5. AP TRAINING IN TAIWAN, R.0.C.
The quality of AP training in Taiwan varies widely. It ranges from weekend "crash-courses" (which are usually intended as an ongoing part of an integrated study of AP) to formal courses lasting one month to three years. As well as this, one may opt for "self- study" from the human AP textbooks, with or without formal course work.
Unscrupulous people who attend one or two weekend crash-courses (and who may happen to be medical or vet graduates!) may use this as their "qualification" to practice AP. Poor clinical results by such people brings AP into disrepute and unsuspecting patients suffer as a result of the incompetence of the charlatans. This problem is not confined to Taiwan - it is now an international problem.
Each teaching centre has its own methods of assessing its students but the course content and duration vary widely. Taiwan, as is the case in most other countries, appears to have no standard Examination or Assessment Board at State (National) level to assess and certify the level of competence of AP practitioners. Thus, the level of competence varies from excellent (as observed in the VGH and CMC) to poor.
The content (orientation) of courses varies with the teaching centre. In VGH (Taipei) the course content is mainly "Western" oriented - little emphasis is placed on the ancient traditional concepts of Pulse Diagnosis; Five Phase Laws and Points; the Perverse Causes of Disease etc. Because of its closer ties to traditional medicine, CMC (Taichung) places more emphasis on traditional concepts and on traditional needling techniques (tonification/dispersion etc). However, CMC is also very "Western" oriented in its basic undergraduate medical training. Students from this college understand both Eastern and Western concepts. CARF (Taipei) because its faculty numbers include both "traditional" and "Western" doctors, also teaches the two differing concepts. There are many other centres for AP training in Taiwan, but I have no information on them.
The foregoing three organisations accept foreign medical graduates and vet surgeons on their courses. Students attending any of these courses can expect to have extensive exposure to clinical material, because VGH/CMC have their own (large) clinics, and CARF can provide clinical instruction in co-operation with Taipei hospitals. The cost of tuition depends on the duration of the course. For example, medical or vet graduates (who have already studied basic AP techniques elsewhere) may enrol for a 1-month intensive advanced course, including clinical work, at any of the above 3 centres. The cost of tuition plus lectures notes etc is approximately 1200 US $. Specialised courses (for example in E.N.T. diseases; internal diseases; myofascial pain, etc) can be arranged by negotiation with the Faculty.
The concession to allow vets to attend these courses was granted by CMC and VGH in 1982 on the understanding that the techniques learned there would be used primarily in vet practice, or for research purposes. It is recognised and accepted throughout China, Taiwan, Japan and other Far Eastern countries that knowledge and skill in AP is not confined to medical or traditional doctors. Many people learn it as part of their cultural training in the martial arts, TaiQi, QiGong and other mental and physical disciplines. It is also common that one may have a basic knowledge of AP for self-help, or for use in "First-Aid" in minor problems and for family use, for example, the AP or massage techniques to relieve tension headaches; teething problems in babies; indigestion in children; pulled muscles; tension insomnia etc.
I recommend these courses to vet colleagues who may have the opportunity to take an extended holiday-cum-study trip in a most beautiful country. I would advise them to ask for an outline of the course material (and the fees involved) and to make their reservations in plenty of time. Those interested may contact the AP Dept., VGH, Taipei, the AP Dept., CMC, Taichung or CARF, Box 84-223, Taipei.
Accommodation in Taiwan and travel to and from the course is the responsibility of the candidate but each organisation offers assistance and advice, if required.
ACKNOWLEDGEMENTS
My first trip to the Far East was made possible by Drs. Hong Chien Ha and T.C. Hsu of the Committee of the First International Symposium on AP and Moxibustion, Taipei, and by Jen-Hsou Lin of the Committee of the Veterinary AP Seminar, Vet School, Taichung. These men arranged for my travel to and accommodation in Taiwan. Great credit and thanks are due to them for their organisation of the scientific sessions and their fantastic hospitality during my stay, from 14th to 28th November 1982.
My sincere thanks are due to all who helped to make my visit enjoyable and educational; the Taiwan Government, for funding the trip; the organisers of the International Symposium and the Veterinary Seminar, for inviting me; medical colleagues at VGH, Yang Ming Medical College and CARF (Taipei) and CMC (Taichung); vet colleagues, staff and students at the Vet College (Taichung), the Pig Research Institute (Chunan) and the Dept. Animal Husbandry, National Taiwan University (Taipei) for their patience in answering so many questions, and for showing me their skills; to the Tsang brothers for their time, car and generosity; to my friend and colleague, Jen-Hsou Lin, who made it all possible; his wife Li Fei, who fed me, and to their little girls I Chen and I Chien, who made the red-haired barbarian laugh on Yang Ming mountain.
AP ANALGESIA (AA) IN COWS
Summary from Sheila White's article (1982) Murdoch Vet. School, West Australia 6150.
White has recently had good analgesia for 2 abdominal operations in cows. #1 was rumenotomy for rumen/omasal/abomasal impaction.
#2 was large (45 cm) abscess with adhesions in the spiral colon (right incision below the paralumbar fossa).
Three points were used. Cows were >600 kg.
A: BaiHui (GV03, lumbosacral space), depth 5 cm;
B: MingMen (GV04), in the space between lumbar 2-3, depth 4 cm;
C: YaoPang (Veterinary point, at tip of transverse process of Lumbar 1. A long needle (12 cm) was inserted anteriorly (pointed at body of last thoracic vertebra) and angled downwards, to slide under the wing of the transverse process, aimed at body of last thoracic vertebra. Depth 5.5-6 cm.
Needles B and C were joined by copper wire and connected to one lead of 73-10 stimulator. Needle A was connected to the other lead. Frequency 15-28 Hz, square wave.
Analgesia in #cow 1 at 20 minutes.
Analgesia in #cow 2 not good at 20 minutes. Needle removed and replaced. Good analgesia 30 minutes later (i.e. at 50 minutes).
Both operations were satisfactory under EA, with no other anaesthetic required. The operations lasted 2-3 hours. Both cows recovered uneventfully.
Note, for right flank operation, right YaoPang was used. For left operation, left YaoPang was used.
AA ATTEMPT IN A COW IN TAIPEI
by J.H. Lin and P.A.M. Rogers
We attempted to induce AA in a Friesian cow at the Dept. Animal Husbandry, NTU. We have used BaiHui, MingMen and left YaoPang, as described above. The stimulator used was made locally. The frequency was approximately 15 Hz.
The pain stimulus used was to (attempt to) transfix a fold of skin grasped between thumb and index finger using a 1.5", 21 gauge needle. The cow had a very nervous temperament. Any quick touching of the skin (of either flank) by the needle, evoked strong, immediate reflex muscle twitch, and defensive action.
After 20 min. of stimulation, the cow reacted as before to quick needle stimulus and no penetration of a skin fold was attempted because of this. After 30 min. of stimulation, the reaction to quick stimulus was less active but still present on most sites. Then we realised that (because of the nervous temperament of the cow) the reaction to quick needle stimulus might have been due to touch (rather than pain). We then applied slow, gradual and firm pressure on the needle to a skin fold. There was no reaction and it was possible to completely transfix the fold. In c. 9/10 sites tested on the left flank, perinaeum, vulva and upper (posterior) aspect of the udder, no defensive reaction or rapid muscle twitch was elicited on transfixing the fold. Full sensitivity was still present at this time on the right flank and on the right and left thorax.
We concluded that the attempt (our first, using these points) was about 90% effective to the slow transfixion and that the hypoalgesia was limited mainly to the left flank area.
TAIWAN
WOOD -
BEGINNING
0
terrible orgasm of Mother Earth,
Awesome
power in aeons past,
With
mighty roars she came and came-
No
pleasure here, no slippery thighs,
No gentle
fingers, no trembling sighs
But
bowels churning with white heat-
Gushing,
pouring, spewing, heaving
Sulphurous
molten rock:
Taiwan.
FIRE -
BIRTH
Alone and
unattended She,
Her
bearing closed by sand and sea,
Through
gaping wound across Her belly
Expelled
Her screaming child.
Up, up it
rose from ocean floor
To tower
high o'er boiling shore:
Taiwan.
EARTH
- GROWTH/DEVELOPMENT
O'er Yang
Ming peak I saw you born.
Fierce
winds and waves and whistling sprays
Scraped
and shaped your wondrous bays.
On Chunan
plains you saved the corn.
From
little junks you hauled your nets.
In
alleyways you placed your bets.
On
crowded streets you hurried by,
By taxis,
cycles nearly killed.
0
slant-eyed beauty of black eye !
You
caused my semen to be spilled
Ten
billion times:
Taiwan.
METAL
- MATURITY
Young
girls proud in country free,
Young men
summoning TaiQi,
Army
alert constantly
Face the
threat from o'er the sea:
Taiwan.
WATER
- DEATH/REBIRTH
Little
jewel of the East
May your
people live in peace.
May they
never have to see
Obscenity
like Nag'saki.
May the
West learn what you teach:
Hard
work, honour, close family,
Pride of
self and history:
Taiwan.