SUMMARY
1. Sources of acupuncture (AP) literature (textbooks, journals), equipment supply houses, societies, training courses and schools are discussed.
2. AP study techniques are discussed.
3. Memory aids help the learning of the Channel-Organ Systems (COSs) , direction and importance of Qi flow, Qi tides, first and last points on the Channels.
4. The course of the Channels is outlined.
5. Memory aids help the learning of Master Points: Shu-Back Association (Paravertebral Reflex) points; Mu-Front Alarm points; Luo-Connecting points; Yuan-Source points; Five Phase (Wood, Fire, Earth, Metal, Water) points; Xi-Cleft points; Hour points; Earpoints and other important points.
6. This paper contains the basics of AP as regards the Jing-Luo (Channels and Collaterals), the COSs, and the main AP points. Its intrinsic difficulty is acknowledged but students are encouraged to read and re-read it until its contents are mastered.
INTRODUCTION
Elsewhere, we discussed the necessity of the transposition method from human AP as the essential starting point for a study of vet acupuncture (AP). In this paper, we consider information sources on human AP. Some techniques which I found useful to my study of the basic and classic concepts are discussed also.
TEXTBOOKS, JOURNALS, SUPPLY HOUSES AND EQUIPMENT
There are dozens of textbooks in English on human AP and Traditional Chinese Medicine (TCM). If one also counts those in French, German and other European languages, the number of texts is very great. The beginner should be aware of few difficulties in choosing texts.
1. Many textbooks in European languages are poor copies of the originals in Chinese. They contain errors in the location of points and in the therapeutic indications. If possible, the beginner should choose texts published in European languages by the Chinese themselves. Examples are the Beijing text (1), the Shanghai text (2), Hong Kong texts (3,4,5) or the Shanghai charts (6). Having studied these texts, the student will be better able to integrate material from European sources.
2. Many texts (even some Chinese ones) use point names and alphanumeric point codes which differ from other texts. The beginner is advised to use one text as his/her basic reference work for point name and code and to check, point by point, each new text against that reference, making appropriate adjustments to point names and codes in the margins of the new book. This is essential, as most therapeutic indices which the student will create for personal use, use the alphanumeric point code. Thus, if the student uses the code LI04 for HoKu (Large Intestine 4) and another text uses Co (Colon) 4 for the same point, it is obvious that she/he must be aware of the difference. Similarly, some texts use ST01 for Tou Wei. Some differences occur between texts in the coding of Bladder points from the shoulder area to the back of the knee. The student is strongly advised to adopt one convention and to retain that one as his/her reference. It is not difficult to make appropriate changes in all new textbooks.
Basic charts: I suggest the Newest illustrations of the AP Points (1975), Medicine and Health Publishing Co., Hong Kong) (3) as a primary reference. The other texts (Beijing, Taiwan etc) can all be referenced back to this.
Basic texts: Basic texts recommended by IVAS are: The Essentials of Chinese AP (1); Chinese AP and Moxibustion (1a) and Grasping the Wind (1b). Other textbooks which I found helpful are listed in the Appendix. Some texts however, do not mention the classic AP Laws. They are purely technical or mechanical/pragmatic in their approach to AP.
Texts on Classical AP: For mastery of AP, one must study and incorporate into one,s day-to-day thinking the classical laws and concepts of AP. These are covered very well in The Web that has no Weaver (15b) and the Fundamentals of Chinese Medicine (15d); see also references 14, 14a, 15, 15a, 15c and 16.
Veterinary Texts: Having grasped the principles and the anatomy of human AP, one may then study the vet texts. Later in this paper, we will discuss aids to help memorize the human system. Unfortunately, I have no help to give you in memorizing the vet texts! They are difficult to learn because they are poorly integrated as compared with human texts. However, vets who deal mainly with horses and cattle can gain valuable information from Klide and Kung (9), Kothbauer (12a), Rubin (13), Westermayer (11, 12), White (12b) and Yu & Hwang (12c). Those who deal mainly with small animals will benefit from Altman (7a), Brunner (8), Demontoy (7c), Gilchrist (8a), Janssens (7b), Molinier (7d).
Journals which specialise in the publication of AP articles, or which frequently publish such articles are listed in the Appendix. One of the best, as regards clinical articles is the American Journal of AP. The latest (1990) is the International Journal of Clinical AP.
It must be understood that some of the papers which are accepted by specialist journals would not be accepted by more critical scientific or medical journals, as their quality would not pass professional referees on technical or academic grounds. Some of the "research" articles are of poor or very poor quality, have poor experimental design, no controls, have group sizes which are too small, lack detail, have no or poor statistics or are written badly. Nevertheless, these journals are the main source of new information on AP and allied methods.
AP Supply Houses are common in most European countries now. Some addresses are given in the Appendix, in case some of you have not made contacts in this area already.
AP EQUIPMENT
a. Needles: Standard hypodermic needles are satisfactory for occasional use: Large animals; 12-100 mm, 19-24 gauge. Small animals, 12-50 mm, 21-26 gauge.
Solid AP needles are preferable for routine AP. Small animals: human AP needles 12-50 mm, 21-30 gauge are satisfactory. Large animals: 12-150 mm, 21-24 gauge. The Richter Company (Feldgasse 19, A-4600 Wien, Austria) makes excellent needles for small and large animals but, as for most equipment, Hong Kong supply houses are usually cheaper for equipment, even if one pays air-freight and import taxes.
b. Moxa: Standard moxa punk is available at all Supply Houses.
c. Stimulators: There are dozens of electro-AP stimulators of Chinese, Japanese, American, Canadian and European manufacture on the market. Most of these are designed for human use but IVAS has assessed some veterinary models. In general, human stimulators are also suitable for vet work and ones with bipolar electrodes are less likely to cause electrolytic lesions than ones with conventional positive and negative electrodes. I am not competent to advise on which model is best. However, I find the Chinese model 71-3 General Purpose AP Apparatus or the cheaper AWQ-100 Multipurpose Electronic Acupunctoscope to be satisfactory for routine use. The latter has a variable resistor in the Point Detection facility, which may help beginners to locate low-resistance points in the vicinity of the AP point to be stimulated.
Other equipment which is available from Supply Houses includes magnetic-, static-, electrostatic-, electromagnetic, ultrasonic-, microwave- and laser- stimulators, TENS, TENS/roller stimulators etc.
SOCIETIES, TRAINING COURSES, SCHOOLS
SOCIETIES: Vet AP has a very short history in the West, dating from about 1973 (except for countries like France, Austria and Germany). At present, between 0.5 and 10% of vets in most Western countries use AP. Most countries in northern Europe now have formal vet AP societies. Medical AP societies exist in these and in many other countries and they often accept vets and dentists as associate members. The Appendix lists some of the vet societies.
VET AP TRAINING COURSES
Australia: Vet AP courses have been organised by AVAA.
Austria: Oswald Kothbauer (Fax: 43-724-62438) organises training courses with assistance from other vet colleagues and medical colleagues from the Ludwig Boltzmann AP Institute (Vienna).
Belgium: Luc Janssens (Fax: 32-3825-0040) and Emiel van den Bosch (Fax: 32-1656-1374) have run IVAS-standard (120-hour) courses with assistance from other colleagues in the BVDA.
France: l'AVAF (led by Milin, Molinier, Demontoy, Janacek and others) organises a course and week-end seminars.
Finland: In 1980, the Government introduced AP to the official university training of med, vet and dental students. Finland is the first Western country to do this and she must be congratulated for having set the precedent for other countries. Jukka Kuussaari (Fax: 358-247-391381) was the organiser of the Helsinki Course.
Norway: Are Thoresen (Fax: 47-334-66775) organised the first IVAS Course in the Vet School, Oslo, 1988-1989. A formal course will be run in 1996.
Sweden: Ritva Krokfors (Fax: 46-141-10371) organises training courses in Sweden.
USA: IVAS, founded in 1974, organizes training courses each year. Contact David Jagger, 5139 Sugarloaf Rd., Boulder, CO 80302-9217, USA (Fax: 1-303-449-8312). Though most participants are from North or South America, some European, Australian, South African and Far Eastern participants have taken the course. IVAS now has a policy to give the full course (in English) in any country which can organise enough participants to cover the cost of IVAS-approved lecturers.
Apart from these, recent AP seminars and training courses for vets in European countries have been run mainly by individuals or by national Vet AP groups, or in association with medical AP groups. Such courses have been given in Denmark, Germany, Sweden, UK. Details of future courses may be available from the national Vet AP societies (see Appendix).
AP SCHOOLS: Vets who wish to study AP formally have to decide whether to rely on week-end seminars or full-time study. Week-end seminars are run by the medical AP groups in most countries. Vets are usually welcome to attend as associate members.
Study of human AP in detail over a period of months to years is possible in special AP Schools. Some vets go to Vienna, Hong Kong, Taipei, Beijing or other Chinese centres for intensive training but most rely on their local schools. Unfortunately, there is little standardisation between schools. Some are excellent. Some are merely "diploma mills". Many of these "schools" are run by persons with no qualifications in medicine, vet medicine or science. They can be fine acupuncturists but poor clinicians. The student should seek advice from an experienced acupuncturist before she/he enrols in one of these schools.
INTERNATIONAL CONTACTS: When one travels abroad, it is often very useful to have a contact in another country who can introduce one to people with similar interests. Therefore, should you be interested to meet other vet acupuncturists you may consult the addresses of contacts in the Appendix.
STUDY TECHNIQUES
On the assumption that most of you will not be able to attend full-time, intensive training in AP it follows that your knowledge of AP must be self-taught, at home. Most of the vet acupuncturists whom I know began in this way.
When I began my study of AP in 1973, I spent 3 hours a night, 5 nights a week for 6 months studying in the wrong way! I had no friend or colleague who could help my study, as I knew no vets or doctors in Ireland at the time who were acupuncturists. I bought the wrong textbooks (bastardized copies of the original Chinese) and tried to understand classic AP in too short a time. Most frustrating of all, my Western-trained mind asked too many questions which could not be answered to my satisfaction by the classic concept.
After 6 months of frustration, I was about to give up this study as hopeless, when, without warning, the picture began to "click" into position. Since then, I have made many valuable contacts who guided my study and I have learned from my many mistakes. I am still a student, with much to learn yet.
To those of you who wish to study AP in depth, I give the following advice:
1. Forget your Western training while you study the AP textbooks especially those dealing with classic AP, such as those by Austin, Connolly, Kapchuk, Mann, van Nghi or Wiseman.
2. "Skim" the books a few times in the beginning; read from cover to cover, quickly to get the general "feeling". Later, read them more slowly, trying to absorb as much detail as possible.
3. Use memory aids to remember the circuits of the Channel-Organ Systems (COSs), the Master Points (including the 66 Command Points), the first and last points etc. Examples of memory aids are given later; if these do not meet your needs, make up your own memory aids.
4. From the beginning, using one basic reference, as mentioned earlier, learn the points by their alphanumeric code and the Chinese name. As you study the details of each main point, check that the alphanumeric code refers to the correct point location. Repeat the exercise for each new textbook. (Codes are not the same in all books). Locate each point on your own body (or on a friend's body if the location is not visible on your own) and mark it with a pen. Remind yourself of its location frequently in the next days.
5. Learn one point on each Channel first (e.g.) LU07, LI04, ST36, SP06, HT07, SI06, BL23, KI03, PC06, TH05, GB34, LV03, CV12, GV26. Later add more points when you know these well.
6. Pick 3 or 4 common conditions, such as gastroenteritis, low-back syndrome, muscular lameness, dystocia. Compare the approach to treating these conditions in the various textbooks which you use and make a synthesis of your own approach. Expect to encounter differences in approach between the various sources and make your study interesting by noting where the authors agree and where they take alternative courses.
7. Experiment with AP on yourself and on family volunteers. Try to treat the simple day-to-day conditions such as toothache, headache, pulled muscles, stomach ache etc, using especially the massage technique or the non-invasive techniques using transcutaneous electrostimulation, ultrasound etc. If you have the courage, arrange with your dentist that he/she does your dentistry under AP analgesia. For this you will need a good electro-stimulator. Use needles in points Chia Che (ST06) and the Earlobe Dental Anaesthesia Point (10 mm needles, 30 gauge). Electro-stimulate to maximum tolerance for 30 minutes before surgery. You can sit in the car if you don't want to alarm other patients in the waiting room! (While the stimulator is working, your face will contract strongly in time with the stimulator, say 5 Hz!). Leave the stimulator on during surgery. For surgery on both sides of the mouth, needles will be required on the left and right sides.
8. Join med and/or vet AP study groups. As often as you can, meet medical and vet colleagues who use the method. Discussions on and observation of their techniques, successes and failures are very helpful.
9. Read the AP Journals, especially the American Journal of AP. Encourage your nearest University Library to subscribe to as many of these Journals as possible.
LEARNING THE COSs, DIRECTION OF QI FLOW AND THE QI TIDES
There are 12 pairs of main COSs (the main Channel (Meridian) Organ Systems of AP). The Channels either begin or end on a finger or toe: Lung (LU); Large Intestine (LI); Stomach (ST); Spleen-Pancreas (SP); Heart (HT); Small Intestine (SI); Bladder (BL); Kidney (KI); Pericardium (PC, Circulation-Sex, Heart Constrictor); Triple Heater (TH, Respiration-Digestion-Reproduction-Elimination and Endocrine); Gall-bladder (GB); Liver (LV). The superficial paths of the Channels are bilaterally symmetrical longitudinal lines of low electrical resistance (high conductivity) which connect AP points of similar function. The deep paths are planes of low electrical resistance (high conductivity) which connect the superficial path to their related organs. Each Channel (Jing) has a Mate Channel in the same Phase. Its connection to the Phase-Mate is by a special Luo (Collateral, or Connecting Channel).
There are Eight Extra Channels in addition to the 12 Main Channels. These are: the Du (Governing Vessel, GV) in the dorsal midline; the Ren (Conception Vessel, CV) in the ventral midline, plus six other Channels, which link other parts of the body. These are the: Chong; Dai; Yangqiao; Yinqiao; Yangwei and Yinwei. The Eight Extra Channels are seen as Qi reservoirs or regulators, which can help to maintain optimal levels of Qi in the main Channels. Each Extra Channel has its own superficial and deep pathways, which link with a number of the main COSs and with specific organs, such as the uterus, brain, eyes etc. Each has its own symptomatology, as described elsewhere (Anon 1993; Wiseman & Ellis 1995).
MEMORY AID FOR THE 12 MAIN CHANNELS AND THE DAILY QI CIRCUIT
A simple memory aid teaches the 12 main pairs of COSs: "LULISTo/SPHTSI/BLaKI-PC/TRI-GALL-LV" = LU LI ST / SP HT SI / BL KI PC / TH GB LV.
LULISTo/SPHTSI/BLaKI-PC/TRI-GALL-LV. Repeat this aloud, like a child, until you know it by heart. It is the basic memory aid. You must know it, or one like it.
LULISTo/SPHTSI/BLaKI-PC/TRI-GALL-LV: LU = Lung; LI = Large Intestine/Colon; ST = Stomach; SP = Spleen/Pancreas; HT= Heart; SI = Small Intestine; BL = Bladder; KI = Kidney; PC = Pericardium/Heart Constrictor/Circulation-Sex; TH = Triple Heater; GB = Gallbladder; LV = Liver.
LULISTo/SPHTSI/BLaKI-PC/TRI-GALL-LV. Say it aloud until you can say it in your sleep! Write it out forwards, backwards, downwards, upside-down. You must know this one (or your own version of it) inside-out!
TCM teaches that the vital (defence) energy (Qi) circulates in the Channels, which have superficial courses and deep (internal) connections to their respective organs and associated parts of the body. The COSs (LULISTo SPHTSI BLaKI-PC TRI-GALL-LV) are connected in a definite sequence, like a series of hose-pipes joined end to end in one continuous circuit.
The Qi flows through the COS circuit, in a diurnal cycle, like a tide. It begins in the LU COS at 4 a.m. (3-5 a.m.), going to the LI COS at 6 a.m. (5-7 a.m.) -> ST -> SP -> HT -> SI -> BL -> KI -> PC -> TH -> GB -> LV at 2 a.m. (1-3 a.m.). It then returns to the LU COS to begin a new day.
In the diurnal Qi circuit, the LU is called the Mother of LI (because it feeds LI) and LI is called the Son of LU (because it is fed by LU). In turn, LI is Mother of ST and ST is the Son of LI.
During the circuit of Qi through its daily cycle, it travels three times around the body (i.e.) each 24-hour cycle it composed or 3 X 8 hour revolutions:
Each or these 8-hour circuits is further divided into 4 X 2 hour phases: chest to finger, finger to face, face to toe and toe to chest (where a new, similar revolution around the body begins again). Thus in one day, the Qi travels three times around the body (Chest -> Finger -> Face -> Toe -> Chest in each circuit).
LULISTo / SPHTSI / BLaKI-PC / TRI-GALL-LV is the basic memory aid of all AP. It can be arranged in 3 circuits of 4 COSs as shown below.