CHOICE OF ACUPUNCTURE POINTS FOR PARTICULAR CONDITIONS


Philip A.M. Rogers MRCVS
e-mail : progers@grange.teagasc.ie
1984 (updated 1990, 1993, 1995)
Postgraduate Course in Veterinary AP, Dublin, 1996

SUMMARY

1. Veterinary acupuncture (AP) is based primarily on human AP principles and the choice of points for particular conditions is very similar to the choice for similar human conditions.

2. Using a Hewlett-Packard Minicomputer, data from over 55 textbooks and clinical articles were stored. Frequency-ranked prescriptions for >1100 clinical conditions were generated from the computer database.

3. The Top Twenty Points from each prescription were extracted from the database summary. From this list, the most important points for major body regions (head, neck, thoracic limb, thorax, nose, throat, shoulder, elbow, lung, stomach, etc) and common symptoms (shock, nausea, vomiting, diarrhoea, fever, etc) were extracted.

4. Appendix 1 comments on the use of the point Index, the structure of the Index and the code and name of each point. Appendices 2 and 3 list the points. Examples of methods of point selection for specific conditions and for more complex syndromes (combinations of symptoms) are given in the text.

5. Advantages and disadvantages of the COOKBOOK METHOD of point selection are discussed in relation to holistic (traditional) AP.

INTRODUCTION

Western veterinary AP is based primarily on transposition of human AP principles to animal patients. To select effective points for therapy, one makes appropriate adjustments for differences in anatomy, location of peripheral nerves, and temperament of the animal (Rogers, 1980b; Molinier, 1983; Westermayer, 1981). There are some texts on traditional veterinary AP and some Western experts have produced texts which are based on traditional points. Others have written texts on the transposition method. Advantages and disadvantages of the transposition method have been discussed elsewhere (Rogers, 1982b).

Studies of the electrical resistance of skin in dogs, horses and cattle have confirmed the existence of REPP (reactive electropermeable points) at locations predictable from the human AP system (Janssens; Krueger; Greiff; Kothbauer). In AP research with primates, laboratory animals (mice, rats, guinea pigs, rabbits) and larger species, the human transposition system is the one used routinely to locate points such as LU01; LI04,11,15,20; ST09,25,36; SP06,09; HT07; BL points; PC06; TH05,08,14,17; GB20,30,34; LV03,14; GV26 etc. The clinical and experimental effects of stimulating these points have been confirmed worldwide in the past 10 years in many animal species (laboratory, farm, domestic and zoo).

Uses of the computer in AP and the advantages and disadvantages of computer -generated prescriptions were discussed elsewhere (Rogers 1984 a, b). Many professionals still refuse to use a computer. I believe that this refusal stems from fear (that they will not be able to master it) and ignorance of what a modern computer can and cannot do. Traditionally-trained acupuncturists may scorn the idea of cookbooks (although they use their own favourite prescriptions - a poor Cookbook). They would be horrified at the idea of computerising AP.

COOKBOOK AP: Many have told me that "prescription AP", especially the free availability of prescriptions, do AP a disservice. They assume that the cowboys (quacks, charlatans, get-rich-quick merchants) will proliferate and thrive if such information is freely available. I do not believe this. I would prefer to see AP develop rapidly. This will not happen if we must wait for a high percentage of the professions to develop to Master Acupuncturist status. The use of AhShi therapy and cookbooks brings more professionals into the active AP field than any other method that I know.

This paper discusses computer-based AP prescriptions for selected areas and symptoms under 3 main headings

: computer AP databases

: prescriptions for major body areas, functions, subregions

: prescriptions for common symptoms

It has taken me more than 11 years to amass these data. Therefore I ask each of you to treat the material as copyright. You are welcome to use it for clinical, study and research purposes, but not for commercial publication in text, computerised, microfiche form, etc. You are free to make personal copies for friends or colleagues, but only on condition that they also agree to respect the copyright.

The Channel and Point coding used throughout this text is: LU, LI, ST, SP, HT, SI, BL, KI, PC, TH, GB, LV, CV, GV; ST08 (TouWei) is on the temple, BL41 (FuFen) is at T2 and BL40 (WeiZhong) is in the popliteal crease. This is the same as that used by IVAS. The alphanumeric code and name of each point is shown in Appendix 1. As there is no internationally accepted coding system to-date, you are urged to check my coding system (Appendix 1) at this stage and to compare it with the one which you use. This is most important to prevent confusion and error.

COMPUTER AP DATABASES

The larger the database, the more points are filed under any given region, symptom or condition. However, the first 6-10 points listed (in order of descending citation score) are the most important for routine use. For example, in the most recent summary of the database, 401 points were listed from a base of 44 texts for the treatment of sequelae (hemiplegia, paralysis) of CVA or polio. The Top Ten points were:


Ranking       1    2    3    4    5    6    7    8    9   10

Point      LI04 LI11 ST36 GB34 ST06 GB30 ST04 LI15 TH05 GB39

Score       .86  .79  .77  .74  .73  .72  .68  .66  .62  .62

The Maximum score possible was .964. The bottom 10 points were:


Ranking     392  393  394  395  396  397  398  399  400  401

Point      CV13 CV17 BL65 LI01 ST23 BL07 KI20 GB06 GB43 LV06

Score       .02  .02  .02  .02  .02  .02  .02  .02  .02  .02

The scores have been rounded up or down to the second decimal place. Clearly, the first list would be expected to give better therapeutic results than the second list above.

However, selection of the Top Ten points in the above list would not necessarily be the best selection for a CVA sequel which was primarily mutism or aphasia. For such cases, the top 10 points are:


Ranking       1    2    3    4    5    6    7    8    9   10

Point      CV23 GV15 HT05 LI04 Z 21 TH03 GB02 TH17 NZ32 SI19

Score       .82  .72  .44  .37  .27  .23  .23  .21  .20  .18

(From a total of 71 possible points listed by 27 texts, maximum possible score was .952)

The differences between the Top Ten points for CVA and the Top Ten points for aphasia underline the need for formulating specific questions for the computer search. Where possible, one should search the database for general data (CVA), general region (head, neck, thoracic limb etc), specific region (arm, leg, hip, etc), specific nerve (mandibular, hypoglossal, radial etc). Where specific symptoms are marked (aphasia, incontinence, etc) they should also be searched.

The greatest volume of data refers to the abdomen and its organs/functions. Although there are points listed for "abdomen", "digestive upsets", "reproductive disorders" etc, these lists should be used as guidelines for general study or general consideration. In specific cases, it is preferable to search under the most relevant symptom or condition, such as "vomiting", "diarrhoea", "constipation" etc, rather than "digestive upset" or "metritis", "infertility", "impotence", "oligospermia" etc, rather than "reproductive disorders".

The database covers >1100 headings (regions, organs, conditions, symptoms, etc). The printout of the complete listing for the Top Twenty points runs to some 160 pages of full-width (132-character) computer paper. In one hour, it is not possible to cover these data. Therefore, I have chosen to list the Top Twenty points for about 130 of the major body regions and their subregions and organs (Appendix 2). The Top Twenty points for about 130 of the more common symptoms are also listed (Appendix 3).

PRESCRIPTIONS FOR MAJOR BODY AREAS, FUNCTIONS, SUB-REGIONS AND COMBINATIONS OF SIMILAR CONDITIONS

In the database (see Appendices 1,2,3) points are filed under separate condition codes such as:

040201 Shoulder area (unspecified conditions)

040202 Clavicle: APA for fracture reduction

040203 Shoulder: APA for dislocation reduction

040205 Shoulder, scapula : pain .. ache.. .arthritis etc

040211 Shoulder, scapular: paralysis

040219 Deltoid: myofascial syndrome

Using the computer, it was possible to combine information to retrieve all points used in, for example, all conditions of "shoulder, clavicle and scapular area" (a total of 181 points from 45 references). In this way, the entire database was summarised by amalgamation of data for major body areas, functions, subregions and combinations of similar conditions.

The Top Twenty points and their scores are listed in Appendix 2. These lists should prove useful in the study of AP and as reference material for teaching seminars. They do not, however, supplant the lists of points for specific symptoms but should be seen as general guidelines in the choice of points.

PRESCRIPTIONS FOR COMMON SYMPTOMS

The database was searched for a cross-section of common symptoms, especially those relating to the musculoskeletal system (pain, paralysis) and to major body functions. The Top Twenty points and their scores for some 130 symptoms or conditions are listed in Appendix 3. It must be remembered that only the Top Twenty points are given here. There are many other points which could be considered, especially if a number of symptoms occur together. In complicated cases, for example, neurogenic vomiting and dehydration in the dog, points for the main symptom (vomiting: PC06; ST36; CV12; ST25) could be combined with supportive therapy (fluid replacement).

In cases of anaesthetic emergency or respiratory arrest, main points (GV26, KI01) could be combined with artificial respiration (though the latter is seldom needed if the points are stimulated strongly). In cases where cardiac arrest has also occurred, point PC06 (very powerful on heart and lungs) could be added to GV26, KI01, and open or closed heart massage, defibrillation or other methods would be added.

Please scan Appendices 1, 2 and 3 now, and then return to the discussion which follows.

MASTER POINTS FOR CHANNEL THERAPY

Apart from the 66 Command Points, there are other powerful points to redistribute Qi between imbalanced Channels. These are the Shu-Back Association (Reflex) Points, the Mu-Front Alarm Points, the Luo-Passage (Connecting Points between the Phase-Mate Channels within one Phase), the Xi-Cleft Points, the Test Points, the Ryodoraku (Japanese Points), and the HE (Sea Points). The latter points are not the same as the HO points on the Channels. In addition there is an Hour Point (the Phase point of a Channel, for example the Earth Point of SP, the Water point of BL etc). SP21 is the Great Luo point (Luo point of all the Yin Channels).

Taken together, the 66 Command/Su Points, plus the Shu, Mu, Luo, Xi, Test, Ryodoraku, HE, Hour and SP21 Points are called the Master Points of AP.

                   The Five Phase Points     Tonic Sedat.

Affected COS    Wood Fire Earth Metal Water  point point  Yuan  Luo

LV (Wood-Yin )    01   02    03    04    08     08    02    03   05

GB (Wood-Yang)    41   38    34    44    43     43    38    40   37

HT (Fire-Yin )    09   08    07    04    03     09    07    07   05

SI (Fire-Yang)    03   05    08    01    02     03    08    04   07

PC (Fire-Yin )    09   08    07    05    03     09    07    07   06

TH (Fire-Yang)    03   06    10    01    02     03    10    04   05

SP (Earth-Yin )   01   02    03    05    09     02    05    03   04

ST (Earth-Yang)   43   41    36    45    44     41    45    42   40

LU (Metal-Yin )   11   10    09    08    05     09    05    09   07

LI (Metal-Yang)   03   05    11    01    02     11    02    04   06

KI (Water-Yin )   01   02    03    07    10     07    01    03   04

BL (Water-Yang)   65   60    54    67    66     67    65    64   58





                            Xi-                  RYODO   HE

                            Cleft  HOUR   Test   -RAKU   (SEA)

Affected COS    Shu   Mu    point  point  point  point   point

LV (Wood-Yin )  BL18  LV14     06     01     08     03       -

GB (Wood-Yang)  BL19  GB24     36     41  33-39     40    GB34

HT (Fire-Yin )  BL15  CV14     06     08  07-09     07       -

SI (Fire-Yang)  BL27  CV04     06     05  03-04     05    ST39

PC (Fire-Yin )  BL14  CV17     04     08     04     07       -

TH (Fire-Yang)  BL22  CV05     07     06  04-10     04    BL53   

SP (Earth-Yin ) BL20  LV13     08     03     09     02       -

ST (Earth-Yang) BL21  CV12     34     36  34-36     43    ST36  

LU (Metal-Yin ) BL13  LU01     06     08     06     09       -

LI (Metal-Yang) BL25  ST25     07     01     11     05    ST37

KI (Water-Yin ) BL23  GB25     05     10     07     05       -

BL (Water-Yang) BL28  CV03     63     66  59-60     65    BL54

1. In disorder of the associated Channel-Organ System (COS), there is usually tenderness on palpation of the Yuan, Mu, Shu and Test points. The Test points may feel cold in Yin states and hot in Yang states. The RYODORAKU points are electro-sensitive diagnostic points used in Japanese diagnosis. Their readings are hypo- in Yin and hyper- in Yang states.

2. All MASTER points, except Shu, Mu and HE points, are on their respective Channels and lie between the elbow and finger or between the knee and toe.

3. The Yuan-Luo combination uses the Yuan of the affected Channel with the Luo of the Phase-Mate Channel, i.e in lung disease, LU09 (Yuan of LU) plus LI06 (Luo of LI).

An examination of most of the listings in Appendices 2 and 3 shows that the Top Ten points obey the basic laws of choosing AP points. In summary, these laws suggest a choice of points from:

a. AhShi points (including Trigger Points, tender scars, fibrositic nodules etc)

b. Local points (which also meet condition (d)).

c. Distant points on the Channel through the affected area or on the Channel of the affected organ. A chain of points on the affected Channel is said to be specially powerful.

d. Points on the affected nerve, the nerve supply related to the affected organ or area, or in the same or a nearby spinal nerve segment.

e. Encircling the problem area; "Fore and Aft" points; combination of Yin side and Yang side points (medial/lateral; anterior/posterior).

f. Combination of Mu and Shu (Front Alarm + Back Association) points.

g. Combination of affected Yuan and Luo of Mate (Source Point of the affected Channel plus Passage point of its Phase-Mate Channel (LU-LI; ST-SP; HT-SI; BL-KI; PC-TH; GB-LV).

h. Xi-Cleft point of affected Channel.

i. One or more of the Five Phase Points (Energetic balancing points).

j. Symptomatic points (traditionally known to have marked effect for the specific symptoms, for example, GV26 in shock, emergencies; PC06 in nausea or vomiting).

k. Extra-Channel points ("New" or "Strange" points, points not on the Main Channels), especially those effective for the condition, e.g. NX04 (TingChuan) in asthma.

l. Points on the Phase-Mate of the affected Channel (e.g.) ST points in spleen diseases; SP points in stomach diseases.

m. TianYing point (OT02, centre of the goitre etc).

n. One point on each of the 4 limbs (e.g. LI04 and ST44, both bilateral, in tonsillitis or toothache).

Let us examine the Top Ten points from some prescriptions (Appendices 2,3) in detail under three basic headings:

1. Local conditions or regions

2. Conditions of specific internal organs or their functions

3. Generalised conditions and complex syndromes.

In each of these conditions, codes (a) to (n) mentioned above are used to show the laws observed by the points in the Top Ten list.

1. LOCAL CONDITIONS OR REGIONS: Let us pick problems of the eye, nose, neck, shoulder, elbow, lowback, hip and knee (stifle) as examples from Appendix 1:

EYE: BL01 (b); LI04 (c, as the LI Channel connects to ST Channel at the eye); GB2O (c);also Wood (GB,LV) controls the eyes; ST01 (b); Z09 (b, k); BL02 (b); ST02 (b); GB14 (b,c (Wood)); TH23 (b); BL18 (liver controls eyes. BL18 is Shu point of liver, b). The combination BL01, ST01, Z 09, GB14 meets law (e) above and is very useful in eye diseases. 7/10 of these points are local points.

NOSE: LI04 (c,g,i,j); LI20 (b); GB20 (j); GV23 (c); LI11 (c,i,j); GV14 (c,j); Z 03 (b,k); BL07 (c); LI19 (b); ST02 (b). The combination LI20, Z 03, ST02 also meets law (e). 4/10 of these points are local points.

NECK: GB2O (b); GV14 (b); LI04 (c,g,i); BL10 (b); SI03 (c,i.j); LI11 (c,i,j); OT01 (AhShi point - a); GB21 (b,c depending on site of problem); GB39 (c,j); SI15 (b). The combination GB20,21, BL10, GV14, SI15 also meets law (e). 5/10 of these points are local.

SHOULDER area: LI15 (b,j); LI11 (c,i,j); TH14 (b,j); Sl11 (b); Sl09 (b); LI04 (e,g,j); OT01 (a); Sl10 (b); OT05 (local points, b); BL11 (d ,j ). A combination of SI09, LI15 and a new point l" above anterior axillary crease is known as the "shoulder triplet". The combination meets law (e) above and has powerful effects in shoulder conditions. 6/10 of these points are local points.

ELBOW: LI11 (b,i,j); TH05 (c,j); LI04 (c,g,i); HT03 (b,i); LU05 (b,i); LI10 (b); OT01 (a); LI12 (b); TH10 (b); SI07 (c). 6/10 of these points are local.

LOWBACK: BL23 (b,j); BL40 (c,i,j); GB30 (c, linked to lowback via BL Channel, d,j); BL60 (c,i,j); GB34 (c (via BL link), i,j); BL25 (b); BL37 (c); GV04 (b); BL57 (c); BL31 (b). 4/10 of these points are local.

HIP: GB30 (b,j); GB34 (c,i,j); GB29 (b); GB31 (c); BL40 (c via link to GB Channel, i,j); BL60 (c,i,j); OT01 (a); GB39 (c,i,j); ST36 (d,i); LV08 (-). Although only 2/10 of these points are local, 2 of the top 3 points are local.

KNEE: GB34 (b,i,j); BL40 (b,i,j); L 16 (b,k); ST35 (b); SP09 (b); ST36 (c,i); ST34 (b); LV08 (c); OT01 (a); GB31 (c). The first05 of these points are the most commonly used combination (obeying law e) and all are local points.

In the eight local conditions discussed above, seven have a local point as the first in the list (the 8th has a local point as second on the list).

2. CONDITIONS OF INTERNAL ORGANS AND THEIR FUNCTIONS: Let us consider the Top Ten points in five of the conditions in Appendix 2. Close examination of other lists in the appendices will show that they follow similar logic.

PLEURA: BL42, BL47, BL43, KI23, KI22, BL13, GB32 (7/10 points) are on the thorax or dorsal paravertebral area (local). Two of the other three (ST12, BL11) are at the thoracic inlet and the 10th point (GB44) obeys law (c).

HEART, PERICARDIUM: Only 3 of the Top Ten (BL15, BL14, CV17) are over or near the organs. They obey laws (b), (d), (e) and (f). Six of the remainder (PC06, PC07, HT05, PC05, PC07, PC04) are on the HT or PC Channel (laws c, i, j). The 10th point (ST36) is a Master Point, with many functions, including effects on HT and PC.

COUGH, GENERAL: BL13, CV22, GV12, BL12, CV17 (5 of the top 10 points) are over the thorax, trachea or dorsal paravertebral area. They obey laws (b), (d), (e), (f), (j). Three points (LU05,07, 10) are on the LU (lung) Channel (laws c, i). The remaining two points (ST4O, GV14) meet laws c and i.

LIVER: 6/10 points (BL18,19,20,48; GV09; LV13) are over or near the liver. They obey laws b, d, e, f, j. The remaining four points (LV03, ST36, GB34, SP06) are master points. They obey laws c, g, i, j.

GENITALIA FEMALE AND REPRODUCTION: 6/10 points are in the lumbosacral innervation area (low abdomen or l/s paravertebral area). They are: CV03,04,06; GV04; GB26; BL32. They obey laws (b), (d), (e), (j). The four remaining points (SP06,10; LV03; ST36) are Master Points with major effect on low abdomen and its functions. They obey laws (c), (i), (j).

2a. IF AN ORGAN OR FUNCTION HAS NO NAMED CHANNEL, points can be chosen from combinations relating to the nearest organs, or Channels, or functions. For example, suppose there were no entries for the following organs:

Thymus: consider points from combinations for heart, lungs, stomach (nearest organs) and immunity (a closely allied function).

Diaphragm, oesophagus: consider heart, lung, stomach combination.

Appendix: consider lower right abdomen and large intestine combinations + immunity.

Adrenal (beside kidney): consider kidney combinations.

Ovary, tubes, uterus: consider kidney, bladder, low abdominal and large intestinal combinations.

Vagina, vulva, scrotum, testicles, penis: these are controlled by the 3 Leg Yin Channels (SP, LV, KI). Consider points on these Channels + points for low abdomen, bladder.

3. GENERALISED CONDITIONS AND COMPLEX SYNDROMES: Generalised conditions include metabolic, hormonal, toxic, general autonomic upsets, etc (such as gout, diabetes, food poisoning, shock, neurasthenia, etc). Although one symptom may be dominant, it is usual to have a number of symptoms and abnormalities occurring together.

For example, in gout, the presenting symptom may be pain in the big toe (or other joint), but other symptoms could include liver enlargement + pain; headaches; irritability; blurred vision; tiredness, etc. The comprehensive treatment would entail dietary advice (possibly involving food allergy/intolerance testing) and increased fluid intake. AP would be aimed at the more severe symptom (say toe pain) but other points (especially LV and GB) would be aimed at the other symptoms. The liver is central in gout and many allergies. Treat the liver.

In diabetes mellitus, polyuria, neuropathy and other signs can arise. Dietary advice, together with points for diabetes (see Appendix 2) the local regions affected by neuropathy and the kidney (Appendices 1 and 2) would be indicated.

In food poisoning, vomiting and diarrhoea would be tackled by points such as CV12, PC06, ST25,36,37 but other symptoms (dehydration, prostration etc) would best be tackled by fluid replacement. Medication (kaolin, chlorodyne) can assist the gastrointestinal symptoms.

In shock, points like GV26, KI01, ST36, PC06 can be of immediate help but accurate diagnosis of the pathology is essential and would indicate other interventions (surgery, if severe internal bleeding; fluids, stimulants, warmth, etc where indicated).

In neurasthenia, insomnia, excitement etc, the HT and PC Channels control these functions in traditional belief. Consider HT, PC points.

DISCUSSION

1. IN MOST LOCAL PROBLEMS (joint, muscle, superficial organ etc) the best prescription combines AhShi points and local points + distant points on the affected or related Channel. It is important to check the location as regards the nerve supply and the Channel. For example, the best combination for pain in the medial epicondyle of the humerus will not be identical to the best combination for the lateral epicondyle. However, in traditional AP, it is not enough to pick any local point. (Some local points are better than others, or, at least, are more frequently recommended than others).

Modern neurophysiological concepts of AP stress that adequate stimulation of the affected or related NERVES will produce results as good as the traditional method but adequate clinical or research testing of the traditional versus modern (nerve theory) methods has not been done. For the moment, I give the benefit of the doubt to the traditional system, which has stood the test of time.

2. IN DISEASE OF INTERNAL ORGANS, the most important points lie near the organ in the thoracoabdominal area or in the paravertebral area (the Mu, Shu and Huatochiachi (X 35) points, CV and GV points). Where the organ has a named Channel (LU, LI, ST, SP, HT, SI, BL, KI, PC, GB, LV) it is common to include one or more points on that Channel (distant as well as local points). Also, the course of the Channel is important. For example, the liver, kidney and spleen Channels traverse the inner thighs and groin area. Distant points on these Channels are important in genital and lower abdominal conditions.

In general, if a symptom or abnormal function can be traced to a specific COS, treat that COS. If more than one symptom/organ system is involved, choose a combination of points which will influence all the major symptoms or upset organs.

3. IN ACUTE SERIOUS CONDITIONS, WITH MULTIPLE SYMPTOMS AND PATHOLOGY, it is unwise to rely solely on AP. AP can often give considerable help (using points as indicated by the main symptoms and pathology) but conventional or unconventional (complementary) therapies may need to be used as well.

4. IN CHRONIC COMPLICATED CASES, where immediate life-threatening symptoms or pathology are absent, one can rely more on AP as the main therapy (in cases amenable to treatment). At all times, however, the aim of good medicine is to help the patient to the greatest extent, with the minimum of side effects. Therefore, it is good practice to use whatever complementary therapies seem best indicated.

Analysis of the database indicates that points from the list: LI04,11;

ST25,36; SP06; HT07; BL23,40; PC06; TH05; GB20,34; LV03; CV06,12; GV04,12,14,20,26 arise in a high proportion of cases. In complex cases, if one has difficulty in deciding on a prescription, it is advisable to include a few points from that list.

LIMITATIONS OF COOKBOOK AP: How would one treat the following syndrome? The patient had the following symptoms (at different times) during a period of 6 years, beginning two years after radical right lung surgery: recurrent haemorrhagic nephritis; cystitis; right-sided sciatica; right- sided paravertebral pain (C6 - T4 area); right-sided headache and bouts of acute conjunctivitis (right); right ear tinnitus; waking at night with severe pain along the SI Channel of the arm to the little finger, with the arm in spasm.

To try cookbook prescriptions in such a case would be second-rate AP. There was obviously a connection between all these symptoms (all relate to SI, BL, KI) and most were right sided symptoms. On examination, the patient's thoracotomy scar was badly twisted, with adhesions on the right BL line. This was the clue. Blockage of the Qi flow (traditional concept) or reflex irritation effects (Western concept) could cause all of these symptoms via the Chinese SI-BL-KI energy cycle. Treatment was physiotherapy + injection of the scar plus a few AP sessions using BL points. All symptoms were successfully cleared. Cookbooks have their limitations and Chefs do not need them.

CONCLUSIONS

Cookbooks or computerised prescribing is very valuable for beginners and for those working in a clinic. However, one should not rely too much on machines or computers. Computers need electrical power. In national disaster and warfare, and in many of the developing countries, electrical power, batteries etc may be unavailable where they are needed most. Therefore, it is important for the development of medicine and veterinary medicine that as many professionals as possible should study the basics of AP. This learning process can be accelerated by interaction with a computerised database (Rogers 1984a). Adequate knowledge of AP will enable it to be used more widely in field work (large animal work, medics and paramedics in the bush).

Although the data reported here (Appendices 1,2,3) are but a small fraction of the database, it is obvious that for most conditions, the Top Ten Points usually will be worth considering. However, in some complicated cases, points not in the Top Ten may be most relevant. The statistical method is very useful for population medicine, but it may be disastrous for the unfortunate patients who need individually designed care.

As a general rule, if a Cookbook prescription does not produce definite results by 2-3 sessions, it is necessary to (a) change the choice of points, or (b) consider other therapies, or (c) regard yourself as unable to assist.

The enthusiastic amateur AP practitioner will get useful results with the COOKBOOK but more complicated or deeply rooted problems require more holistic (traditional + modern + complementary + intuitive) therapy. Therefore, I strongly encourage you to continue your study of Chinese AP in depth. To get the best results, use the cookbook as the first-line of attack (in conditions amenable to AP) but be prepared to fall back on traditional and other methods if results do not follow quickly (Rogers 1984b). This assumes that the user is trained in basic AP and is able to interpret the point selections.

When using the prescriptions given in this paper, please note (a) the number of references in the prescriptions, (b) the maximum possible score, (c) the score of each point in the list (calculated by ratio to the maximum possible score), and (d) the variation in scores between points. If there are few references, the prescription may be of doubtful value. If the maximum possible score is (say) .90 and the max. score for any point is (say) less than .40, the prescription may be doubtful. If there is little variation between the scores and all scores are greater than .40, various combinations of points should be equally effective.

Remember that the best prescriptions usually combine AhShi points, LOCAL points, DISTANT points and (if internal organs are involved) Mu + Shu + Yuan + Luo combinations. Thus, the wheel turns full circle. The traditional methods of point selection were best after all. Modern technology has merely re-invented the wheel !

REFERENCES

Greiff, Walter; Janssens, Luc; Kothbauer, Oswald (1970-1983). Verification of AP point locations in nimals by electrical methods and by experimental and/or clinical results.

Kothbauer, Oswald ( 1983). Veterinary AP - Ox, Swine and Horse. Verlag Welsermuhl, Wels, Austria, 334 pp.

Krueger, C. (1976). AP point topography in the horse. Am. J. Acup. 4, 276-.

Molinier, F. ( 1983). Localisation of veterinary AP points. Rev. d'Acup. Vet. (Paris), No. 17 (4), 6-.

Rogers, P.A.M. (1982a). The study of AP: Sources and study techniques IVAS Annual Congress, Cincinnati, Ohio (33pp + appendix).

Rogers, P.A.M. (1982b). The study of AP: Points and Channels in animals. Ibid. (23 pp).

Rogers, P.A.M. (1982c). The choice of points for AP therapy. Ibid. (26 pp).

Rogers, P.A.M. (1984a). Computer applications in the study and clinical use of AP. IVAS Annual Congress, Austin, Texas, 13 pp.

Rogers, P.A.M. (1984b). Traditional versus cookbook AP. Ibid. 40 pp.

Westermayer, E. (1981). Channels and ancient points, especially in cattle. IVAS Annual Congress, Cincinnati, Ohio, 21 pp.

Yu Chuan & Hwang Yann-Ching (1990) Handbook on Chinese Veterinary AP and Moxibustion. FAO Regional Office for Asia and the Pacific, Bangkok, 193pp.

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