Hello everyone. Thank you for attending this introductory lecture on the use of acupuncture points. Acupuncture is practised in all over the world in various different forms.
In some countries, it is one of the major forms of medical treatment that applies the concepts of traditional Chinese medicine. In other countries, it has become a popular alternative therapy either on its own or in conjunction with modern medical practises. This is commonly referred to as integrative medicine.
Before I begin the lecture, let me introduce myself. I began my integrative career late, beginning about 21 years after I graduated from the University of Missouri Veterinary College in 1983. So for those of you out there who have been practising veterinary medicine for a few years, you can still add this modality to your treatment skills.
This is a summary highlighting my accomplishments as a veterinarian, and integrative veterinary practitioner, instructor, and lecturer. I am fully retired from active practise, but I continue to teach and present at various different venues such as those listed below. I would like to acknowledge my affiliation as a paid basic course instructor to the International Veterinary Acupuncture Society, a nonprofit organisation that was established about 52 years ago with affiliates all over the world, and their goal is to teach traditional Chinese medicine and acupuncture to veterinarians.
Should you choose to take a photo of my PowerPoint slides, you have my permission, as long as it will be used for your own personal non-commercial use and will be not used in any republication of in any form without my written permission. I would like to take the time to discuss the basic concepts of traditional Chinese medicine. In simplistic terms, q is the body's vital energy.
It has been established that chi, or electromagnetism, exists all over the body within the very atoms that make up our bodies. Q is fluid and wears different hats, assuming various forms to fulfil necessary functions based on the need and the body location. Nutritive chi nourishes the body.
Defensive chi protects the body from the environment. Heart chi maintains heart function. Similar to Western medicine, blood carries the nutritive resources necessary for life.
In TCM, blood and chi are dependent on one another. The blood carries the chi, and the chi is a force that moves the blood. When not travelling within the blood vessels.
Q also moves through the body within meridians or channels. There is no Western structural counterpart to these channels. Visualise the channels as pipelines or highways crossing the body.
In traditional Chinese medicine, qi energy flows as either as yang energy or yin energy. The dualistic yin and yang theory applies to everything in nature. The yin components are darkness, cold, nighttime, the interior of the body, and the resting phase.
Yang aspect is associated with the light, warmth, daytime, exterior parts of the body, and activity. In addition, males are considered to be yang and females are considered to be yin. In nature and within our bodies, there is a constant balance flux between the yin and the yang.
Within a healthy individual, the flow between yin and yang is balanced, allowing the qi and blood to move freely back and forth smoothly through the body, ensuring healthy organ function. In the unhealthy individual, a prolonged imbalance between the yin and yang results in the qi, the blood, or both becoming overabundant, absent, or obstructed, and this then results in tissue and organ dysfunction. TCM medicine uses many approaches to restore that balance between the yin and the yang, and one of these approaches is acupuncture.
Acupuncture is the practise of inserting small needles into specific points in the body originally based on the principles of traditional Chinese medicine. However, clinicians unwilling to accept those concepts now insert the needles solely based on the concepts of the neurological system, and this is referred to as either medical acupuncture or dry needling. One of the ramifications of treating patients only via medical acupuncture is that it limits the clinician to treating only local localised pain and trigger points.
Traditional Chinese medicine acupuncture allows a clinician to treat a wide range of medical conditions, including seizures, emotional imbalances, endocrine problems, reproductive issues, and things like inflammatory bowel disease, cancer, etc. The accupoints are identified based on their channel location. From the traditional Chinese perspective, the channels are described as energetic pathways traversing the body, and they carry the qi and blood through the body.
The channels are listed on this slide. I do want to tell you though that these channels here. They, there is one lung channel on the right side of the body, and then there is one lung channel on the left side of the body.
There is one gallbladder channel on the right side of the body, and there is another gallbladder channel on the left side of the body. So, there's 2 lung ones, there are 2 gallbladder 34s, there are 2 liver 3s. The governing vessel and the conception vessel, there, they are not paired.
They're the governing vessel runs along the dorsal midline of the body, and the conception channel runs along the ventral midline of the body. The World Health organisation recognised the necessity of developing a common language and standardising the acupuncture locations to facilitate increasing levels of research worldwide. In 1991, the World Health organisation issued the standard International acupuncture nomenclature report.
In this report, the names and the locations of the 14 channels were defined, as well as the 361 points located on the 14 channels. All acupuncture points have a local effect on healing and pain as well as medical conditions. Individual acupuncture point functions or influences are dependent on three factors where in the body, the specific channel, and the location within that channel.
In traditional Chinese medicine, the transporting points, those located between the fingers and the elbows and between the toes and the knees, have long been regarded as the most effective. It is seldom that you find a point prescription does not include at least one or more of these points. The traditional Chinese medicine reasoning for their impact is that the qi, the energy, and the blood, nourishment, they lie closer to the surface at these points.
This enables the needle easier access to the qi in the blood, thus increasing its ability to influence the body's responses. From the Western perspective, research done by Yun Tao Ma demonstrated that these points, when needled, stimulated large regions in the brain's sensory gyrus. Essentially, these acupuncture points are located in areas of the body with a higher concentration of sensory receptors connected to the brain.
The more receptors stimulated, the higher the degree of influence. This slide shows the pathway of the stomach channel as it flows over the body. It begins at a midpoint between the medial and lateral canthus of the eye just below the eyelid.
It heads toward the commissure of the mouth and then travels along the craniolateral aspect of the neck, along the ventral abdomen. Stomach 25 is lateral to the umbilicus. It Heads toward the pubic area.
At the pubic area, it then travels cranial medially along the thigh and along the medial aspect of the patella. At stomach 36, it now hitches over to the cranial lateral aspect of the tibia and rides then along the lateral aspect of the tibia all the way to digit number 3. Every point along the stomach channel has a local effect on wherever that point is.
Every point along this channel has an effect on the organ, the stomach organ that's associated with the channel. The effect of that on the stomach is dependent upon the location of the point on the stomach channel. And then again, the points that are between the knee and the toes tend to be more influential and more dynamic than those that are located around the head, the neck, or the ventral abdomen.
Despite acupuncture's high safety margin, there are situations where acupuncture and specific acupuncture points are contraindicated. One, never place or insert a needle within an open wound, whether or not it's clean or dirty. Number 2.
Never place a needle into CV8. CV8 is located within the centre of the umbilicus. I freely admit I do not know why.
It's just stated in the classical texts and by previous instructors, and I know of no colleague of mine that has attempted to go against the rule. Because acupuncture immediately increases the blood flow to the local area, this would possibly accelerate cancer growth. So avoid needling within a tumour near a cancer site, and this also includes areas of surgical resection.
Never use electroacupuncture in seizure patients. Electroacupuncture involves the use of adding electrical energy when stimulating the acupuncture point. The addition of the electrical energy is to increase the needle effects within the body as well as the duration of the effects.
While it can be used for any medical condition, it is primarily used in the veterinary world for paresis or paralysis. The points listed on this slide are contraindicated in pregnant patients, especially those in late pregnancy. You can use these points in early pregnancy, using maybe one or two.
Using multiple points on this list increases the risk of premature labour. The combination of stomach 36, spleen 6, liver 3, and large intestine 4 is often used to promote delivery during labour. Acupuncture is not contraindicated in patients with bleeding issues.
After all, the acupuncture needles are tiny compared to intravenous catheters and phlebotomy needles, but cautions should still be applied when placing the needles. Monitor insertion depth, especially in the areas where you have a potential of organ puncture, pneumothorax, or pneumoperineum. And finally, in the very old, the very young, the weak, or the debilitated, place as little needles as necessary.
All individuals have a finite amount of energy. The healthy you are, the more energy you have. Every time you insert a needle, you actually tap into and influence the energy reserves.
The very old, the very young, the very weak, the debilitated, they have severely decreased amounts of energy. Too many needles in these patients can overwhelm them. Too many needles can actually cause a dilution effect.
The needles actually begin to cancel each other out. When I practised, the maximum amount of needles that I attempted to place would always be 20. My average was typically 10 to 16 needles, and in the very weak, the very emaciated, the young, the very old, I would always put 10 or less needles.
Before I proceed into the discussion of acupuncture points, I would like to discuss a treatment protocol called Circle the dragon. When a needle is placed into the body, a series of events occurs. They include increased blood flow to the area, the initiation of the inflammatory cascade with the release of cytokines, immune factors, and more, all involved in the healing process.
The protocol is only used when the wound is clean. Although the wound on the left looks rather ugly. It is still a clean wound.
The slide lists various situations where circled the dragon would be appropriate. The last one, a toxic scar. From the TCM perspective, a toxic scar is a scar that impedes the flow of the qi and blood through the channels where the scar is located.
One example is a scar following a C-section. Many women, after a C-section, they have problems with various different reproductive problems or pain in the area of the stomach, etc. And that one is called a toxic scar.
The protocol involves placing the needles surrounding the healthy tissue, and the needles are placed about 0.5 inch or like 1 centimetre or so away from the margins of the wound. You angle the needles toward the wound.
At an angle, and the first needles that you put in are essentially put in at the 3 o'clock, the 6 o'clock, the 9 o'clock, and the 12 o'clock position. So you're one, you surround them in that manner. After placing the anchor points, you can then add more needles within and between the anchor points.
There's no reason to place this amount of needles around a wound unless the wound is quite large. Again, try to keep 20 needles or less. Leave the needles in place for about 20 to 30 minutes and remove.
How often can you do this? You can actually do this as. Often as you'd like.
You could do it daily if you saw the patient on a daily basis, but more than likely, the majority of times that you're going to see your patient is maybe once or once a week or twice a week, during the time period that you're having this wound heal. If you're one of the lucky ones that the patient is in there, in your clinic, and is having hospitalised care, go ahead and treat that patient on a daily basis. The location of the acupoints on our patients are transposed from human anatomy using human descriptions.
They then apply them to the species anatomy. The Chinese realised many generations ago that due to differences in individual size, absolute measurements of inches or centimetres could not be used to work around this conundrum over the centuries, they developed the relative unit of sun. Different body parts have different soon measurements.
For example, the medial aspect of the hind limb from the stifle to the hock is divided into 13 soon. So it's 13 equal proportions between here and here. But the lateral aspect of that from the stifle to the hock is divided into 16 equal proportions.
The location of the acupuncture point is then described as a soon distance from like the medial malleolus or the lateral malleolus. In other parts of the body where the soon proportions are not identified, and in our patients we're talking about the thoracic region, one soon is equal to the width of that last rib. In some of the textbooks they talk about it being the length of the first tail vertebrae, but who can really actually measure that.
Some of the acupuncture points are described as a proportional difference between a body landmark or an acupuncture point. So for example, CV12 is defined as being the midway point between the sternum and the umbilicus, which would be right about here. So between the midway between there and there with CV12 in that position where the dot is.
The points that we will be discussing throughout the rest of this lecture are commonly referred to as empirical points. These empirical points have consistent effects and are effective on their own. Additionally, because they have these consistent effects without other points, they can be used without traditional Chinese medicine training.
When I am describing the location of the point, the descriptions are primarily for cats and dogs. They can be transposed to other mammalian species like the rabbit, the rat, the mouse, even the guinea pig. However, many of these point locations, especially on the distal limbs, may not be correct for the equine species.
So, our first point we're going to discuss is stomach 36, and stomach 36 is located on the stomach channel that runs from the midpoint just below the eyelid margin along the cranial lateral aspect of the neck, as well as along the ventral midline, just offset from the midline into the pubic area, and then out to the craniolateral aspect of the leg, where stomach 36 is located to digit number 3. Stomach 36 is called the master point for the abdomen and the GI tract. This point is by far the most essential homeostatic point within the body.
From the Western perspective, one would assume that from its name, as the master point for the abdomen and the GI tract, it would limit its actions to only the abdomen and the GI tract. It is far from the truth. In TCM medicine.
It is effective for any medical condition. In TCM medicine, it is a bidirectional point. The reaction of the body is then dependent upon the medical condition.
It can be used for both diarrhoea or constipation. If the body has diarrhoea, the body is influenced in the opposite direction so that it would form more solid stools. If the patient is suffering from constipation, it influences the body to have softer stools and to enable the body to push the faeces out.
For those of you who are not practising TCM medicine, this point is most often used for any GI issue from the mouth to the anus, so that it would involve tooth pain, vomiting, anorexia, esophageal dysfunction, diarrhoea, constipation. And if you think further, the GI system is the organ system that supplies your body with energy. Therefore, this point is an excellent point for those patients who have a lack of energy, who have muscle atrophy.
And if you think of nutrients, you know that the production of nutrients also includes the production of blood. This point is an excellent point when you have any blood issues, causing bleeding, anemias, in fact, even those that are involving high or low blood pressure. As I alluded to earlier, all acupuncture points act as local points.
Therefore, stomach 36 is a local point for the knee. However, because it also helps to supply energy to the body, it is often used for hind limb issues that involve weakness, paresis, and paralysis. This point is commonly used for inflammatory conditions, fever, infections.
It's also beneficial in metabolic issues and abdominal masses. It can be used for mental issues involving anxiety, insomnia, or loss of consciousness, but it is not the best. There are other points that are more that are more effective.
The combination of stomach 36, large intestine 4, liver 3, and governing vessel 20 is used for the sympathetic regulation of arterial blood pressure. It is more commonly used to increase blood pressure, but because stomach 36 and large intestine 4 are homeostatic points, it can be used to lower blood pressure. The combination of large intestine 4, spleen 6, liver 3, and stomach 36 is the base formula for promoting delivery.
Again, any of these points by themselves in pregnant patients should be used in caution, and the combination of these points should definitely be avoided in late pregnancy. Bladder 67 is a specific point commonly used in human medicine for foetal malposition. In our patients, this point is located on the lateral aspect of the nail bed on the 5th toe.
Stomach 36 is located in the depression just lateral to the distal aspect of the cranial border of the tibial tuberosity, the tibial crest, and approximately in the middle of the cranial tibialis muscle. So in this point what you would do then is you would locate the best way to do this is to actually locate and palpate the patella. Then put your fingers on either side of the patella, ride it down till it hits the tibial tuberosity.
The cranial aspect, or should we say the proximal aspect of the tibial tuberosity, then you follow the crest down all the way to the most distal point. The point now is located at that level to then finalise it. You would then isolate the cranial tibialis muscle, and the cranial tibialis muscle is easy to find because it is the most cranial lateral muscle along the tibia.
And at that level, at the distal aspect of the tibial tuberosity, the tibial crest, right in the middle of the cranial tibialis muscle is the location of stomach 36. 1 of the problems that occurs though, is that. Cranial, the cranial tibialis muscle is a rather thin muscle on the dog and the cat, and there is another muscle that runs along right here, and I can't remember the name of it in all honesty, but what you have to do is you have to make sure that you are not grabbing.
The two muscles that run together because it's a little bit of a subtle division between the two muscles. If in the dog, unless it's a large dog or as definitely in the cat, if this muscle is more than a thumb's width, then you are probably grabbing the two muscles that are lying side by side. Spleen sex is called the master point of the caudal abdomen and the urogenital system.
However, this is somewhat misleading. Instead of thinking just the caudal abdomen, spleen sex is actually effective within the entire abdomen. So with this in mind, anytime you have a problem within the abdomen or the urogenital system, you can use spleen 6.
Spleen 6 is often used to promote parasympathetic regulation of the body functions that involve the rest and digest or feed and breed functions of the body. Similar to stomach 36, it is effective in all GI issues diarrhoea, anorexia, vomiting, inflammatory bowel disease, esophageal issues. You can use it for diseases of the oral tract that involve gingivitis, dental pain, or stomatitis, but it is not as effective as stomach 36.
Similar to stomach 36, because it is also involved in the production of nutrients in blood, it is also useful for the generalised weakness and muscle atrophy conditions. Because it is also involved with the production of blood, it can be used as an immunostimulant for anemias, for low white blood cell counts. This point is more effective for bleeding issues than stomach 36, and it is most effective if the bleeding is occurring within the bowels or the reproductive tract, primarily the uterus.
At spleen 62 other channels intersect with it. The intersecting channels are the liver and the kidneys. In TCM metaphor, whenever there's an intersection of a channel, this enables that point at that intersection point to exert an effect on the intersecting channels.
Therefore, spleen 6 can also be used for any liver or kidney condition. And because the kidney is associated with the reproductive tract, the reproductive system per TCM medicine, spleen six can be used for problems that involved the reproductive tract. Primarily, we're talking about conception and fertility.
It is also useful again for pain and paralysis, but it's not the primary point. It must be usually used in conjunction with other points. It can also, similar to stomach 36, be used for anxiety and insomnia, but similar to stomach 36, it is not the best point.
Again, it is one of the major points in that basic point prescription that helps to promote delivery and is contraindicated in late pregnancy. To locate this point you must utilise that concept of sun I alluded to earlier in the lecture. This point is located on the medial aspect of the tibia, and the medial aspect of the tibia is from the stifle.
To the to the hawk is equivalent to 13 equal units. So the description says that the point is 3 soon proximal to the tip of the medial malleolus. So the medial malleolus is here.
So from here to here, it's 13. Halfway is 6.5, halfway is about 3 1/4, and a little below that is 3 soon.
At this level then. Is where the point spleen 6 is located. So the final description says that it is at the caudal border of the tibia.
So whenever I put the point in, I locate that level, then I'll place the needle, and I actually ride along the caudal border of the tibia and insert my needle, and you have spleen 6. Large intestine 4 is the master point of the face and the mouth. Therefore, it can be used for any medical condition involving the areas of the face, the mouth, essentially the head region.
It is very effective for problems involving the respiratory system, especially those involving the nose. Large intestine 4 on its own is effective in addressing pain in the head, including pain in the soft tissues of the mouth, the teeth, as well as headaches. The large intestine channel starts at the medial aspect of the 2nd digit on the front limb.
In general, it travels along the lateral aspect of the front limb and the neck, goes around the mouth, then crosses under the nose to a point lateral to the nares on the contralateral side. So essentially it starts on digit 2 on the right side and ends at large intestine 20 on the left side of the face as a result of this pathway and its distal location at the toes. This point is effective for clearing pain in the front limb and neck as well as with problems with the facial and trigeminal paralysis.
Large intestine 4 is also called the one source point of the large intestine channel, and when a point is designated as the one source point of that specific organ, it is the most effective point for treating that particular organ, in this case, the large intestine. So if you have a problem that involves a large intestine, and in in metaphor, it also includes a small intestine, using large intestine 4 is very beneficial. The combination of liver 3, stomach 36, and GV20 with large intestine 4 is useful for regulating blood pressure, and then of course it is one of the 4 points in that basic point prescription for promoting delivery.
Large intestine 4 is an easy point to locate. It is on the medial aspect of metacarpal 2, approximately in the middle. If the dew claw is present, you may have to move the dew claw out of the way.
For the human location. Place your thumb alongside your index finger. When you do this, you'll see a bulging muscle next to the thumb.
Now place your index finger in the middle of the bulge. Open your thumb, and now roll your finger onto the medial aspect of metacarpal 2. At that level is large intestine 4.
In patients that have pain in the body, especially if the pain is involving the front limb, the neck, or the head, this point can be extremely sensitive. Lung 7 is the master point for the head and the neck. Again, it is a homeostatic point.
However, unless you have TCM training, this master point of the head and neck tends to be a bit misleading. For those of you with no training, you will use this point primarily for respiratory conditions, any respiratory condition, asthma, pneumonia, rhinitis, tracheal bronchitis, a cough, although it can be used for other medical conditions. Of the head and neck, like tooth pains, stiff pain, stiff necks, facial paralysis, front and leg, front limb or shoulder pains, it is seldom used on its own for these medical conditions.
If you do choose to do so, combine it with large intestine 4. For those of you that may have some TCM training, a practise tip for deficient lung medical conditions, use lung 9 in lieu of lung 7. For respiratory conditions that involve damp heat, essentially anything that involves inflammation with a respiratory condition, it may be better to use lung 5 versus lung 7.
Lung 7 is not the point for use for emergency respiratory situations when the patient can't breathe or is turning blue. Instead, you use CV 22. CV 22 is an easy point to find.
Find the tip of the manubrium, and it is directly proximal to the tip of the manubrium. So on your own body, find the manubrium, roll over the tip of it, and that is where CV22 is. It's the same location in the dog.
Lung 7 is described to be 1.5 soon proximal to the transverse crease of the carpus, and what is the transverse crease? Bend your hand, your wrist up and down, and as you bend your wrist down, you'll see a crease form that is the transverse crease.
The distance from the transverse crease to the elbow crease on the medial aspect of the radius and actually on the lateral aspect of the radius also is 12. So the halfway would be 6. Then halfway from that would be 3, and then halfway from that would be 1.5.
So, the point then is 1.5 soon from the transverse crease. It goes on to say that that point is proximal to the most medial prominence of the radial styloid process.
The prominence of the radial styloid process is right here, and it's proximal to that on the level of where you determined 1.5 soon is. I find it easier to tell my students the following way to discard to locate lung 7.
What you do is you palpate that most medial prominence of the radial styloid bone. And then follow the ridge down toward the body of the radius. At the level of 1.5 soon, just before it reaches the body of the radius, you'll actually feel a little bit of a divot, and that is where lung 7 is located.
Point number 5, PC 6, known as the master point for the chest and the cranial abdomen. Again, this is a homeostatic point and that it can increase or decrease the heart rate depending on what's going on in the body, or it can increase or decrease mental activity. It is the most effective point for nausea on its own, and it is especially.
Effective when combined with bladder 21. Don't worry, we'll go over bladder 21 later. It is also a point that is commonly used whenever there is any type of thoracic issue involving the, the cardiac problem involving chest pain, involving lung issues.
It is also often used on its own and often in conjunction with other points to help with mental disorders of anxiety and insomnia. I have found that this point is one of the more difficult points to locate for people on the dog. Again, soon measurement is also used, so it is described to be too soon proximal to the carpal crease.
So here again, then, let me use the get the little dot. You have from here. To here, it's 12 soon.
So halfway would be 6, and then halfway would be 3, and then a little below that would be 2. So at this level, you would have your 2 soon. Now it says specifically that it's between the tendons of the flexor carpi radialis and the superficial digital flexor.
So the flex superficial digital flexor is typically the big muscle that's running right here, and the carpi radialis tendon, you can actually use your finger and flick that tendon. And in the dog, you can actually, it's a very thin tendon and you can actually flick it. So it's between that muscle band and that tendon at the level of too soon.
One of the things that you have to realise though is the muscle descriptions in the human, it's different. They say it's described between the tendons of the palmaris longus muscle and the flexor carpi radialis, and the best way to find that in you as a human, I had to go look at this, is essentially create a fist, and once you create a fist, you'll see two prominent tendons. And with that prominent tendon, then you will know too soon below the transverse crease in between those two tendons is PC6.
So, if you use those little nausea bands, that is where you would, you would place the little ball, and then that elastic band would be at the level of too soon, and then the ball would be between those two tendons. I created this slide to give you a comparison of where PC6 is and lung 7. PC 6 then is again between the superficial flexor digitorum and then the flexor carpi radialis tendon at the level of too soon.
Lung 7 then is just proximal to the radial styloid process right along that ridge. So PC 6 is caudal. To lung 7, and they're really pretty close in distance away from the transverse crease cause lung 7 is 1.5 and PC 6 is too soon away from the transverse crease.
Our 6th point is liver 3. Liver 3 is the one source point of the liver. The one source point is almost always the most effective point for that specific organ system.
Therefore, liver 3 is the most effective point for any liver associated medical condition. Additionally, the gallbladder is strongly linked to the liver in both Western and Eastern medicine as well as structurally. This point is effective for any gallbladder medical condition.
It is the most effective point when dealing with blood and qi circulation. It's a very effective point for blood disorders including anemias and low blood cell counts. It's one of the more useful points for anxiety and insomnia.
If anxiety, consider using both PC6 with liver 3. At this time, I would like to discuss the concept of pain from the traditional Chinese perspective. When a patient is suffering from pain.
The TCM perspective says that the patient's qi or blood is not moving. They could be partially obstructed or they could be totally obstructed. Partial obstruction results in mild to moderate pain, while total obstruction will result in severe pain.
The treatment goal then is to move that qi or to move that blood. Liver 3 is the most effective point in moving blood and moving qi. By itself, if combined with large intestine 4, it's even more effective because then it goes against those moderate to severe levels of pain.
We've already discussed that large intestine 4 was effective for pain located in the head, but for those really severe migraines, combine it with liver 3. Another TCM metaphor are wind patterns. Wind is indicated when a medical symptom appears suddenly or when a medical symptom or symptoms, they appear, then disappear, and then 2 or 3 weeks later they appear and disappear again.
Another aspect of wind is the variability of the range of severity. It goes from mild to moderate to moderate to mild back to severe again, changing hour to hour or day to day. All conditions that involve shaking, such as seizures, tremors, nervous tics, muscle fasciculations, those are also considered to be wind conditions.
Itching is a wind condition because it comes and goes, and in most instances the degree of discomfort varies from hour to hour or day to day. Wind patterns also include dizziness or vertigo. Liver 3 is one of the most effective points in helping with these medical conditions.
In summary, liver 3 combined with large intestine 4 is a common point prescription. The combination is called the 4 gates. They are useful in conditions of pain, wind patterns such as seizures and tremors, headaches and anxiety.
The second combination of 4 points are often used in human medicine for blood pressure control, and of course, the combination of the points in the 3rd section is used for promoting delivery and contraindicated during late pregnancy. Liver 3 is located on the dorsum of the foot between metatarsal 2 and 3 just proximal to the metatarsal phalangeal joint. GV 14 7.
This point is another bidirectional point. It reduces heat as well as increases heat, so it can be used for patients that have fever or heat stroke. And at the opposite end of the spectrum, if the patient lacks energy or is very cold, it can warm them up and increase their energy.
This point is used for immunodeficiency problems. It can help with anemias, with low white blood cell count. Due to the location, it is very helpful for any type of cervical pain along the vertebral column.
Because of its location, the nerves that go down to the front limbs, down to the fingers or the toes, it is very helpful for forelimb problems, and it is often used for mental disorders, anxiety, insomnia, apathy, dullness. It is more often, however, used to increase mental activity. GB 14 is located on the dorsal midline at the base of the neck.
There's two methods of, locating this. You can first follow the dorsal processes of the thoracic vertebrae, and as you're bending the neck up and down, you will actually then fall. Into an area just in front of T1.
That's where GV 14 is. Another method is to actually come downward from the head along the dorsal midline, bending the neck up and down, and then once again, is you'll fall into the area just in front of T1. To enhance the effect of GV-14, combine it with the tip of tail points.
The tip of tail point is a point in the centre of the tail tip, and the dog is called Weijian. In the cat, it is Weiduan. You can also use these points for patients with bilateral hind limb paralysis.
Practise tip number one. These points are very potent when used together and can be overwhelming in the debilitated or the elderly. If you are using them for heat stroke, as you are advised to stop aggressive cooling techniques when you reached a temperature of about 103 to avoid hypothermia, remove these needles at the same time.
If you are using them for paralysis in the elderly or the debilitated, don't leave these points in for extended periods of time. Remove them after about 20 minutes. GV 20 8.
Again, another homeostatic point. This point is used primarily for its calming effect. It decreases anxiety.
It can increase the mental faculties, but the majority of people will use this. To decrease anxiety. This is the one that in a human is right at the top of the head, and people will have that placed in them if they have a lot of anxiety and they go to their acupuncturist.
It is also used similar to GV-14 as an immunostimulant. This point is immediately rostral to the sagittal crest right on the dorsal midline. Other than the calming effects, it is also helpful for problems with the nasal area, the ears, and vertigo.
I found that the best way to needle this point in my patients was to actually needle from the top of the head down toward the nose. In humans, this point is an intersection of a line drawn from the middle of your two ears, and they meet along the dorsal midline, and where they intersect at the very top of your head is GV 20. I added this point because some of my colleagues use this point more than GV20 for calming effects, or they use a combination of the two to get an enhanced effect.
Again, this point is located. Yintang is a black and It's located where you draw a line from the lateral canthus to the other lateral canthus, and where they intersect with the dorsal midline is yin tang. And again, the best way to needle is to go from the top of the head towards the nose.
The 9th point, GV 26. This point is commonly referred to as the resuscitation point. It's used for stimulatory effects to increase brain activity, increase the heart rate, increase the respiratory rate.
It increases. Endorphin release. It is primarily used for situations for the neonates that are having problems with bradycardia or, or dipspnea, anaesthetic complications, medical induced comas, or shock situations.
The location of GV 26 is at the intersection of two lines. The first line runs downward along the philtrum. The second line runs along the ventral border of the nares.
At their intersection is GV 26. The stimulation of this point is strong. This point is for emergency situations to restore respiration, reverse anaesthesia, increase the heart rate.
You choose the largest needle, typically a hypodermic needle, not an acupuncture needle, and you peck away at this point, hitting the bone beneath. And if at all possible, add CV 22. CV 22, as I alluded to earlier, is the emergency point for respiration, and it's located proximal to the tip of the manubrium along the midline.
I came across this article on a study comparing the use of GV26, kidney 1, and conventional Western medical techniques of positive pressure ventilation and oxygen mask therapy. The study was done by the neonate Research Group at the University of Veterinary Medicine in Brazil. 60 apneic bradipnic or dipsnic or bradycardiac newborns were randomly assigned to the following groups.
The stimulation of acupuncture GV 26 alone, 20 were assigned to that. Stimulation of acupuncture of kidney 1 alone, 20 were assigned to that, and the remaining 20 were assigned to the use of conventional resuscitation procedures of the positive pressure ventilation and the mask oxygen therapy. There were no significant differences between the use of GV 26 and kidney 1 by themselves.
Both led to clinical improvement and stabilisation of the heart rate and the respiration rate. However, in the clinical observation of the patients. That received conventional resuscitation manoeuvres first, positive pressure ventilation and mask oxygen therapy, 7 of those 20 animals, it was necessary to use advanced resuscitation manoeuvres such as cardiac massage and the use of epinephrine.
There was no need for any other resuscitation procedures in the groups that had GB 26 or kidney 1 alone. This demonstrates that starting neonatal resuscitation with acupuncture points was more effective than starting with the conventional resuscitation manoeuvres. The bladder channels begin at the medial aspect of the eyes.
They travel up the forehead over the dorsum of the head and then run parallel to the vertebral column on either side, ending at bladder 67 on the lateral aspect of the nail bed of the fifth digit on the hind limb. The 10th point is actually a group of bladder points aligned along the thorax and lumbar region, and they are called association points. They are called association points because each of these bladder points has a direct connection to the organs associated with it.
For example, bladder 18 is a liver association point, and it has a direct connection to the liver. Bladder 23 is the kidney association point, and it has a direct connection to the kidney. This organ connection is explained via the embryological development involving sclerotomes, myotomes, and dermatomes.
Referring back to the slide showing the soon proportions along the vertebral column. The one sun is equivalent to the width of this last rib. This slide illustrates the location of the various different points.
So, liver, the bladder 18 is the liver association point. It is 1.5 soon off of the thoracic vertebrae T10.
The kidney, bladder 23 is 1.5 soon off of midline at the level of L2. The bladder points are almost always placed bilaterally on either side of the vertebral column as compared to a point such as liver 3.
There are two liver 3s. There's one liver 3 on the left leg, and there's one liver 3 on the right leg. It is very rare that you put both liver 3s in, meaning putting a needle in both the left leg and the right leg at liver 3, but with the bladder points, you almost always put them both in.
So if you have a liver problem. You put bladder 18 in. If you have a problem with anorexia, vomiting, or some type of GI issue, you put bladder 20 in.
If you have a stomach problem, specific to the stomach, you also have that anorexia vomiting, but you also have maybe, gastric ulcers, that type of thing. You put bladder 21. Have a kidney problem, any type of kidney problem, kidney stones, kidney infection.
It also involves the bladder, so bladder infection, you would put bladder 23. On this page, I've placed some basic appoint prescriptions that you could use without any TCM training in reference to some of the more common medical conditions that you may see in your patient. I often get asked what needles I use.
When I first started practising acupuncture and as a novice acupuncturist, I actually went out and bought all sorts of different sizes of needles and everything like that, and I realised after about 3 to 5 years, probably closer to 5, that you don't need different size needles if you are a small animal practitioner. The largest needle that you should really have is probably no longer than 0.5 inch, because the acupuncture points are located at the superficial level.
The only reason you go deeper than 0.25 inch to 0.5 inch is because you want to set the needle in the skin so that the needle cannot be easily displaced.
I finally chose when they came out, they came out with these plastic coloured, needles. The hubs were plastic and coloured, and this makes it quite a bit easier for you to locate the needle in the middle of all that hair. You, if you do electroacupuncture, what you do then is you would connect the electroacupuncture, clasp just at the, just below the plastic hub.
So, you can still use electroacupuncture with these needles that have the plastic hubs. And with that in mind, then, I use this size, Diameter and this length of 15 millimetres more, whether or not it was a cat, whether or not it was a 2 pound dog, or whether or not it was a 120 pound dog. I did keep some small, what we call sarin hand needles in for the small, small exotics, and they are even tinier than the needle, than the half an inch.
The angle of needle insertion is dependent on the body area along the dorsal midline. Most practitioners will place perpendicular to the body plane. In the other areas of the body, the limbs, especially when encountering bony prominences, the ideal is to go at a 20 to 30 degree angle.
The needle direction, either going up or angling down, is based on clinician preference and clinician training. The more classically trained individuals will angle the needle based on the effect that they are wanting to produce. The traditional Chinese medicine practitioner is taught to manipulate the needle in various different ways.
For those of you with no TCM training, I advise you to use what we call the even needling protocol, where you don't manipulate the needle in any excessive way. You place the needle with medium force, you remove it with medium removal, which means you don't remove it too fast, you don't remove it too slow. The needle retention time is typically 20 to 25 minutes.
However, if you have a patient that has an excessive condition, they're feverish, they're hot, there's pain, those needles should be left in 25 to 30 minutes. And if you have a patient that is very elderly or very weak, then leave the needles in 15 minutes or less, ideal, no more than 20 minutes. Lasers can be used for acupuncture point stimulation.
In all honesty, lasers are my second choice. I used my laser primarily for cats because of their lack of tolerance for needle insertion. You usually will be able to get two into a cat before they become a little bit testy.
The small wiggly exotics do well with the laser like ferrets, guinea pigs, etc. The crazy dogs that cannot sit still, you put one needle in and 4 go flying out. The needle phobic animals that for any little bit of pain they start to overreact, as well as the needle phobic owners.
There are many lasers offered for the veterinarian. Some are less worthy than others. If you are purchasing a laser primarily for acupuncture, the key factor is the ability to focus that beam to a specific point on the body, not an area of the body.
Should you be interested in what laser I use, reach out to me and I'll give you that information. I will give you a practical tip that it took me a while. As soon as you can afford the expense of a handheld laser, buy it.
The decrease in frustration in dealing with these patients will make it all worth while. Thank you for attending this webinar lecture. I hope that I was able to give you some practical information that you can use in your practise.
Should you have any questions in the future. Feel free to email me, but remember to put in the subject line Webinar EU. I do not open emails if I do not recognise the sender's email address.
Some of you will encounter a memo that asks you to fill out a form. And every so often one in 20 people or so has a problem with the form. Don't worry, I check the suspected folder often and your email will be in that folder and I will see it.
Once again, thank you for listening to my webinar.
