History

Acupuncture, together with Chinese herbal medicine, form the basis of Traditional Chinese Medicine or TCM, one of the oldest systems of healing in the world. Although relatively few animals in the UK are treated with Chinese herbal remedies, the demand for acupuncture is growing steadily.

Surprisingly veterinary acupuncture has a long history and is linked closely with the history behind human acupuncture. TCM was practised around 1700 BC but there is some evidence that acupuncture was used to treat animals during the Zang and Chow dynasties, around 2000-3000 BC. The first real medical text to detail acupuncture did not appear until 300 BC during the Chou dynasty. The “Huang Ti Nei Ching”, The “Yellow Emperors Classic of Internal Medicine”, was the medical bible of the time and gave descriptions of nine different types of acupuncture needle as well as details of the meridians and the locations of 365 acupuncture points together with their uses.

The use of acupuncture to treat disease was largely confined to China until the 1600’s when it was briefly introduced into Europe, rapidly falling into disrepute until the late 1920’s and early 30’s. Veterinary acupuncture first really emerged in Europe in the 50’s gaining popularity following Nixon’s visit to China in 1972. The first report on veterinary acupuncture was published by the BVA in The Veterinarian, now more familiar as the Veterinary Record. Since the 50’s, veterinary acupuncture has become widely accepted as a form of treatment by both veterinary surgeons and animal owners.

The concepts behind TCM and acupuncture

Acupuncture encompasses the medical philosophy behind TCM whose principles have been developed and tested repeatedly over many centuries. The Chinese perception of the body, disease and health are unique and often seem illogical to those more familiar with Western medicine which views the body as individual parts. In contrast, TCM sees the body as series of integrated systems, which are closely related and exist in a state of harmony. The most familiar TCM concept is of course the familiar Yin Yang symbol, which represents a simple way of displaying the dynamic nature of life and the state of balance.

The Yin Yang symbol

Yin and Yang interact and react with each other to maintain a state of balance. Neither can exist without the other and neither can exist in isolation. There is always yin within yang and yang within yin. This is represented by the small blank circle (yin) within the yang (white) portion of the symbol and vice versa.

Yin represents the negative or dark side and is associated with such things as water, cold, deficiency, slow, night, winter, female and chronic situations. In contrast yang represents fire, heat, excess, fast, daytime, summer, male and acute situations. Many examples of yin and yang are seen in every day life. For example night cannot exist without day. Flexor muscles cannot operate without extensor muscles to oppose them. Male cannot exist without female. There is no heat without cold.

Yin and yang should exist in balance but this state of balance rarely exists. The Chinese see disease as the result of yin and yang being out of balance to the extent that the regulatory mechanism is not able to correct the fault. Acupuncture is just one of the ways in which the balance can be restored and the patient returned to a state of health. TCM can also encompass the use of herbal medicine, diet and changes in lifestyle and environment to readdress any imbalance within the body.

Qi and other vital substances

The opposing forces of yin and yang represent Qi which is the vital force or energy within the body that maintains life. Qi is also one of the Chinese Vital Substances along with Blood, Essence (also called Jing) and the Body Fluids.

Qi is derived from food and the air through breathing, then stored and distributed throughout the body. Qi performs several functions including protecting the body from infection and is responsible for movement, flowing throughout the body. It is also responsible for the production of the other Vital Substances and for warming the body. Qi also holds the organs in place and helps keep the blood within the blood vessels preventing haemorrhage. The Chinese also consider that there are different forms of Qi. Each internal organ has its own Qi and it is Qi which circulates in the meridians.

Essence or Jing can be roughly equated to the genes, DNA and the concept of heredity. The Chinese divide Essence into pre-heaven essence which is inherited from the mother and father at conception and post-heaven essence. Pre-heaven essence makes up the constitution, strength and vitality of the animal and is fixed and cannot be changed. Post-heaven essence is derived from food by digestion.

Pre-heaven and post-heaven essence give rise to Kidney Essence, a form of hereditary energy, which can be replenished. Kidney essence is stored in the kidneys and is very important. It determines growth, reproduction, development, puberty, conception and pregnancy. Kidney essence also produces “marrow”. This includes not only the marrow which fills the cavities of the long bones but also the substance which fills the spinal cord and the brain. Western medicine has no direct equivalent to the Chinese concept of marrow.

Blood in Chinese medicine is also not the same as in Western medicine. Blood is seen as a form of Qi and is formed through the action of the spleen, the lungs and the heart. Wherever Qi goes the blood will follow and like yin and yang, one cannot exist without the other.

The Chinese body fluids are called Jin-Ye and encompass the tears, saliva, joint fluid, urine, cerebrospinal fluid and lymph. The fluids also cover the liquid which moistens the skin and muscles.

The meridian system

Qi and Blood circulate within the body along pathways known as meridians. The use of acupuncture points along the meridians constitutes the basis of acupuncture. It is not possible to see the meridians, but their existence has been verified by various electrical measurements taken along the routes which they follow. The meridian system is unique, connecting the outside of the body with the internal organs and allowing for the maintenance of harmony and balance. Not only can the meridian system and acupuncture points be used in treatment, but they can also be used diagnostically as well.

Chinese medicine and the organs of the body

In Chinese medicine the internal organs of the body are divided into six yin or solid organs of the body and six yang or hollow organs. These are sometimes referred to as the Zang-Fu organs respectively. The yin organs comprise the Liver, Spleen, Kidney, Heart, Lungs and Pericardium and are considered the most important having specific functions unique to Chinese medicine.  The yang organs, the Stomach, Small intestine, Large intestine, Gall bladder and Urinary bladder are less important and have functions which are largely similar to those of Western medicine. The yang organs also include the Triple heater, an “organ” unique to Chinese medicine and concerned with the division of the body into upper, middle and lower sections which have different functions. Each yin organ has a paired yang organ. For example the lung is associated with the large intestine and the kidney with bladder. Oddly the Chinese ignore the uterus and brain as their actions are undertaken by other organs.

The twelve organs in total, correspond to the 12 major paired meridians of the body. Qi circulates through the meridians in a 24-hour cycle, staying in each of the meridians for 2 hours and follows a set pathway. Qi flows from the Lung to the Large intestine then onto the Stomach, Spleen, Heart, Small intestine, Bladder, Kidney, Pericardium, Triple heater, Gall bladder and Liver in sequence, then back to the Lung again. Qi flows in the lung meridian between 3 and 5 am and then at 2 hourly intervals through the other organs in the sequence. This is known as the Chinese circadian clock.

THE CIRCADIAN CLOCK

Apart from the 12 main meridians, there are 8 extra non-paired meridians which are not connected directly to the Zang-Fu organs. Of these only 2 are regularly used, the Governing vessel meridian and the Conception vessel meridian.

The 12 main meridians

The lung meridian (LU)

The lung meridian has 11 points and runs from the axilla (armpit) down the front leg, crossing over the front of the elbow joint and ending on the end of the first toe or dew claw. The lung in Chinese medicine governs Qi and respiration as well as regulating the passage of water and controlling the skin and hair. This meridian is used to treat respiratory problems, including coughs, asthma and bronchitis. It is also used in the treatment of problems related to the elbow and neck as well as skin problems.

The Large intestine meridian (LI)

This meridian has 20 points along its course and is the yang partner of the yin lung meridian. It starts on the second toe and runs up the front leg crossing over the forearm to the outside of the elbow crease, up in front of the shoulder joint, over the lower neck to end by the nostrils. This is an important meridian for pain and for the immune system as well as conditions of the elbow and shoulder joint. It is also used to treat respiratory problems.

The stomach meridian (ST)

There are 45 points along the stomach meridian which starts below the eye and runs down the neck, under the abdomen and then down the outside of the back leg, crossing over to end on the second toe. It is used to treat problems relating to the digestive system, the eye, the face, the knee joint, hock and catarrhal problems.

The spleen meridian (SP)

This meridian has 21 points and runs from near the first toe, upwards on the inside of the back leg, over the underside of the tummy to end midway up the chest between the 6th and 7th ribs. The spleen in Chinese medicine controls the blood as well as the muscles and four limbs. The spleen houses thought and is injured by worry. It is also concerned with the digestion of food and the production of Qi. The spleen is the yin partner of the yang stomach. The spleen meridian is used to treat digestive problems, particularly diarrhoea and constipation as well as endocrine problems, reproductive problems, allergic related conditions and general weakness.

The heart meridian (HT)

The heart meridian starts in the middle of the axilla and runs down the inside of the front leg to end on the 5th toe. It has 9 points along its course and is used to treat heart problems, elbow conditions and behavioural problems. In Chinese medicine the heart governs blood, controls the blood vessels, sweating and houses the mind. Hence the use of this meridian in treating behavioural problems.

The small intestine meridian (SI)

From the heart Qi flows into the small intestine meridian which is the yang partner of the yin heart meridian. This has 19 points and runs from the 5th toe up over the outside of the front leg, zigzags over the shoulder blade and heads towards the ear. It is used to treat neck pain, problems relating to the shoulder, elbow, the face and ear.

The bladder meridian (BL)

This is the longest of all the meridians and has most points along its course which total 67 in all. It starts on the inside of the eye and runs over the top of the head, down the top of the neck and over the top of the shoulder blade where it splits into two branches. The two divisions run in parallel over the back, sacrum and ischium to meet behind the knee. The single branch continues over the outside of the hock to end on the outside of the 5th toe. Points on the bladder meridian can be use to treat a very wide variety of conditions ranging including eye problems, back problems, digestive problems, kidney and liver disease, paralysis and reproductive conditions. The bladder meridian has direct acupuncture point connections with all the Zang-Fu organs. These points are known as the Back Shu or Association points and are used diagnostically and in treatment. The bladder is the yang partner of the yin kidney.

The kidney meridian (KI)

The kidney meridian has 27 points and starts in the middle of the underside of the back paw and then runs inside the back leg, along the underside of the abdomen to finish near the first rib. In Chinese medicine the kidneys are the root of life and store Essence which governs birth, growth, reproduction and development. The kidneys also govern water and affect the ears, the hair and bone. The kidney meridian is used in treating emergencies such as shock and epilepsy as well as urinary and reproductive problems. It is also used in treating back pain.

The pericardium meridian (PC)

The first point on the pericardium meridian is at the back of the axilla. The meridian then travels down the inside of the front leg, curving round the back of the carpus to end near the 3rd toe. This meridian which has 9 points is used to treat vomiting, heart conditions, shock and coma as well as behavioural problems.

Triple heater meridian (TH)

The triple heater meridian, the yang partner of the pericardium, originates on the 4th toe, travels up the front of the leg and curves around the outside of the elbow. It then crosses the bottom of the shoulder blade, travels up around the ear to finish over the eye. It has 23 acupuncture points along its course and is used to treat throat problems, deafness, carpal, shoulder and elbow problems.

The gall bladder meridian (GB)

The gall bladder is a yang organ and paired with the yin liver. There are 44 points along the course of the gall bladder meridian. It starts near the outside of the eye, zigzags over the head before travelling down the neck, in front of the shoulder blade and then under the chest and then up onto the chest wall. It then continues up and around the hip joint and down the outside the back leg to finish on the 4th toe. It is used to treat eye problems, epilepsy, arthritis, liver conditions as well as hip dysplasia and knee problems. It is also used for conditions related to tendons and marrow.

The liver meridian (LIV)

The liver meridian which has 14 points, runs from near the 1st toe upwards on the inside of the back leg, over the inside of the knee joint, curving forwards to end near the bottom of the 9th rib. In Chinese medicine the liver stores blood and ensures the smooth flow of Qi. It is also linked to the eye, nails and tendons. Points on the liver meridian are used to treat metabolic problems, epilepsy, liver and gall bladder problems, diarrhoea and mastitis.

The governing vessel meridian (GV)

This is a single meridian which has 27 points and runs in the midline over the back from the rectum to the nose. It has a wide range of uses.

The conception vessel meridian (CV)

This is a single meridian running in the midline on the underside of the body from the rectum to the. It has 24 points and is used to treat urinary and reproductive problems as well as general weakness and stomach problems.

Modern ideas on acupuncture

Although the Chinese concept of the body differs vastly from that of our familiar Western ideas, there is now a lot of scientific evidence to support acupuncture and how it works. We know that for acupuncture to be effective the nervous system needs to be intact. We have also discovered that at least 80% of acupuncture points lie on points of the body where nerve bundles pierce the underlying tissue and lie close to the surface or where there are nerve motor plates. These areas also have a lower electrical resistance, increased electrical conductivity and are associated with increased numbers of sweat glands.

Stimulation of an acupuncture point with a needle results in the release of neurotransmitters (endorphins, serotonin and noradrenalin) which block the transmission of pain. This effect is cumulative so that repeated sessions of acupuncture can afford long term pain relief in conditions such as back pain and arthritis. In fact western acupuncture is used mainly to treat musculoskeletal disorders especially chronic pain. The effect of this type of acupuncture acupuncture is largely segmental, that is nerves, muscles and acupuncture points are treated in the same spinal areas as the affected or painful area. This is referred to as “pain gating”, and involves the inhibition of pain via various brain and spinal cord nerve pathways. These effects, combined with local needling of painful trigger points in taut muscle bands, can result in marked pain relief.

Acupuncture points, needles and treatment

In total something like 2000 acupuncture points have been recognised, although classically only 150 or so are used regularly. Individual acupuncture points vary in size from about 1mm in diameter to around 25 mm. Some points have specific uses. For example BL11 is used to treat any conditions relating to bone and GB34 is used to treat tendon or ligament problems. Along with the special Shu points located on the bladder meridian along the back, there are other points known as Alarm (or Mu) points on the underside and side of the body which signal problems which individual organs or the associated meridian. There are also Source points where Qi enters a meridian, connecting (or Luo) points which link paired yin and yang meridians as well as points to tonify or sedate energy flow in a meridian.

The normal way of stimulating points is by needling using fine gauge stainless steel needles inserted into the points. The needles are tapered and very sharp. Unlike needles used for injections, they do not cut the skin. Needles are left in place for 10-20 minutes. Treatment is usually carried out every week to 2 weeks initially with the interval lengthening as the condition improves, often with breaks of several weeks or months between top-ups. Treatment is cumulative, building on previous treatments. So even if the response to treatment is not great initially, things can improve with repeated treatments.

Using knowledge of the meridians and points, an acupuncturist can treat a surprisingly wide variety of conditions. Points will be selected on meridians passing over the affected area and on the meridians related to the organs involved as well as appropriate back Shu and front Mu points. In addition points with specific actions will also be added together with Source and Luo points. The overall effect of this is to rebalance the body and stimulate healing so that symptoms resolve and the animal improves.