Examples of Standardised Approach

July 14, 2003

Hi All, & Hi Matthew,

Matthew wrote:

> I think we may need a definition of " standardized/cookbook "

> approach. It does NOT necessarily mean " no TCM content " or " no

> theoretical basis. " Of course, the formulae used in cookbook

> approaches are usually adapted from TCM, as well as other sources

> such as research, clinical experience, etc.

Agreed 100%; I tried to develop that point in my last mail.

Chinese medical classics [or for most of us, their translations] and

their more modern versions (commentaries, textbooks, clinical

papers based on Chinese theory) are the MAIN wells from which

we MUST draw the water-of-knowledge for our study and use of

Chinese medicine. De facto, [until a similar depth of new

knowledge/experience arrives], broadly-based AP or Herbal

Cookbooks MUST reflect data drawn from those sources.

> Since TCM was the only approach to acupuncture for so many

> centuries, it is likely that all trials will continue to have at

> least vestiges of " TCM content " for years to come. I have been

> subscribing to several Chinese-language acupuncture journals for

> years, and have seen the TCM content dwindle.

That, too, is inevitable; indeed the Law of Change inself predicts

that!: All Changes, yet Nothing Changes! The principle of Cycles

(implying Change, Revolution, and Return to the Same Position) is

implicit in the Law of Change - birth - death - rebirth, etc.

That said, HOW can SMALL-ANIMAL practitioners practice TCM-

AP? There is little if anything written in ancient texts on the Organ-

Channel-Points system of cats, dogs, or lab animals! That does

not deter vet acupuncturists from using principles derived from

HUMAN AP and transposing it to SA patients. However, SA vets

make very significant ADAPTATIONS to the human point locations.

For example, I think that Are Thoresen was the first vet to

" relocate " the distal points on the LU, LI, LV and SP Channels one

place lateral to their human locations. When Are suggested that

" heresy " , many TCM-focused vets thought him to be misguided.

But those of us who " relocated " to Are's positions, for example for

LI04 and LV03, very quickly found that HIS locations induced the

clinical effects that one would attribute to their human counterparts.

Similarly, the horse (with ONE digit), posed special problems for

equine AP vets. There are NO ancient texts [to my knowledge] that

give Channel and Point locations in horses like those of humans.

Yes, there were traditional Chinese equine charts [with some

descriptive text], but they referred to isolated points, not on a

Channel system.

Did that deter modern equine acupuncturists from developing a very

effective AP system for horses? Not at all!. Starting with a paper by

Marvin Cain in 1984, we transposed human principles (as best we

could, taking the bizarre anatomy of the horse relative to humans)

to horses. And it worked well. Today, there are a few versions of

equine-point transposition charts in use, the best (IMO) being

those of Emiel van den Bosch and Jean-Yves Guray.

Then Are Thoresen proposed another " heresy!. He described " his

locations " for the 12 Jing-Well Points in the horse. He placed them

at the hoof-hair junction in the same sequence as they fall on the

human Wrist crease - from medial to anterior to lateral - LU - LI -

TH (straight ahead) - SI - HT and PC between the bulbs of the fore-

heels, with similar extrapolated positions on the hindlimb - from

medial to anterior to lateral - SP - LV - ST (straight ahead) - GB -

BL, with KI between the bulbs of the hind-heels).

His first paper on the topic went so far as to suggest that novices

who could locate the most abnormal point in one of these 12

locations could induce excellent clinical results by needling that

point! Few of us believed Are at first. This was too simple! It could

NOT be correct! But, as colleague after colleague studied Are's

method (and went to see him in action) many of us now agree that

he had discovered a powerful system for horse AP.

But do SA- and Equine- vet acupuncturists use real TCM? IMO,

definitely not, because such methods simply were not described in

TCVM! In that respect, Quackbusters (who recognise that fact) are

correct. But Quackbusters are way off the mark when they claim

that vet AP has no basis in reality, especially in its clinical

importance!

Matthew also wrote:

> Perhaps some of the other list members who regularly use a >

" standardized approach " would like to offer a definition? Phil?

Matthew, I will defer to others on the Lists for the definition, but I

give the following as EXAMPLES of standardised approaches:

(1) Treatment of vertebral disc-disease in the dog with ANY of the

following protocols:

AP at LV03, bilateral [Are Thoresen?]

AP at GB34, bilateral [Jan Still and Jen-Hsou Lin's team,

independently]

AP at Si03 + BL62 + most sensitive paravertebral local Pts [one

suggestions from human sources]

AP at Ahshi points + GB34 + BL23 + BL11

For neck: add GB20 + GB21, or human equivalent of " Handpoint

Neck " [between the lower heads of metacarpals 2-3]

For Thorax: add GV14 + BL40

For Lumbar area: add BL29 + BL40

Any NSAID (at stated dose/day (mg/kg LW) + enforced rest (in a

play-pen)

(2) ANY of the following to treat ulcerative colitis in humans:

Any specified AP protocol

Any specified herbal protocol

Any specified WM protocol

For UC + visible blood in stool: add:

Any effective haemostst herb, such as Sanqi

or any specified WM haemostat

In summary, I agree with Matthew that " Standardised Tx " (including

Cookbook AP) can embrace many key principles of TCM, or WM.

It can be repeated faithfully by different clinicians in different

places, and offers a great tool to assess the benefits (or otherwise)

of AP, Herbal Med, or WM.

Best regards,

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July 14, 2003

In summary, I agree with Matthew that "Standardised Tx" (including Cookbook AP) can embrace many key principles of TCM, or WM. It can be repeated faithfully by different clinicians in different places, and offers a great tool to assess the benefits (or otherwise) of AP, Herbal Med, or WM. >>>>>>>>>Fascinating discussion

Alon