APPENDIX: ACUPUNCTURE POINT LOCATIONS AND CHANNEL FUNCTIONS
TRADITIONAL VERSUS TRANSPOSITION SYSTEM OF AP IN HORSES
Traditional Chinese Veterinary Medicine (TCVM) includes herbal medicine and acupuncture (AP). The TCVM system of AP concentrates on the location and uses (diagnostic and therapeutic) of isolated AP points (APs). TCVM does not show a Channel system in animals. Its concepts of diagnosis and therapy are very difficult for westerners to master.
Texts on the TCVM system in horses are scarce. They include those by Hwang, Klide & Kung, Kothbauer, Lin, White and the late Erwin Westermayer. Readers are referred to those texts for details.
The human AP system is based on Channel concepts. It is much better integrated than the TCVM system. Therefore, it is much easier to learn. Once the human system is mastered, its principles can be applied in animals by transposing the anatomical location and functions of the human AP point system to animals. This transposition system is very useful in the horse, especially in painful local conditions. The greatest difficulty is in locating points below the carpus or tarsus. It may be better to use TCVM points in these areas. The TCVM system differs from the transposition system in some respects but the two systems are basically very similar and either may be used alone or they may be combined.
Cookbook prescriptions for common conditions, body organs and parts in humans are listed in Appendices 1-3 of the paper on "Choice of points for particular conditions" (Rogers 1996). Those prescriptions may be applied in the horse although they are extracted from texts on humans.
The horse has no gallbladder but some GB points have important local uses. These codes are the same as those used in the Cookbook prescriptions, as mentioned above.
In this paper, the transposition system is used mainly, except for some TCVM points, which are described below.
1. TCVM POINTS IN THE HORSE
See the texts, listed at the end of the Appendix, for a complete list of names, locations and uses of TCVM points.
The following are a few of the TCVM points mentioned in the paper:
AnHua between spines of T8-T9
BaoSai in jaw muscles behind last molar
ChiChia between spines of T3-T4 (= GV12)
ZhongFu LU01 in some texts: behind shoulder joint in 2nd intercostal space (ICS 2). AP analgesia point with TH08.
FuTu behind occipital protuberance
XieQi 2 cun lateral to root of tail, in bicipital groove
JiuWei 9 points on the upper lateral neck. Point 1 is 6.5 cm behind the base of the ear, 4 cm from the mane (Fig. 7). Point 9 is 4 cm anterior to scapula, 6 cm from the mane. The other points are at equal intervals between these points
KaiGuan in jaw muscles behind molar 3
BaiHui lumbosacral space (GV03)
PiShu 1 hand from GV line in 3rd last ICS
SanChuan between spines of T4-T5
SouKou behind oral canthus
TianPing thoracolumbar space
WeiShu 3 spaces in front of PiShu
YanChi one third distance from tuber coxae to dorsal midline
YinTang midline of forehead, between the eyes
YungChi between the free ends of the transverse processes of L5-L6
FL 2 PoChien at anterior junction of scapula and its cartilage (TH15)
FL 4 PoLan one third distance down anterior edge of scapula
FL 7 ChangFeng 5 cun post. inf. to shoulder joint point in fossa between long and lateral heads of triceps m., behind humerus, at anterior edge of deltoid m. (LI13)
FL12 JianYu hole below upper head of humerus at its anterior edge
FL13 JianWaiShu Just behind and below shoulder joint
FL19 ChanWan on lat. and med. digital veins dorsoposterior to fetlocks
FL20 TiMen midpoint of med. and lat. cartilages at back of hoof. Needle from behind.
FL21 TiMen midpoint of lat. and med. cartilages at back of hoof. Needle from behind.
FL22 ChienChiu centre of pit in hollow above back of hoof
2. TRANSPOSITION SYSTEM
At this time there is no International Standard Chart to show the location of the Channel points (LU, LI, ST, SP, HT, SI, BL, KI, PC, TH, GB, LV, CV, GV) in horses. To locate the Channel points in horses, one can transpose the locations of human points to similar anatomical locations in the horse.
Figures 1-26 respectively show the approximate locations of the equine Channel points. These charts must be taken as provisional. They are for teaching purposes only, as they may help the beginner to locate the more important areas for treatment, especially if using Cookbook Prescriptions (Appendix 1-3 in Rogers 1996) or the points recommended for the conditions discussed in the clinical part of this paper.
From extensive clinical experience in equine AP, MJC made many corrections to earlier charts prepared by PAMR. MJC's locations are often (but not always) similar to those of other experts (Giniaux, Kothbauer; Westermayer etc). Emiel van den Bosch DVM, G. van Heuvelstraat, Ramsel, Belgium (Fax: 32-1656-1374) published very fine charts (Acupuncture Points and Meridians in the Horse, 1995). We recommend those charts to equine acupuncturists.
Location of GV and BL points in the thoracic area must take 18 pairs of ribs into account. Apart from the rib area, transposition of other GV points (GV01-04, 14-28) and BL points (BL01-12, 36-40 (old BL50-54) and 55-60) are similar to human positions:
GV01 Midline between anus and coccyx (as in human)
GV02 Dorsal midline in sacrococcygeal space (as in human)
GV03 (BaiHui) in midline in lumbosacral space (L4-L5 space in human)
GV04 (MingMen) in midline in L2-L3 space, between left and right BL23 (KI Shu) (as in human). Some equine vets put it between left and right BL23a, in L3-L4 space.
GV05 Dorsal midline in L1-L2 space (as in human), between left and right BL22 (TH Shu)
GV06-10 are located by counting 2 spaces for each point forward from GV05 (below spine of L1), with GV10 below spine T10
GV06 (TianPing): Dorsal midline behind the dorsal spine of T18 (thoracolumbar) space, between left and right BL21 (ST Shu)
GV07 Dorsal midline, 2 spaces before GV06 (behind spine of T16), between left and right BL19 (GB Shu)
GV08 Dorsal midline, 2 spaces before GV07 (behind spine of T14)
GV09 Dorsal midline, 2 spaces before GV08 (behind spine of T12), between left and right BL17 (Diaphragm, Haemorrhage, Blood point)
GV10 Dorsal midline, 2 spaces before GV09 (behind spine of T10), between left and right BL15
GV11-12 are found by counting 3 spaces/point forward from GV10 or backward fromGV13.
GV11 Dorsal midline, 3 spaces behind GV12 (behind spine of T7)
GV12 Dorsal midline, 3 spaces behind GV13 (behind spine of T4), between left and right BL12
GV13 Dorsal midline in T1-T2 space (as in human)
GV14 Dorsal midline in C7-T1 space (as in human)
GV15-28 as in human
The Shu points (Organ-associated points or paravertebral reflex points) run parallel to the GV line, in humans about 1.5 inches and in horses about 1 hand from the GV line. They are covered under the BL Channel (see below).
The Mu (Abdominal Alarm) points are used in diagnosis and therapy in humans and small animals. The Mu points are: Lung = LU01,01a; Colon, large intestine = ST25; Stomach = CV12; Spleen-Pancreas = LV13; Heart = CV14; Small Intestine = CV04; Bladder = CV03; Kidney = GB25,25a; Pericardium, Heart Constrictor = CV17; Triple Heater = CV05; Gallbladder = GB24; Liver = LV14. Because of the danger to the operator, CV03,04,05 and ST25 are seldom needled in horses but CV12,14,17, GB24,25, LV13,14, LU01,01a are relatively easy to needle. Horses tolerate Shiatsu (deep massage) of awkward points and this can be very useful.
LV13,14 (Mu points of SP, LV) are very powerful points for balancing the Yin Channels, especially when coupled with SP21,21a (linking point for all Yin Channels, the Luo point for all Luo points).
T8 and L4: LU & LI Channels (Metal) (FIGURES 1 & 2)
LU (Lung) and LI (Large Intestine, Colon) are related in Metal. When Shu point tenderness or clinical signs indicate Channel imbalance, treat the Shu point and the Shu of the paired Channel. LU Shu is BL13,42 and LI Shu is BL25. LU Mu is LU01,01a and LI Mu is ST25.
When treating LU problems, the Mother (SP) Channel must be balanced and stimulated (BL20) and the Son (KI) Channel must be assessed (BL23) and treated, if needed.
When treating LI problems, the Mother (ST) Channel must be balanced and stimulated (BL21) and the Son (BL) Channel must be assessed (BL28) and treated, if needed.
Metal may be used to support weakness of Water. Thus, BL13 (LU) may help weak KI and BL25 (LI) may help weak BL.
The LU Channel runs from the lung to the anterior edge of the lower third of the scapula (LU01a), level with the base of T1 (M.J.C), to just lateral to the biceps tendon (05). It then runs down the anteromedial edge of the radius (06,07,08) and carpus (09), down the inner splint to the medial sesamoid (10) and medial heel (LU11). Internal branches go to the colon.
Traditional texts place LU01 in ICS 2, just behind the shoulder joint.
BL13,42 (LU Shu) may show acute tenderness with inside forelimb splints, check ligament, inside carpal, inside suspensory and sesamoid problems. They (and BL42-46) are usually tender in acute respiratory problems (see 1.4.2).
LU01,01a relates to the inside forelimb and carpus.
The LI Channel runs from the centre of the medial aspect of the pedal joint (LI01), up the medial side of the pastern, fetlock, to the top of the inner splint (04) and carpus (05). It ascends the forearm, curving anterolaterally, to the front of the elbow joint (11), to the point of the shoulder (15), to the nerve plexus at the base of C6-C7 (17), to the lateral side of the larynx (18), teeth and nostrils (LI20). Internal branches go to the colon and lung.
LI04 is near the upper head of the inner splint.
BL25 (LI Shu) may be tender in problems of the sacroiliac joint/ligament, the iliolumbar ligament, the inside splint, the 3rd and intermediate carpal bones, the elbow and shoulder, misalignment of vertebrae C6-T1, larynx, teeth, sinuses etc. It may be tender also in colic and impaction and in gluteal problems.
LI16 relates to the shoulder and inside carpus, fetlock and pastern.
LI17 has powerful effects, similar to LI04 in humans. It affects the sympathetic ganglion, producing endorphin-like effects and blocking the sympathetic nervous system. It is very tender in subluxation of C6, C7 or T1. Tenderness at LI17 may arise in shoulder, outside arm, inside carpus and fetlock. It may also arise ipsilateral to lumbar pain (BL25, LI Shu) or in contralateral hindlimb lameness.
LI18 relates to the forelimb shins.
T9 and L1: PC & TH Channels (Fire) (FIGURES 9 & 10)
PC (Pericardium, Circulation-Sex, Heart Constrictor) and TH (Triple Heater) are related in Fire. When Shu point tenderness or clinical signs indicate Channel imbalance, treat the Shu point and the Shu of the paired Channel. PC Shu is BL14,43 and TH Shu is BL22. PC Mu is CV17 and TH Mu is CV05.
When treating PC problems, the Mother (LV) Channel must be balanced and stimulated (BL18) and the Son (SP) Channel must be assessed (BL20) and treated, if needed.
When treating TH problems, the Mother (GB) Channel must be balanced and stimulated (BL19) and the Son (ST) Channel must be assessed (BL21) and treated, if needed.
Fire may be used to support weakness of Earth. Thus, BL14 (PC) may help weak SP and BL22 (TH) may help weak ST.
The PC Channel arises in the pericardium, runs to the medial side of the olecranon (PC01), to the medial side of the biceps tendon (03), down the medial side of the leg in the ulnar-radial groove (04,05,06,07), down by the inner splint (08), to the coronary band (over the medial plantar digital vein) (PC09). Internal branches go to the Triple Heater.
BL14,43 (PC Shu, pericardium) may show tenderness in cases similar to BL15,44 (see) and in anxiety and psychological problems.
PC points (BL14,43, PC06) are used in nervousness/psychological disorders and PC09 is a useful point to bleed in laminitis (M.J.C). Some females with breeding problems show sensitivity of BL14 (PC Shu) and GV10 (beside BL14). (See TH Channel also).
The TH Channel arises at the lateral side of the coronary band (over the lateral plantar digital vein) (TH01). It ascends the anterolateral side of the metacarpus (3) and carpus (04) and then follows the lateral ulnar-radial groove (05-08) and anterior edge of the olecranon (09,10). It runs behind and parallel to the humerus (10-13) to the lateral side of the shoulder joint (between the joint and the scapular spine, TH14). Then it runs to the anterior edge of the scapula at the junction with the scapular cartilage (15), to the dorsal side of the C3-C4 joint on the brachiocephalicus m. (16), to the posterior side of the ear (17). It runs over the root of the ear (18-22) and ends behind the lateral canthus of the eye (TH23). Internal branches go to the PC and the endocrine centres.
The TH Channel is important in endocrine disorders, especially in female infertility (M.J.C). TH14,16 are often sensitive in ovarian problems, cyst, oestrus). TH14 may be tender in shoulder lameness, but true joint lameness (OCD) is rare. More often, shoulder lameness is muscular, referred from subluxation of vertebrae C6-T1, via the brachiocephalicus m., attached to the humeroscapular joint. Painful ovary or neck can cause spasm of that and other muscles and a choppy forward stride on the ipsilateral forelimb. If the problem is ovarian, treat BL22 (TH Shu) and the sensitivity at TH16 usually disappears. If the problem is shoulder lameness, treat TH14 and SI10, with BL22 and 27 (SI Shu). If the shoulder pain is referred from the neck, treat the neck (see 1.2.4).
TH16 may be tender in problems of the ovary/testis and in pain of the outside forelimb.
Excess activity in TH (Fire) can weaken LU (Metal) (via the Ko Cycle). This manifests as poor hair coat (LU controls skin) (M.J.C).
BL22 (TH Shu) may be tender in endocrine imbalance (thyroid, gonads, adrenal), in disorders of thermoregulation (non-sweaters), psychological problems, neck problems of the spinal accessory nerve (mid-cervical) and in neck vertebral misalignments. It may be tender in thoracolumbar problems, post-castration pain, cryptorchidism, inguinal ring problems (see BL23) and pain of the outside forelimb.
TH05 is used in shoulder problems and in navicular disease.
TH17 is a tranquillizer point.
T10 and S1: HT and SI Channels (Fire) (FIGURES 5 and 6)
HT (Heart) and SI (Small Intestine) are related in Fire. When Shu point tenderness or clinical signs indicate Channel imbalance, treat the Shu point and the Shu of the paired Channel. HT Shu is BL15,44 and SI Shu is BL27. HT Mu is CV14 and SI Mu is CV04.
When treating HT problems, the Mother (LV) Channel must be balanced and stimulated (BL18) and the Son (SP) Channel must be assessed (BL20) and treated, if needed.
When treating SI problems, the Mother (GB) Channel must be balanced and stimulated (BL19) and the Son (ST) Channel must be assessed (BL21) and treated, if needed.
Fire may be used to support weakness of Earth. Thus, BL15 (HT) may help weak SP and BL27 (SI) may help weak ST.
The HT Channel arises in the heart, runs to the posteromedial side of the shoulder joint (HT01), to the anteromedial side of the elbow (medial to the biceps tendon (03) and down the posteromedial side of the arm (04-06) and carpus (07), to the medial sesamoid (08) and the medial bulb of the fore heel (HT09). Internal branches go to the small intestine.
BL15,44 (HT Shu) may be tender in problems of the posterior side of the forelimb, tendons, sesamoids, heel bulb bruises, elbow (rare), circulatory function. BL14,15 (PC, HT) may be tender in anxiety and nervousness.
The SI Channel arises at the back of the outside bulb of the foreleg coronary band (SI01), ascends to the sesamoid (02,03), along the outer splint (04), along the posterolateral edge of the carpus (05), to the lateral side of the ulnar-humeral notch (06,07), to the olecranon (08), to the first muscular groove behind the shoulder joint (09), to a deep hole just below and behind the lower limit of the scapular spine (10). Then it zig-zags up the scapular spine (11,12) to the edge of the scapular cartilage (13) at T4-T5. Then it runs down and forwards to the side of C7 at the centre of the C6-C7 joint (15), to the centre of the C4-C5 joint (16), to the lower edge of the C2-C3 joint (17), to the malar bone (18) and the anterolateral root of the ear (SI19). Internal branches go to the small intestine and heart.
The SI Channel is very important. It is involved in many race-track injuries. It is used to treat bowed tendons, inferior check ligament injury, posterior branch of suspensory at outside sesamoid, "windgalls", and annular ligament damage. Subluxation of the lower neck (C6-T1), or of the atlas, or sacrococcygeal injury (in the starting gate, or in transport, due to backing-up), sacral plexus (parasympathetic) damage may involve the SI Channel (BL27, SI15,16). Reflex lameness in the superficial gluteal muscles at GB30 may arise in GB imbalance (GB is the Mother of SI). The SI is often involved in shoulder lameness. SI09,10,13 and the SI Shu (BL27), its Mother Shu (Wood-GB Shu, BL19) and its Son Shu (Earth-ST Shu, BL21) are indicated in such cases (see 1.1.3).
BL27 (SI Shu) may be tender in problems of the posterior side of the forelimb, tendons, sesamoids, heel bulb bruises, elbow (rare), sacral nerve plexus, biceps femoris, intestinal function.
SI10, if still tender after proper Channel balancing, is diagnostic for LOCAL shoulder lameness (OCD) - see 1.1.3.
SI13, at the edge of the scapular cartilage at the highest point of the
withers (see GV11,12 below) is very important in neck and thoracic muscle pain. The bursa between the nuchal and the supraspinous ligaments is very easy to injure. Needling SI13, GV11,12 in such cases is useful but proper Channel balancing, using BL19 (GB, Mother of SI) and BL21 (ST, Son of GB) is important.
SI17 is related to the outside sesamoid, suspensory ligament and lameness at the posterior side of the forelimb. It also relates to ipsi- and contra- lateral lower sacral injury, hindlimb lameness and all neck problems.
SI18 is a tranquillizer point.
BL16 (GV Shu) and BL17 (Diaphragm/blood/haemorrhage Shu)
BL16 and 17 are used for local problems as well as special effects. Their helper (outer) points are BL45 and 46 respectively.
BL16 (GV Shu) is used to increase or reduce GV activity. It assists the supraspinous ligament. Problems of the ligament are common in racehorses because they seldom have the opportunity to fully stretch their neck and paraspinal muscles (grazing, drinking from streams, rolling etc are seldom allowed !). Weakness of the supraspinal and nuchal ligaments predispose to neck and back problems and to tender bursae on top of the withers.
BL17 (Diaphragm Shu) is used for diaphragm/blood/haemorrhage problems. It helps in anaemia (increased PCV and Hb), bleeders (prothrombin and reduced blood pressure in lung vessels), other respiratory problems (to stimulate breathing in neonatal foals) (with GV26). It is an immunostimulant point (with GV14, ST36, LI11), useful in viral diseases.
BL19 (GB Shu) is associated with whirlbone, outside stifle, outside hock, outside hind splint, curb.