2.2.2 Disorders of the gastrointestinal tract in cattle
Cows often develop digestive upsets, especially after calving or when on a high intakes of concentrates at peak lactation. These upsets include: inappetance, acidosis, acetonaemia (ketosis), fatty liver syndrome, atony of the forestomachs or intestines, abomasal torsion, diarrhoea, constipation etc. Cattle at pasture may develop tympany (bloat), diarrhoea, inappetance etc.
When treating digestive disorders, locate any reactive points between vertebrae T8-S4, especially in the paravertebral area, intercostal area and lateral abdominal areas on the left and right side. If reactive points are found, they are used. Points for the affected organs (rumen, reticulum; omasum, abomasum; small or large intestine; liver) or functions (stress- adrenal; appetite; nervousness etc) are added as needed. Distant points such as ST36; SP06; GB34 may be added to help the effect.
These points are especially useful in indigestion and diarrhoea, especially when combined with local points on BL, GV, CV Channels or with HuaToJiaJi points locally.
Points for the SPLEEN, PANCREAS, LIVER, ADRENAL are given in 2.2.1. above and the liver and metabolic disorders are discussed in 2.2.3 below.
Rumen, Reticulum: The most important points are on the left-hand side (Channels GV, BL and HuaToJiaJi points in the area T8-L1, left side). Points in the intercostal spaces 8-12 may also be important, as are CV, KI, ST, SP, GB, LV points in the posterior thoracic and anterior abdominal area (i.e.) the points ST21-24; SP14-17; BL18-22,47-51; KI18-23; GB24,25; LV13,14; CV10-15; GV05-9 and HuaToJiaJi points from T8-L1.
Omasum, abomasum: The most important points are on the right-hand side - basically similar to the rumen-reticulum points.
Intestines: Small intestine points are on the right-hand side and more anterior.
Large intestine points are on the left-hand side and more posterior.
In colic, Kothbauer uses BL51-1,51-2,51-3.
The most important points are on the Channels GV, BL and HuaToJiaJi points in the area L1-S4. Points in the abdominal wall may also be important, as are CV, KI, ST, SP, GB, LV points in the posterior abdominal area, (i.e.) points ST24-28; SP13,14; BL22-34,51-53; KI11-18; GB26,28; CV04-10; GV02-05.
Treatment is as in 2.2.1 above for chronic cases. In acute or serious cases, treatment is given every 12-48 hours, as needed.
2.2.3 Disorders of the liver and metabolic disorders in cattle
AP can help to restore normal function in metabolic disorders, including: bloat, acidosis, ketosis, nervousness, hyperthyroidism, convulsions, milk fever and "downer" cows, fatty liver syndrome etc.
In metabolic disorders, as in all clinical AP, the signs and history and the location of the reactive points are used to locate the organs, parts or functions affected. Points are chosen according to this information.
In serious conditions, other treatment (western drugs or oriental herbs etc) should be considered as the main treatment, with AP as a supplementary treatment.
Kothbauer's points for metabolic disorders are mainly for liver, adrenal and thyroid (see 2.2.1) but other points are added, depending on the clinical signs and the organs and functions affected. For example, in ketosis with constipation and drop in milk yield, points for liver, large intestine, adrenal and udder might be used.
Fatty liver syndrome with milk-fever (hypocalcaemic paresis): Combine points for liver, parathyroid, shock and circulatory disorders.
Parathyroid points: ST09; CV23; BL23,52.
Circulatory disorders: PC06; BL14,15; CV14,17; ST09,12.
Shock: adrenal points (2.2.1) plus GV26; BL15; WEICHIEN.
2.2.4 Disorders of the musculoskeletal system in cattle (Kothbauer, Westermayer, Turnbull):
Musculoskeletal disorders in cattle which respond well to AP include:
a. pain, sprain, trauma of muscle, soft tissue, spine and major joints;
b. tendovaginitis, pododermatitis, laminitis;
c. inflammation (arthritis), especially of the shoulder, elbow, carpus, hip, stifle, tarsus, cervical and lumbosacral vertebrae;
In most cases of arthritis, especially chronic cases, the pain and stiffness is mainly of MUSCULAR origin (Moss 1972; Fox 1975). If the muscles above and below the affected joint are in spasm or contain TPs, the spasmolytic effect of AP can result in great clinical improvement.
d. muscle paralysis due to nerve trauma (suprascapular, radial, facial, obturator, sciatic etc) and in the DOWNER SYNDROME (postpartum recumbency in the absence of detectable pathology). The genetic condition of spastic paresis ("straight hocks") in heavily-muscled European beef breeds can be helped but not cured by AP.
The principles of choosing points for musculoskeletal disorders are:
a. Identify the major affected area(s): neck ? shoulder ? elbow ? lumbar ? hip ? stifle ? etc or the affected nerve: facial ? suprascapular ? etc
b. Locate the reactive points in the muscles in, above and below the affected area. All TPs are used. In the case of lumbosacral sprain, search also the thigh and posterior tibial muscles. Many back injuries are caused by mounting other cattle and may be associated with injury of muscles in the hindlimb also.
c. Use TPs + 2-3 Local Points + 1-2 Regional Points +/- a Distant Point on a Channel through the affected area.
Some examples are given in table 6 but APPENDIX 3 of the paper on the CHOICE OF POINTS FOR PARTICULAR CONDITIONS gives much more detail of points for various joints, nerves and body areas.
Lumbosacral or hindlimb pain in stud bulls: AP can be of great help in stud bulls who refuse to mate because of back or hindlimb pain. The principles of treatment are as in a), b), c) above.
DOWNER COW, postpartum recumbency (Westermayer; Kothbauer; Turnbull; Greiff): Where causes such as toxaemia, hypocalcaemia, metritis/mastitis/pneumonia, septicaemia, fractured pelvis or hindlimb bones etc have been eliminated or treated and the cow will not stand, the cause is often pelvic nerve trauma, sacroiliac or lumbosacral strain. In such cases, there is usually ischaemia and pain of the muscles nearest the ground. Occasionally there is also liver degeneration (fatty liver), general weakness due to poor nutrition and prolonged calving etc. AP combined with mechanical lifting (using a hip-lift) can give excellent results in 10-20 minutes. Some vets prefer EAP in such cases but point injection, strong needling or moxa can be successful also.
The most important points are GV02,03,14; BL23,40. Some vets add points from BL21-34,50-54 or other hindlimb points (table 6) also. If there is suspicion of forelimb involvement, add 1 or 2 forelimb points (table 6).
If the cow is depressed or "stupid", GV26 and WEICHIEN can be added. If the examination suggests the involvement of liver, uterus, gastrointestinal or other pathology, points related to these organs, especially if reactive, are added (see 2.2.1, 2.2.2, 2.2.3).
Hock swelling and mastitis: Many cows with mastitis, especially of the hind-quarter, develop tarsal (hock) swelling, especially on the medial side. Westermayer, Kothbauer and Turnbull report that such cows often show pain points over the posterior sacral area and over the tuber ischii. In severe mastitis, intramammary antibiotic is advisable and in toxic cases or cases of suspect septicaemia/ bacteraemia parenteral injection of antibiotics and antitoxins may be needed. However, the mastitis and hock swelling can be helped by needling the pain points and other points for the udder and hock (see figure 3a and table 4). One might add some needles at LOCAL points (table 6) also.
Needling the points for the udder (table 4) can relax the teat sphincter and 200-1000 ml of pus and infected milk often leaks out spontaneously, within 5-10 minutes of AP stimulation.
In acute mastitis, AP treatment is every 1-2 days. In chronic mastitis or in hock swelling, sessions can be 2-5 days apart. Point injection or simple needling is effective.
Piper implants gold beads at ST36, BL27 in chronic mastitis, with BL30 (hind-quarter) or SP18 (forequarter). He also uses Moxa on the needles in chronic cases.
In disorders of milk letdown reflexes in heifers, Kothbauer uses the "MILK HOLE" (his ST18, at the entry point of the milk vein into the abdomen behind the sternum) with other udder points.
Peripheral nerve paralysis: AP can help to speed up the return of motor and sensory function following peripheral nerve trauma. The principles of treatment are: LOCAL points on or near the affected nerve (and bilaterally), regional points (see table 6), a chain of points along the nerve (for example BL23,36,40,60; GB30,31,34,39 in sciatic paralysis).
In motor and sensory paralysis, the consensus is that EAP is more effective than simple needling. However, simple needling has also given good results. In SENSORY paralysis, care must be taken not to cause electrical burns by setting the output of the electrostimulator too high. This is less likely to happen in motor paralysis but output settings tolerable by healthy tissue should be used as a guide to the settings in paralysed areas.
Treatment: intervals of 1-2 days in recent cases and 5-9 days in old cases. If improvement is not seen by one week after session 6, AP is not likely to be successful.
2.2.5 Disorders of the respiratory system in cattle (Westermayer, Kothbauer, Grady Young, Turnbull, Piper)
There are claims that AP alone, without antibiotics or herbal medicine, can rapidly and effectively treat severe infections, such as cholera, dysentery and pneumonia (Anon 1979a, 1980a). AP is successful also in bronchitis, cough, asthma, 'flu etc in humans.
Lower respiratory (lung, bronchi) problems: The main points in cattle are in the area of vertebrae T4-T8, especially BL, GV and HuaToJiaJi points, BL13-17,42-46; GV09-13 (plus GV14, if fever is present); HuaToJiaJi beside vertebrae T4-T8.
The other Channels crossing the thorax are ST, SP, KI, GB, LV, CV. Points on these Channels over the lung area can be used. The arm YIN Channels (LU, PC, HT) also influence the lung, especially points LU05; PC06.
In lower respiratory problems, a careful search of the paravertebral area T4-T8 or 9 and the intercostal area and sternal area will usually show some pain points. There are used in AP therapy.
Few western vets claim good results with AP alone in pneumonia, lung allergy, congestion and bronchospasm in cattle. This may be because few have tried it. Most would use Western drugs in such cases and would use AP only as a supplementary treatment. Experts, such as Kothbauer and Westermayer combine AP with other methods in pneumonia. Grady Young has reported good success with cold Laser on the LU reflex points (BL13-16 area) in cattle with shipping fever (Pasteurella pneumonia). If the claim can be verified by other clinicians, the implications for vet and human medicine are very great. Recently, Nam et al (1996) reported the results of a controlled trial of AP alone v AP + medication v medication alone in the treatment of respiratory disease ('flu, bronchitis, pneumonia) in calves. AP was given daily at ... for ... days. The results showed ...
Upper respiratory problems: AP has been used in many species (man and animals) in disorders of the nose, sinuses, pharynx, larynx and trachea. These conditions include inflammation (rhinitis, sinusitis etc), bleeding, signs such as coughing, hoarseness, reluctance to swallow etc.
The choice of points for upper respiratory conditions would be based on the site of the problem. (Is the cough due to irritation of the lung, trachea, larynx, pharynx etc or is it secondary to circulatory failure etc ?).
The main points would be LOCAL (over or near the primary affected parts) but lung Shu and Mu points (BL13; LU01) might be included and Distant Points such as LU05; LI04; GB20 might be added, depending on the primary affected part.
Example: Rhinitis, sinusitis: Local points would include LI20; GV24,26; YINTANG (between the eyes in humans). Distant points from LU07; LI04. Shu point for Lung (lung controls respiratory system): BL13.
Treatment: every 1-2 days in acute cases or 3-7 days in chronic cases.
Technique: personal preference (mainly needling or point injection).
2.2.6 AP for surgical hypoalgesia in cows
Acupuncture analgesia (APA) is not a correct term. It should be called AP HYPOALGESIA, as it is NOT a true analgesia.
AP as a surgical analgesic has advantages and disadvantages. More details are in the attached paper "AP ANALGESIA FOR VETERINARY SURGERY".
Teat surgery under APA was reported by Kothbauer in the early 1970s. Since then, he, White, Lakshmipathi, Miljkovic et al and the Akita AP Research Unit (Cattle Health Centre) have reported successful laparotomies (Caesarians, rumenotomies etc). However, not all were perfect successes and Lakshmipathi used heavy sedation before APA.
The main problems of AP analgesia are:
a. Poor results by some operators (Baumgartner and Kanis 1983)
b. Variable results, even in skilled hands (other anaesthetic, such as xylocaine, may be needed to supplement the APA effect)
c. Adequate restraint is needed whether operating in the standing or lying position
d. Excessive stimulation of the AP points in the GV or paraspinal area may cause the cow to lie down.
e. No agreement as to the best combination of points for APA
f. Induction period of 20-40 minutes
g. Poor muscle relaxation may impede surgeon
Points and method used in abdominal surgery by various workers were: Figure 13 shows the location of the main APA points in cattle and horses by Sun et al (1980). Although many combinations of those points are possible, one might use BaiHui; TIANPING; YAOPANG 1 as the basic set, with more anterior points added for more anterior surgery and more posterior points added for more posterior surgery.
Kothbauer: usually excellent result. Sometimes, local anaesthetic was needed. Points: BL30; LV14 (ICS8, level with shoulder). Frequency 3-40Hz
Akita AP Res. Unit: excellent results. Different combinations were tried. Points: TIANPING; BaiHui together were best. Frequency 30Hz.
Miljkovic et al (1981): good result in 4 caesarians but analgesia was not perfect. Points: BL30; LV14. Frequency 3-40Hz
Lakshmipathi (1983): excellent results reported but sedation was used. Sedation (triflupromazine 0.2mg/kg bodyweight). Points: TH08; BL30; LV14; BaiHui; TIANPING; WEIGAN. Frequency 120-200Hz
Baumgartner and Kanis: Bad results !! Points: GV02; BaiHui; SP18; BL30. Frequency 7-10Hz
Lin (1984): 2/3 laparotomies needed local anaesthetic to complete. Points: BaiHui; TIANPING
White (1985): (not full analgesia in one cow). Points: BaiHui (4-6cm); YAOPANG 1 (5-6cm); GV04 (4cm). Frequency 15-28Hz
At this time it seems unlikely that APA will replace drug anaesthesia but a combination of both, especially in high-risk cases of in prolonged surgery, seems practical. APA could be very valuable in national disaster and warfare, when drug anaesthesia may be unavailable.
2.3 AP treatment of disorders in pigs
Klide and Kung (1977) and Kothbauer (1983) discuss AP therapy in pigs and White (1985) gives some information on EAP in pigs. Most of the points in those texts are TCVM points. Data from those three sources were combined to produce a summary of the points and prescriptions for the pig. The data are attached in APPENDIX 1 of this paper.
For fuller details, those texts should be consulted. In general, the selection of points in the TCVM method is very similar to the selection in cattle or to selection by the transposition method.
The important criteria of point selection in pigs are:
a. Select some local points (near the affected part or organ)
b. Select reflex (Shu) points when organs are affected
c. Select Distant Points related to symptoms or to the affected organ.
AhShi points are not so important in the pig and Mu points are not mentioned in the pig texts. Mu points probably exist but have the same difficulty of use as AhShi points in pigs (too noisy !!).
2.3.1 Disorders of fertility and the urogenital system in sows
Lin et al: In Taiwan, large field trials have confirmed the value of BaiHui and WEIKEN in gilts and sows. These points induced oestrus in anoestrous females. The anoestrus was of two types: delay of cycling in gilts (first cycle at 9-13 months) or delay in oestrus post-weaning in gilts and sows. These conditions pose major problems in very hot climates and AP was as good as hormone therapy. Many methods (point injection, simple needling, EAP and direct moxa) were effective. Indirect moxa was not effective. Point GV04 (MINGMEN, in GV line between L2-L3) was NOT effective in the Taiwan trials (Lin 1984). Repeat the treatment after 14 days if unsuccessful at the first attempt.
Kuussaari got 60% success with points CV01,05,08; BL23,25; BaiHui in anoestrus sows, using manual or EAP for 10-30 minutes/day for 3 days at an interval of 3-7 days (mean 4-day interval).
Kothbauer uses points for the uterus and mammary glands in the MMA complex (Metritis-Mastitis-Agalactia) in sows. These points include BL26,26.1,26.2,26.3,27; BaiHui; SP06; ST and KI points on the abdomen.
Dystocia: EAP of points BL23-31 is very useful in the gilt or sow (Kothbauer).
Nephritis, cystitis, urinary retention: points for kidney or bladder are used (Kothbauer). These points are similar to those in cows (see 2.2.1).
2.3.2 Disorders of the gastrointestinal tract in pigs
Lin et al: Field trials of AP in E.coli enteritis in piglets in Taiwan confirmed that AP was as good as antibiotic (Spiramycin) in treating scour. Points used were: T 4, HL17, HN 8, HN10 (Bai Hui, Chiao Chao, Shan Ken, Yu Tang) /or/ T 18, FL 6, HL1, 7 (Pi Shu, Zu San Li, Chiao Chao) /or/ HN 8, FL15, T18 (Shan Ken, Ti Men, Pi Shu). All three combinations were effective when needled for 1 minute/point/day for 3-5 days (Lin 1984).
Kothbauer, White: Indigestion: points behind the last rib (BL21,50) and ST36 are very good (Kothbauer; White).
2.3.3 Disorders of the musculoskeletal system in pigs
Musculoskeletal disorders in pigs are treated similarly to those in dogs, horses, cattle or humans. Lumbar or hip pain in boars may cause them to refuse to mount the sow. AP can be very effective (using points of the BL Channel in the area L3-S1 and BaiHui. If the hip is involved, points GB30,31,34 can be added). Downer sows postpartum also respond well.
TCVM points for the joints are shown in APPENDIX 1 of this paper and transposition points for the main joints are in APPENDIX 2 and 3 of the paper on the CHOICE OF POINTS FOR PARTICULAR CONDITIONS.
Lin reports 25/30 (83%) cure with AP in locomotor disturbance in pigs in Taiwan trials (Lin 1984).
Pigs also suffer from a myopathic form of the Stress Syndrome. The heavy muscles of the shoulder, back or hindquarters may become very painful and myoglobinuria, with kidney and liver damage, may occur. The pig may show severe lameness or may seem to be paralysed in the fore- and/or hind-quarter. Kothbauer and Westermayer have treated many of these cases using AhShi points (the most painful point in the affected muscles) with points for the area. If needed, points for the kidney and adrenal (GV04; BL23,52 area) and for liver (BL18-20,47-49) may be added.
2.3.4 AP for surgical hypoalgesia in pigs
Chinese texts claim that AP can induce surgical analgesia in pigs. Japanese and Taiwanese workers have tried it but Western vets do not seem to have done so. Electrical stimulation should be strong but not too strong.
Lin (1984): a. Inguinal hernia, castration: HUI YIN (CV01), Bai Hui (GV03), 2 cases; good result but pain when spermatic cord pulled).
b. laparotomy: AN SHEN useless in one case. Zu San Li (ST36) was good but the peritoneum was very sensitive.
Akita AP Research Unit: abdominal and inguinal surgery: BaiHui, TIAN PING (no statistics available but results were good)
Chan (1985): points from Chinese text for pig AP analgesia in laparotomy. AN SHEN (behind jaw, midway base of ear to ventral edge of neck. 10 cm needle guided inside mandible to lie near last molar. TUAN HSUEH (T 19) (3-6 cm deep); BaiHui (T 4) (3-6 cm deep); SHEN MEN (T 20) (3-6 cm deep); San Yang Luo (TH08) to YE YAN (PC05)