QUESTIONS
Channel codes used in these questions are: LU, LI, ST, SP, HT, SI, BL, KI, PC, TH, GB, LV, CV, GV.
1. One of the following statements is not correct. Indicate the incorrect statement:
(a) Chinese medicine, as practised in Taiwan, combines the best of "Western" and "Traditional Chinese" medicine.
(b) TCM involves study of AP, moxibustion and Herbal Medicine. The latter is most important.
(c) For all branches of TCM, the medical theory (Yin-Yang, Five Phases, Perverse Causes of Disease, Disease syndromes and Diagnostics) is the same.
(d) In Taiwan, all herbalists are trained in AP and all acupuncturists are trained in Herbal Medicine.
(e) Chinese Herbal Medicine is very valuable in CVA, hypertension, neurasthenia and many other internal diseases.
2. One of the following statements is not correct. Indicate the incorrect statement:
(a) "The Red Book of Chinese Medicine" (by Mao Tse Tung) was the basic text used by most Taiwanese experts in acupuncture.
(b) Methods of selecting AP points for therapy, and of manipulating the needles, were highly individualistic in Taiwan.
(c) There was general agreement that manual needling alone was as good as, or better, than electro-needling for most conditions requiring AP.
(d) Though electrostimulators were freely available in every clinic visited, Rogers saw very little use of electro-AP. Exceptions were: AP analgesia before surgery and in certain chronic conditions, especially paralysis/paresis after CVA or nerve injury.
(e) Great emphasis was placed on a careful search for AhShi points.
3. One of the following statements is not correct. Indicate the incorrect statement:
(a) AhShi points usually are present in pain conditions, such as headache, joint pain and myofascial syndromes.
(b) AhShi points may also arise in some cases of internal disease (lung, heart, liver, gall bladder, gastrointestinal and urogenital tracts).
(c) The Shu points (T3 to S4 on the inner line of the BL Channel) are palpated carefully in internal disease, as are the Mu points (Alarm points on the abdomen/thorax).
(d) AhShi points often arise in joint pain (shoulder, elbow, lowback syndrome, hip, knee)
(e) Headache seldom arises from AhShi points in the neck and shoulder muscles
4. One of the following statements is not correct. Indicate the incorrect statement:
(a) All pressure-sensitive areas are AhShi points but AhShi points are not always Trigger Points (TPs).
(b) The best AhShi point for therapy is the Trigger Point (TP), i.e. palpation pressure on the point causes a pain sensation to radiate to the problem area, muscle, or organ.
(c) The AhShi point seldom occurs within the area of pain. Patients usually are unaware of its presence until it is palpated.
(d) AhShi points always occur far away from the problem area.
(e) AhShi/TP points can recruit new triggers elsewhere, usually in the muscles.
5. One of the following statements is not correct. Indicate the incorrect statement:
(a) Painful areas in scarred tissue may act as powerful TPs and these areas must be treated to obtain optimum results.
(b) Taiwanese acupuncturists placed great emphasis on searching for (and treating) TPs in scarred areas.
(c) Other pain-sensitive areas (motor points, "fibrositic nodules" etc) are useful in therapy but they are not as powerful as the TPs.
(d) AhShi therapy is the best introduction to the benefits of needle therapy.
(e) Unfortunately, AhShi points are not present in every case, and Western doctors who know only the AhShi method are unable to help by needle techniques in such cases.
6. One of the following statements is not correct. Indicate the incorrect statement:
(a) AhShi points disappear when the condition resolves and their disappearance during a course of therapy indicates a good prognosis.
(b) Dr. Chien Chung did extensive clinical research with AhShi points and published the English version of his book ("AhShih point: The pressure pain point in AP - Illustrated guide to clinical AP (1983)".
(c) AhShi therapy consistently gives better results than traditional AP.
(d) Myofascial syndrome involves muscle pain/stiffness, especially around joints. The joints are often stiff, but show no inflammatory or X-ray lesions. There is often a history of intermittent recurrence. The diet usually is satisfactory and the neural causes of the pain are obscure.
(e) AhShi (TP) points often are present in myofascial syndromes, but the patient is unaware of them until they are pressed.
7. One of the following statements is not correct. Indicate the incorrect statement:
(a) AhShi points usually show decreased electrical resistance and decreased local skin temperature.
(b) Local vasomotor abnormalities and dermatographic changes occur in the AhShi area.
(c) Histology of the AhShi area shows local cell infiltration and non-specific inflammatory changes. There is sometimes a fibrous infiltration of the AhShi area (ropy muscle sign).
(d) Pressure on the AhShi often refers pain to the "problem area". Needling the AhShi often causes the "Jump Sign": local muscle contractions cause the needle to jump.
(e) Master acupuncturists always needle the area of referred pain (the area of subjective pain).
8. One of the following statements is not correct. Indicate the incorrect statement:
(a) In myofascial syndromes, AhShi therapy very seldom gives dramatic or immediate relief of pain.
(b) AhShi therapy in myofascial cases can give better results than traditional AP using local and distant points.
(c) AhShi points may arise anywhere in the muscles, but they are often near the problem area.
(d) The most important muscles to search for upper body problems are: infraspinatus, neck muscles and GB21 area. In upper limb pain (shoulder, elbow, arm, etc) the AhShi is often in the infraspinatus of the affected limb. In shoulder pain, sometimes the GB21 area, or scalenus muscle may hold the AhShi. In bilateral anterolateral shoulder pain, the AhShi is often in the sternalis muscle. In such cases, one needle in the sternal AhShi can give immediate pain relief. In middle finger pain, search muscles near TH08.
(e) In abdominal and intercostal pain, check the back and sides for AhShi. For lower body problems search the gluteus, vastus medialis, soleus, gastrocnemius. In heel pain, the AhShi is often in the soleus area, left or right of BL57. In plantar pain, the AhShi is often in the gastrocnemius. In lowback/leg pain, search the gluteus muscle.
9. One of the following statements is not correct. Indicate the incorrect statement:
(a) About 33% of all cases of aching pain are myofascial in origin and respond fast and reliably to AhShi therapy. Expect excellent results in 38% and good results in 60% of cases (98% total cases).
(b) Chung's AhShi findings disagree in major respects from Western experiences of TP therapy, as described by Ronald Melzack (Canada), Pekka Pontinen (Finland) and Alex Macdonald (UK).
(c) Chung found the following points to be useful: Renal colic pain/spasm: GB34, LV03, SP04,06; Gastric colic/pain/spasm: ST36, CV12; Biliary colic/pain/spasm: GB34
(d) Rogers did not see use of Earpoints in Taiwan, but was told that earpoints are sometimes used alone or in combination with body points, with good success.
(e) The most commonly used points use were the Channel points, especially LU07; LI04,10,11,15; ST25,36,37,38; SP04,06,09; HT07; SI03,06,09,11,19; BL10,11,23,40,57,60,62, KI03, PC06, TH05,14,15, GB20,21,30,31,34,39, LV03, CV04,12.
10. One of the following statements is not correct. Indicate the incorrect statement:
(a) GV points were seldom seen used. GV15, needled 2" deep in one patient, appeared to cause a very severe left-sided headache, needle shock and some loss of power in the legs. The patient was being treated for facial paralysis and slurred speech following a minor CVA.
(b) Extra-Channel Points (points not on the main Channels) often were used for their local or distant effects. The most commonly seen were Hand Points "Loin & Leg" between the proximal heads of metacarpals 2-3 and 4-5 respectively. These Hand Points gave immediate relief in some cases of lumbago and lowback/leg pain.
(c) Hand Point "Neck" (between the knuckles of fingers 2-3 with fist tightly closed, needled 1" deep towards the wrist. This point gave immediate relief of neck pain/restricted movement in one patient.
(d) Other points used were: LanWei (Appendix point) in abdominal pain/ constipation, XiYan (Knee Eyes) in knee pain, YinTang (between eyebrows) and TaiYang (temporal fossa) in headache, sinusitis.
(e) As they seldom give good results, distant points were seldom used. For example, the following points gave poor results: ST38, GB39 or GB34 in shoulder or neck problems; LU07 in headaches; TH03, SI03 in neck/shoulder problems.
11. One of the following statements is not correct. Indicate the incorrect statement:
(a) Chung seldom used distant points in myofascial or arthrotic syndromes.
(b) If patient was not helped within 20 minutes, the needles were left in situ for up to 40 minutes and other points (AhShi, Local points) were tried also.
(c) In needle use, operators were very careful to cleanse the skin (alcohol swab), use sterile and/or disposable needles and to touch only the handle (not the shaft) when inserting the needle.
(d) Styles of inserting and manipulating the needle varied between operators but most operators placed great importance on obtaining DeQi after needle insertion.
(e) Chung twirled and pecked the needle very strongly in AhShi/TP points for 15-60 seconds. The patient often had very strong reaction to this (grunts, slight groans, facial grimaces etc). In many cases, the needle was removed within the 15-60 seconds.
12. One of the following statements is not correct. Indicate the incorrect statement:
(a) DeQi has subjective (patient and operator) and objective characteristics.
(b) The patient reports strong sensations ("sore, heavy, tingling, electric shock-like, running, aching but not painful") running, proximally, or distally from the needle. Sometimes the sensation is said to travel proximally and distally.
(c) The patient may grunt, groan, flinch the limb or part being needled. Other responses include explosive intake or expulsion of breath, facial grimaces and occasionally (in strong reactors) sudden jerks involving all or part of the body, and occasional expletives.
(d) The operator usually has the sensation that the needle is being gripped by the tissue, i.e. especially on withdrawal of the needle, (when a definite "nipple" seems to form at the skin surface) or on twirling of the needle (when the needle seems to "lock" at the end of each twirl).
(e) A clear 1-3 cm diameter blanched zone (vasoconstriction) appears around the needle after a few minutes in some patients.