as some lymph capillaries and small efferent lymphatic vessels that measured circa 8 um and 100 um in diameter, respectively. The lymphatic endothelial walls had many intercellular gaps, an imperfect basal lamina, and a few discontinuous pericytes. Between the openings in the lymphatic vessels, there were bundles of junctional filaments extending towards the dental pulp connective tissue. Thus, the lymphatic system, which contains mainly B-3-alpha capillaries, is a leaky tissue. It regulates fluid in the dental pulp.

Vari_SG; Shi WQ; Pergadia VR; Duffy JT; Miller JM; Vanderveen MJ; Weiss AB; Fishbein MC; Grundfest WS (1993) Effects of Pulsed Midinfrared Lasers on Bovine Knee-Joint Tissues. Proceedings of Lasers in Orthopaedic, Dental and Vet Med 1880:17-28. SG Vari, Cedars Sinai Med Ctr, Dept Laser Res & Technol Dev, Los Angeles, CA 90048.

Verhoef_MJ; Sutherland LR (1995) General practitioners' assessment of and interest in Alt Med in Canada. Soc Sci Med Aug 41(4):511-515. Dept of Community Health Sci, Faculty of Med, Univ of Calgary, Alberta, Canada. Canadian physicians' opinions of Alt Med have, as yet, not been assessed. The objectives of this pilot study were to assess general practitioners': 1. desired involvement in Alt Med; 2. perceived demand for Alt Med; and 3. beliefs on the efficacy of different alternative approaches. The study design was a cross-sectional survey of 400 randomly selected Alberta and Ontario general practitioners. Of the 384 eligible physicians, 200 (52%) completed the questionnaire. 73% of physicians felt that they should know the main alternative treatments. However, with respect to other issues, physicians desired less involvement with Alt Med. 65% perceived a demand for Alt Med from their patients, in particular chiropractic. Alt Med was perceived to be needed most for musculoskeletal problems and chronic pain or illness. Chiropractic, hypnosis and AP (for chronic pain) were believed to be most efficacious, while homeopathy and reflexology were considered to be least efficacious. Undergraduate, graduate clinical and continuing Med education will need to address alternative treatments in order to provide physicians with up-to-date and relevant information.

Vincent_C; Lewith G (1995) Placebo controls for AP studies. J R Soc Med Apr 88(4):199-202. Academic Dept of Psychiatry, St Mary's Hospital Med Sch, London, UK. Many studies of AP treatment are seriously flawed by methodological problems. Poor design, inadequate measures and statistical analysis, lack of follow-up data and sub-standard treatment are all too common. However, the major problem, which many investigators consider to be still unresolved, is the definition of an appropriate placebo control. The use of inappropriate placebo controls has bedeviled AP research and led to serious misinterpretation of the results of clinical trials. Different solutions have been proposed, but there is no agreed way to assess the adequacy of control conditions or to decide which placebo to use in a particular trial. We propose that assessing the credibility of treatments and control conditions may provide a way forward to a more rigorous, consensus approach. (Rogers Note: Many "research studies" which showed little or no significant difference between effects of "active" and "placebo" points used placebos which were too near (or in the same neurotome as) the active points. In many cases both sets of points had significant clinical or physiological effects)."

Wang_B (1990) The basic knowledge indispensable for a qualified AP doctor. JTCM Mar 10(1):6-8. Shanghai Inst of TCM, PRC.

Wang_L (1992) Some important links in promoting the curative effect of AP. JTCM Mar 12(1):64-67. Inst of AP, China Acad of TCM, Beijing, PRC.

Wertlen_LE (1993) Playing ostriches about AP? [letter]. S Afr Med J Nov 83(11):861.

Worell_AB; Farber WL (1993) The Use of AP to treat Feather Picking in Psittacines. 1993 Annual Conference, Assoc of Avian Vets :121-126. AB Worell, All Pets Med Ctr, Canoga Pk, CA 91304 USA.

Xu_R (1990) The application of bloodletting in AP therapy. JTCM Dec 10(4):274-275. Taizhou Hospital, Zhejiang Province, PRC.

Zukauskas_G; Dapsys K (1991) Bioelectrical homeostasis as a component of AP mechanism. AETRIJ 16(3-4):117-126. Psychiatric Problems Research Lab, Rep N. Vilnia Psych Hosp, Vilnius, Lithuanian Rep. Low frequency electrostimulation and super-high frequency EMF were applied to AP points of ST Channel in dogs. The stimulation effect on Bioelectrical potentials of 5 AP points of ST, SP, LV, KI, SI Channels and non-AP skin zones was studied in dogs in which autonomic ganglia or neuromuscular junctions were blockaded. The influence of ganglio-blockading and myo-relaxing drugs on Bioelectrical potentials of AP points was also researched. The results are discussed from the neurohumoral and bioelectrical hypotheses points of view. Conclusion: Both mechanisms of AP supplement each other. The principle of bioelectrical homeostasis as a component of AP mechanism is proposed. Bioelectrical homeostasis along with other kinds of homeostasis forms a system of first level homeostats which is united into 2nd level homeostat by the ANS.