MOXIBUSTION (JIU = FIRE)
One of the most ancient forms of treatment is to apply fire (Jiu) to various parts of the body. Many methods were employed, irons treated in a fire being used for centuries in human and animal medicine. In vet practice, line and point firing (using hot irons) is still used for tendon problems in some countries but many Vet Associations have banned this type of treatment on humane grounds.
Moxibustion: In China, a dried preparation of Artemisia vulgaris, rolled into cigar or cigarette shape has been used to heat the points since before the time of Christ. The preparation is called the Moxa and the process of using it is called moxibustion. It is used in human and animal medicine. When moxa is ignited, it burns slowly like a cigar. It is used in 4 ways (a) Non-scarring method, (b) moxa-needle, (c) scarring method and (d) festering method.
a. Non-scarring method: The moxa is held at a distance of about 25 mm from the skin until the patient feels pain (human) or reacts defensively. It is removed for a few seconds and the process is repeated 10-20 times. Alternatively a slice of garlic or ginger is put on the point and a small ball of moxa the size (if a pea, is put on the slice. This prevents severe burning but care must be taken that the moxa does not touch the skin.
b. Moxa-needle: Using moxa to heat the needles, has been mentioned earlier. This method is most suitable for vet use. Moxa emits an acrid irritating smoke and must not be used near the eyes.
c. Scarring method: The moxa is burned directly on the skin, causing intense pain, with second or third degree burns. This method is not acceptable in western medicine or vet practice.
d. Festering moxa: This is also a scarring method. An irritant blister paste is applied to the heated area to increase further the stimulation of the area. Alternatively, garlic juice or crushed garlic is rubbed into the points before moxa is applied. Pustules form within a few days. These are drained and dressed with antiseptic cream until they heal. Festering moxa often causes severe skin damage and is not recommended except in very difficult chronic diseases, such as human rheumatoid arthritis or psoriasis, in which GV points from GV14 to GV03 are used.
In vet AP texts, another method uses alcohol which is ignited and allowed to burn on the skin. This is also not recommended.
Thermostatically heated probes at 80oC have been used to heat the points. They are safe if checked regularly and not applied too strongly or too long.
Other methods of heating the points include ultraviolet rays, infrared rays and microwaves. Special instruments are available for these purposes but they appear to be used in humans rather than in animals.
If heat is to be used in therapy, care should be taken to avoid burning the patient and to avoid sensitive areas such as the eyes, major blood vessels and mucous membranes. Moxibustion should not be repeated in the same area more than once unless the area is perfectly free from burns or blisters. Moxibustion can be used in "cold diseases" (chronic diseases), such as in chronic cases of muscular rheumatism, arthritis, asthma, abdominal pain, severe enteritis and vomiting, pyometra and metritis; chronic tendinitis, chronic lymphangitis and chronic pain.
COLD
Cryostimulation or stimulation of the AP points by the application of cold is effective in many pain conditions. Modern cryosurgical instruments, solid carbon dioxide and ethyl chloride spray may be used. Care is taken to avoid "burning" the skin by reducing the time of application. The idea is to induce numbness and coldness of the tissues near the AP points. It is especially useful in human acute painful conditions. In fever, cold applied to GV14 helps to reduce the fever.
A very useful first-aid treatment of acute human toothache is to massage the LI04 points in the 1st-2nd inter-metacarpal area with ice-cubes until the area seems numb. This requires about 5 minutes. The toothache usually disappears within minutes. Occasionally it may be necessary to add Chia Che (ST06). The method is ideal for treating children. For headaches try GB20, LI04 and Lieh Cheuh (LU07).
The method has not been used widely in vet medicine but applications could include acute myositis and lowback syndromes. If the vet wishes to show the owner the correct points to work on, the owner could use the ice or dry-ice method between therapy sessions, thereby making the vet's work easier.
MASSAGE, PRESSURE, VIBRATION
Massage is a form of self-help and first-aid in minor human conditions. It is widely used in the East by the ordinary people to treat their ordinary day-to-day aches and pains. Massage is sometimes combined with rubbing adrenalin cream, alcohol or rubifacient agents (menthol, eucalyptus etc) into the points. It is of great benefit in minor human headaches, muscle aches, toothaches, earaches, nausea, upset stomach, insomnia, etc. The same AP points as would be needled (for the specific condition) are massaged firmly and deeply.
There are many types of Chinese massage, including slapping, pinching, rubbing, kneading and deep pressure. The type used depends on the area to be massaged. AP points over muscle masses can be heavily kneaded and deep finger pressure and slapping is used also. Points over bony areas are pinched, rubbed or slapped. For human first-aid use, especially useful in children, the following are suggested.
Nausea and upset stomach: ST36, CV12, PC06, BL21.
Earache: GB20, LI04, points around the ears; TH05.
Toothache: LI04 and ST06 with hard pressure on the Earlobes.
Muscle ache: seek out the tender points in the muscles and add main points for the affected region.
Headache: GB20; heavy massage of the Trapezius muscles, especially GB21 + LI04; LU07; Yin Tang (Z 03, between the eyebrows); Tai Yang (Z 09, in the hollow of the temple lateral to the eye).
One of the most useful applications of massage in first-aid is in the treatment of human fainting, shock, collapse etc. For this purpose, the main point is JenChung (GV26) + YungChuan (KI01). Strong pressure and vibration is applied to GV26 (in the philtrum) using the thumbnail. In many cases, especially if the patient's head is kept lowered, consciousness returns in 30-60 seconds. GV26 is the shock point par excellence and can be used anywhere, anytime in emergencies when other therapies may not be available. If nausea or angina pectoris is also present point PC06 is added, pending medical attention.
Spooning is a variation of massage used in humans. The edge of a large soup-spoon is rubbed repeatedly over the area (for instance BL13-16 (FeiShu to TuShu) and BL42-45 (PoHu to YiHai) in asthma and bronchitis) until the whole area is bright red. It helps if oil is spread over the area first to make it easier to move the spoon.
Mechanical vibrators are also useful, especially for muscle massage in rheumatism. Physiotherapists who use these machines could greatly improve their results by adding the main AP points for the region as well as applying local vibration and using the AHSHI (tender) points.
Fisting: Massage techniques are not used commonly by vets in large animals because of the large body areas and the time involved. However, key points, especially the AHSHI points over heavily muscled areas, can be clipped and owners or handlers can be shown how to "fist" the points. Fisting to the animal's tolerance for 4-6 minutes/day between AP sessions can shorten the recovery time. Fisting should not be used over the spine or over bony tissues. It is especially useful in horses with paraspinal AHSHI points.
Vibrators: Some practitioners use vibration techniques in racehorses and dogs for muscular problems and other minor lameness but in general these techniques are not popular in busy practices.
CUPPING, VACUUM
Application of reduced pressure to points (+ the use of needles or moxa) is used occasionally in humans. Special instruments (glass or bamboo cups) are used. A lighted swab, soaked in alcohol, is put into) the cup, which is then applied firmly to the point. Reduced pressure causes suction on the skin, causing congestion to the area. Mechanical devices (similar to vacuum cleaners, or based on a syringe and plunger principle) could cause the same effect. Although it is mentioned in some vet texts, it is rarely used in animals the west.
ELECTROSTIMULATION (ES)
Stimulation of the points by the application of electric impulses is one of the most common methods used in western medical AP. The stimuli can be applied via electrodes attached to AP needles or via simple (non-invasive) skin electrodes, such as those used in ECG measurements. The stimulators are battery operated, easily portable and are available from AP supply houses. Waveform can be single pulses, adjustable from 1-50 Hz or more; dense-disperse forms (a train of high followed by a train of lower frequency pulses). Other waveforms are also used but the common one is single pulses (triangular, square or bipolar) in the range 1-10 Hz. For most purposes a 3 Hz wave is adequate but individual practitioners and patients have their own preferences. Output voltage is fully controllable from 1-160 volts or more. The current is very small, being measured in mA.
Modern stimulators use bipolar pulses to avoid the necessity of altering the polarity of the electrodes. (This was necessary with earlier stimulators which had positive and negative electrodes and which could cause electrolytic lesions if used more than a few minutes without reversing polarity).
Before the electrodes are attached, the needles should be checked to ensure that they are in the correct points i.e. that they can elicit the De Qi sensation (the needle reaction). Julian Kenyon, Liverpool, has evidence that simple needling for a short time is as effective as electro-needling for 10-30 minutes in most conditions responsive to AP, provided that De Qi is obtained when needling. De Qi is most important in effective ap therapy. It is claimed, however, that exact positioning of the needles is not so important with electro-AP as with manual AP because the electrical stimulus diffuses for quite a distance from the needle.
Electrodes are attached to the needles in pairs. The output control for each pair of needles is slowly advanced until the needles begin to twitch strongly (due to muscle twitch) at the same frequency as the frequency setting. (Care is taken that each member of the pair is on the same side of the body for needles inserted in the thorax. Electrical stimuli which cross the spinal area in the thorax may cause cardiac fibrillation). Normally, 10-30 minutes per session is allowed. At the end of the session the output voltage is turned to zero and the power is switched off. The electrodes are disconnected and the needles are removed.
Modern (Western) electrostimulators (such as those used in transcutaneous electrical nerve stimulation (TENS), transcutaneous electro-stimulation (TES) or Faradic stimulation) can be used without needles. The skin (contact) electrodes are coated with electrode jelly and are applied to the points using adhesive plaster. Otherwise they are used in the same way as the AP stimulators. Both types of stimulators can be obtained in mini- versions which fit in an inside pocket. Human patients or owners whose animals who require frequent stimulation may purchase their own and use them at any time via contact electrodes left semi-permanently in position.
ES is most often used in the relief of human chronic pain syndromes, in the relief of past-operative pain and in the treatment of withdrawal symptoms in narcotic/alcoholic detoxification clinics. ES can be used in ANY disease in which AP is indicated. In AP analgesia for surgery, stimulators are regarded as essential equipment. (Although AP analgesia can be produced by manipulation of the needles and other methods, most operations under AP analgesia use the stimulators).
In the treatment of addictions, special ear-clips are used to keep metal ball electrodes in contact with Earpoint LUNG (in the concha of the ears). Alternatively, ECG electrodes can be used to stimulate the area of the mastoid processes. Portable stimulators deliver mild, pleasant electrical stimuli to the ears. Detoxification (without withdrawal symptoms and without substitution therapy) is complete in 6-10 days in 90% of patients.
TES is also useful in childbirth and dental surgery as a method of analgesia and in the relief of cancer pain.
In vet medicine the uses of these techniques are similar to those in humans but the two main uses would be (a) in the treatment of pain, lameness and nerve paralysis and (b) to induce analgesia fur surgery. In spite of its effectiveness, ES is not used often as a therapy in farm animals or pets because of the relatively long time (10-30 minutes) required for each session. For most purposes in human and animal patients, once De Qi is obtained, simple AP can elicit results as good as EAP. In valuable animals, such as stud animals, racehorses and greyhounds, however, EAP is used more widely, but more as a "hi-tech" public relations exercise than as an essential method of stimulation.
MAGNETIC AND STATIC STIMULATION
It is possible to elicit analgesic and therapeutic effects in humans by stimulating the AP points by magnetic, static, electro- magnetic and electrostatic fields without actually touching the body. These claims are made in the American Journal of AP. Japanese workers have claimed to have done Caesarean section on women whose hands and feet were encased in an ES- field. Under experimental conditions in humans, static and electrostatic fields applied to the hands cause analgesia in areas identical to`those which respond to simple needling of LI04. The Chinese make portable stimulators which work on the EM and ES principle.
These methods are rarely used at present (in humans or animals) but they should be mentioned as possible methods for the future. They also set an objective precedent for a physiological effect induced by an intangible field (see the paper on "Holistic concepts of health and disease" and the section below on psychic healing).
Special magnetic beads or discs, for instance "Corimags", can be taped or super-glued onto the points for long-term stimulation.
ULTRASONIC STIMULATION (US)
US has many adherents in human and vet medicine, especially in treating soft tissue injury (muscle spasm, muscular rheumatism, tendinitis etc). In orthodox use, the US head is applied mainly to the area of pain or inflammation. In the Veterinary Record (1980, 106, 427-431), Lang reported treating 53 horses, and 143 dogs and cats with US. The conditions included sacroiliac, thoracolumbar, cervical, lumbosacral and coccygeal spinal lesions (50/67 successes); limb joint lesions (luxation, trauma, synovitis) (35/45 successes), trauma, lumbar spasm, paresis, swelling etc (29/33 successes); bone and joint lesions in horses (5/10 successes); soft tissue trauma in horses (22/25 successes). The average number of treatments was 2.7 per case. Rapid, complete recovery occurred in 64%.
The overall results are summarised below. Unfortunately these results were uncontrolled and it is not known what percentage of these cases would have recovered without treatment.
Success +++ ++ + Nil Total (n) 127 31 9 31 198 (%) 64.1 15.7 4.5 15.7 100
US, as a method of stimulating the AP points is used by medical more than by vet acupuncturists. It is used for many conditions other than soft tissue injury - US merely replaces the needle - and many of the conditions amenable to treatment by needling are also responsive to US. As with all other types of AP stimulation attention is paid not only to the local area of pain/inflammation but also to the AHSHI points and other AP points which are active in treating the affected area. One of the advantages of US is that it is a fast method of therapy. American medical acupuncturists recommend 10-30 seconds/point. The manufacturer's instructions on maximum output and duration of treatment should be followed. A contact jelly must be used if the area to be treated can not be immersed in water.
Those of you who already use US in your practice will further increase your success rate and widen the scope for treatment of other conditions if you combine US with AP theory. It is also useful in treating local infection such as in the ears, vagina, nose etc. US therapy is especially good using the AP points on the human ear. In animals, however, we have much to learn about the potential of this method of treatment. As animal Earpoints are not fully documented, it is not possible to use earpoint therapy to the same extent as in humans.
LASER STIMULATION
Laser light (monochromatic, polarised and coherent) is another type of electromagnetic energy but the wavelength frequency is in the light range. The most common type of cold laser (power <50 mW/cm2) is the visible (red) light from He-Ne lasers. Red light (ruby laser) is also used. Infra-red (I-R) lasers emit invisible light but the clinical effects are marked.
The power of cold lasers varies widely, from 1-50 mW/sq cm. Lasers emitting <10 mW/cm2 are not powerful enough to reach deep trigger points. For large animals, lasers emitting 30-50 mW/cm2 are recommended.
Most He-Ne and I-R lasers, even those emitting <5 mW/cm2, are effective in treating superficial disorders (cuts, bruises, granuloma, ulcers, wounds).
Rapid interruption of the light beam at fixed intervals is called pulsing. Pulsed lasers (especially those interrupted 2000-10000 times/second (Hz) penetrate deeper than unpulsed lasers.
Laser stimulators are available as robust, portable instruments. They are operated by batteries or by mains electricity. The laser probe is held within 0-5 cm from the skin and the laser light is directed to the point. Treatment time depends on emission power. With 30-50 mW lasers, dose time is very short, 10-60 seconds per point. There is no pain or noxious sensation. The method is ideal (if it works !) for treatment of Earpoints (when documented properly !) and all points on nervous or difficult animals, such as the points below the carpus and tarsus of horses. Cats tolerate the laser very well.
The commercial claims are for excellent results. Russian and German workers have used cold laser stimulation of the human AP points for some years now. Since 1984, there are many papers on the method in humans. (See "AP for immune-mediated disorders", Rogers 1990).
The use of cold laser in conventional veterinary practice (as a therapy for tissue trauma, wounds, granuloma, myositis, tendinitis etc) is growing rapidly. Laser is also be used in vet AP (instead of needles) to stimulate the AP points in animals but there are few published studies to date. The author (PAMR) has used a 30 mW I-R laser with similar results to those of EAP or point injection in horses since October 1989. However, there are reports that the lower power lasers (especially those <10 mW/cm2) are not as effective as AP.
Further work is needed to document the uses and limitations of laser, the effects of power, wavelength, different pulse frequencies, different exposure dosage etc. In the next few years, I believe that we will see much more use of electromagnetic types of therapy, including ultrasound, microwave and laser stimulation in medical and vet therapy.
TREATMENT OF CATS AND ZOO ANIMALS
Cats and zoo animals present special problems to vets who wish to use AP therapy. For effective needling, proper restraint is necessary. Cats resent needling on the extremities of the limbs and on the medial aspects of the limbs. Because of their sharp teeth and claws, needling points on the ventral abdomen can also be dangerous for the operator. Also, the duration of needling must be short.
Some vets find it useful to sedate these animals lightly before AP. Methods of choice in these species include painless techniques, such as laser, ultrasound and EM or ES fields. (Sedation is usually not necessary in domesticated species, other than cats, with these methods). Alternative, quick methods are point injection, Dermojet injection and quick needling, all of which may require sedation.
Using the Dermojet method, at a distance of 5 cm from the skin, Demontoy has treated many cats without sedation, using limited numbers of points. Cases which gave excellent responses included vomiting, diarrhoea, (gastritis, enteritis, gastroenteritis), constipation, urolithiasis- cystitis-urethritis; urine retention; induction of parturition in overdue females; hormonal alopecia; coryza (rhinitis, conjunctivitis, gingivitis); cough (tracheitis, bronchitis, pneumonia); shock and anaesthetic emergencies. For details, see: Demontoy, Revue d'AP Veterinaire (1981), No.8, p.17-21 (published by Assoc. des Vet. Acupuncteurs de France, 3 Rue Letellier, Paris 75015, France).
Qi Gong, PSYCHIC AND TOUCH HEALING
This paper has concentrated on the more physical methods of stimulating the AP points. It would not be complete, however, without a brief mention of paraphysical methods. Modern Chinese Communists do not believe in a soul (a personal energy/memory independent of the body) that survives death. However, recent (unconfirmed) reports from China indicate that research in Qi Gong is producing exciting results. Mental and physical focusing/ control of body Qi is possible. It can be learned and used for many purposes, including diagnosis and healing. Acupuncturists who are Masters of Qi Gong can often "sense" the location of disturbed Qi in the patient and, without touching the patient, can treat the disorder by directing their own Qi to the correct AP points.
The whole area of "paranormal" diagnosis and healing is difficult to assess in terms of our scientific methods. Little or no thorough research has been done in the area. Many confidence-tricksters make large sums of money from the public by claiming (falsely) to have these abilities. Nevertheless, the phenomena, although rare and unpredictable, are real.
There are people who are gifted with natural ability to diagnose disease and to heal in strange ways. Some of the diagnostic and therapeutic aspects of psychic methods have been discussed briefly in another paper (see "Psychic methods of diagnosis and treatment in AP and homeopathy" by Rogers, Belgian Veterinary AP Society Seminar 1982). Psychic healers often have no training in biology and medicine. Some of these people believe that God acts through them; others may not believe in a God, but they use some type of meditation /trance or "thought projection" to help the patient. The healer may be near or far distant from the patient. Some vets and doctors have these gifts to a greater or lesser degree. They may not realise that they have the ability and they may attribute their diagnostic skills and clinical success to "luck" or good fortune as well as good medicine. I would ask you to keep an open mind on these questions. If some of you recognise these abilities in yourselves, please read as much as you can of the literature on the paranormal. You will find that your clinical success will improve when you combine these techniques with scientific medicine.
a. Psychic diagnosis: There are people who can sense, by "paranormal" means, the nature and location of human and animal disease. Some do this in the presence of the patient. Others do it from a long distance, using the dowsing (divining) facility or by other psychic means.
The late Erwin Westermayer (Bellamont), a great healer, did not have to see the animal patient or to have a detailed history of the case. He relaxed into a type of trance and within a minute or so, sensed in his own body the site of pain or other lesion which he saw when he later examined his patient clinically.
b. Therapeutic energy emission: The healer's hands are held near or on the patient. Many of these healers have a strange phenomenon associated with their hands - if they hold an earthworm in their hand, the worm dies within a minute or two. If they go fishing, they need to have a friend with them to put worms on the hook for them.
c. Thought projection: There are people who can heal animals or humans by psychic means with or without the conscious knowledge of the patient. They do not have to be near the patient - they simply pray for or visualise or concentrate/ meditate on the patient and "project healing energy / Qi / Prana" to the diseased area, Chakra or AP points.
How does this relate to AP ? Firstly, the seers of the East and West have claimed that all living things have an Aura, or Energy Field. This aura reflects the mental and physical state of the organism. It responds to the internal environment of the organism and also to its external environment (terrestrial and extra-terrestrial forces). It is the interface between the external and internal environments.
The AP points are the areas where the Energy Field is strongest. In disease, the energy pattern at the AP points changes. These changes can be sensed (by paranormal sight or touch) by psychic people. With some experience, the nature and location of disease can be diagnosed by the changes in the Energy Field. (By telepathic means, trance, clairvoyance or other paranormal means, these changes can be sensed at great distances by trained psychics).
Secondly, healing can be stimulated by altering the Energy Field of the patient so that normal patterns of energy are re-established. Transfer of energy from the healer to the patient causes this to occur.
Those who are trained in the AP method can concentrate more specifically on sensing and altering the Energy Field at those AP points which are most affected. I have given much consideration as to whether or not I should discuss this section on psychic healing with a scientifically trained audience of vet colleagues. There is a danger that my discussion of this section may undermine the credibility of the whole paper, if not my entire credibility as a qualified lecturer ! However, whether we like it or not, there is a growing consciousness of these topics in the West. It is time that scientists discuss the "paranormal" even if we do not accept its validity.
If you are scandalised, please, forget this section and try some of the other techniques mentioned earlier. AP can be explained satisfactorily by orthodox physical concepts without the necessity of invoking the "paranormal". To those of us who have first-hand experience of psychic methods, they merely add another dimension to a fascinating tapestry that is total reality.
CONCLUSIONS
It can not be stressed often enough that successful AP is based on the choice of the correct points. These points may be on the body, limbs, ears etc. (See other papers on this). Methods of stimulating the points are of secondary importance.
Many different methods of point stimulation are possible but care and common-sense should be used to avoid damaging the tissues (Rogers 1981).
The methods used by vets are mainly a matter of personal preference and experience. Although the needle and moxa have the longest history of use, they are likely to be replaced in Western AP by electronic, non-invasive methods, such as laser, TES/TENS, US and microwave. Until then, it is likely that point injection, simple AP, EAP and moxa will remain the most commonly used methods of AP therapy in vet medicine.
FURTHER READING ON PSI-ESP
1. Lethbridge, T.C. (1974) ESP-beyond space and time. Sidgwick & Jackson Ltd., London. Paperback. ISBN 0-283-98378-0.
2. Stelter, A. (1976) PSI healing. (Bantam Books, USA) ISBN 0-553-02505-8.
3. Wilson, C. (1973) PSI healing. (Hazell Watson & Viney Ltd., Aylesbury, Bucks, UK). Paperback (Abacus).
4. Parkes, M.W. (1974) Healing and the wholeness of man. (Regency Press, London). Hardcover.
5. Shealy, N. & Freese, A.S. (1975) Occult medicine can save your life. (Dial Press, New York). Hardcover. ISBN 0-8037-8816-9.
6. Koestler, A. (1975) The act of creation. (Pan-Picador Books). Paperback. ISBN 0-330-24447-7.
7. Schumaker, E.F. (1977) A guide for the perplexed. (Jonathan Cope Ltd., London. Hardcover. ISBN 0-224-01496-X.
8. Castaneda, C. (1974-77) The techniques of Don Juan (Penguin).
(1976) Tales of Power (Penguin) ISBN 0-1400-4144.
(1975) Separate Reality (Penguin) ISBN 0-1400-3558-3.
(1973) Journey to Ixtlan (Bodley Head, London). Hardcover. ISBN 0-370-10482-X.
9. Monroe, R.A. (1974) Journeys out of the body. Corgi paperback. ISBN 0-552-09531-1.
10. Heywood, R. (1971) The infinitive hive. (Pen paperback) ISBN 0-330-23102-3
11. Randell, J.L. (1975) Parapsychology and the nature of man. Abacus. Paperback. ISBN 0-349-12926-6.
12. Rogers, P.A.M. (1981) Serious complications of AP ... or AP abuses? Am. J. Acup., 9, 347-351 (added as an Appendix to this paper).
13. Yu Chuan & Hwang Yann-Ching (1990) Handbook on Chinese Veterinary AP and Moxibustion. FAO Regional Office for Asia and the Pacific, Bangkok. 193pp.