bluuebunny/crossref_metadata_2025 huggingface dataset:
Morphological Foundations of Acupuncture: An Anatomical Nomenclature of Acupuncture Structures
Authors: Schnorrenberger Claus C
Published: April 2009

European mistranslations of original Chinese texts have not merely introduced incorrect concepts to Western acupuncturists, but have adversely affected treatment methods. The French diplomat Soulie de Morant published an important treatise, “L'acuponcture Chinoise”, in 1939; this has formed the basis of Westernised “traditional” Chinese acupuncture. Because he had no medical background, he was unable to interpret the medical significance of traditional Chinese concepts in the texts that he had read. More, he could not see that a firm basis of medical knowledge is necessary for the reliable practise of acupuncture, thus unwittingly introducing acupuncture as a playground for lay therapists.

The two most important mistranslations were: i. the use of “point” for Xue-wei, which would be better translated as “foramen” to give the impression of a three dimensional structure; and ii. Qi, which is a particularly difficult concept to translate, but is certainly not equivalent to the Western term “energy”. These errors have now been accepted into standard usage through their transcription into modern, Western language, Chinese textbooks.

Western acupuncturists are mainly unaware of the substantial anatomical basis for the nomenclature in acupuncture, and indeed of the anatomical knowledge of the ancient Chinese physicians as expressed in original Chinese medical texts, examples of which are given in this paper.
Auricular Diagnosis and Therapy for Alopecia: Patient Data Analysis
Authors: Iliev Emil
Published: April 2009

It has been reported that tenderness at a specific point on the ear indicates pathology at a corresponding area of the body. The author has used this relationship to investigate patients with alopecia and to provide a rapid indication for the cause of their hair loss. Where possible this diagnosis was confirmed by conventional investigation. It was found that out of 521 patients examined, almost every one had a different combination of tender ear points, but that different specific groups of ear points were found routinely in the majority of patients in each of three categories of alopecia. The author suggests that when auricular acupuncture is used to treat alopecia, points should be selected from the tender spots found, rather than from a standard list of recommended points.
Tender Spot Injection Therapy for Ankle and Foot Pain
Authors: Bourne I H J
Published: April 2009

Pain of the ankle and foot following injury or surgery indicates soft tissue damage to muscle, tendons, periosteum or ligaments. Injection of a long acting corticosteroid such as triamcinolone with lignocaine to tender spots will relieve pain. Softened collagen at the site of injection will stretch, and heal to normal length and strength. However, care must be taken not to inject close to tendon, since softening may induce rupture. There is particular danger of this in the Achilles tendon. Case histories are given showing the tender spot injection sites used, and composite diagrams of all 69 tender spots found in a series of 28 patients with ankle or foot pain are illustrated.
Acupuncture Studies on Pain
Authors: Thomas Moolamanil
Published: April 2009

The relegation of acupuncture to complementary therapy ignores the history of its development and restricts possibilities for its clinical use and further research. Clinical studies with randomised, controlled trials and double blinding require reconsideration and adaptation when using acupuncture for treatment when multiple patient and treatment variables are involved.

Ample experimental evidence exists for acupuncture to be considered as a modality of peripheral sensory stimulation, but present clinical research has not incontrovertibly validated the use of acupuncture on patients with chronic pain. A basic understanding of the neuro-physiology of pain and its differentiation does provide better indications for its use. More consistent results may then be obtained, as seen from a few recent studies.
An Investigation into the Use of Traditional Chinese Medicine in the Treatment of Orofacial Disorders
Authors: Au F , Cresswell J
Published: April 2009

While on student elective from the Dental School of Bristol University, the authors had the chance to study the basic principles of traditional Chinese medicine and to observe the treatment of orofacial disease in a modern general hospital in Shanghai and in a specialist stomatological hospital at Beijing Medical University. The background to traditional herbal medicine and various forms of acupuncture encountered during their visit is discussed, as are some case histories. They report that clinical experience in China suggests that the combination of traditional Chinese and Western treatment techniques offers better results than either method alone.
A Visitor's View of Acupuncture in the Usa
Authors: Downey Paul
Published: April 2009

A visit to the Department of Family Practice at the University of Maryland, Baltimore, where education, research and teaching is taking place in all forms of complementary medicine, provides the background to a discussion of the current status of acupuncture in the USA.

Health insurers commonly reimburse for complementary therapy, forty medical schools provide modules in complementary medicine, and federal funding is available for the study of non-orthodox treatments: ten national centres for disease prevention are currently researching and evaluating the non-orthodox therapies.
An Investigation into the Possible Additive Effects of Acupuncture and Autogenic Relaxation in the Management of Chronic Pain
Authors: Rakshy M El , Weston C
Published: April 2009

This randomised, controlled trial investigates the use of concomitant relaxation during acupuncture treatment for pain. Twenty seven patients attending an out-patient acupuncture clinic with chronic pain of various origins were asked to listen to a tape either of music or of autogenic relaxation suggestions during acupuncture treatment. Measurements pre and post treatment were taken of perceived pain, and comparisons between the two tape uses and a no tape group was made. Whilst no significant difference was found between the methods, a trend towards benefit from the use of an autogenic relaxation tape during acupuncture treatment was shown. Further research is planned.
Tennis Elbow: A Combined Approach Using Acupuncture and Local Corticosteroid Injection
Authors: Chilton S A
Published: April 2009

In a controlled study, a group of 16 patients in a north of England general practice received acupuncture treatment for tennis elbow, followed by a small dose of corticosteroid with lignocaine to a residual tender spot at the elbow. These patients were compared with a similar group of 19 who received a larger dose to a tender spot at the lateral epicondyle, without any initial acupuncture treatment.

In the acupuncture with steroid group: 13 patients had benefited following two treatment sessions, two after three sessions and one was no better at the end of the permitted three treatments. In the steroid alone group: 13 had had benefit after two sessions, three after three and three were unsuccessful. This suggests a trend towards increased and more rapid success in the acupuncture with steroid group, but the small number of patients precluded useful statistical analysis. The physical advantage in using acupuncture before administering local corticosteroid injection is that a lower dose of steroid can be used, with consequent reduction in the risk of tissue necrosis and inflammatory reaction.
Thermographic Evidence for the Effectiveness of Acupuncture in Equine Neuromuscular Disease
Authors: von Schweinitz Dietrich G
Published: April 2009

Thermographic scanning provides an objective method of detecting sympathetic-autonomic status of vasomotor tone in the horse by imaging thermal gradients. Through observing persistent abnormal sympathetic nervous tone causing hypothermic or hyperthermic regions the clinician is able to diagnose neuromuscular disease - a common but often unrecognised cause of chronic pain and performance problems in horses.

Thermography studies at the Equine Veterinary Clinic in Guildford demonstrate that acupuncture often corrects abnormal vasomotor tone within a half to three and a half hours of needling, usually resolving vasoconstriction affecting large thermatomes. Thermal imaging can provide objective, measurable evidence of the ability of acupuncture to restore normal homoeostasis in the autonomic regulation of vasomotor tone and suggests that it may simultaneously relieve associated sensorimotor disease.
Acupuncture and the Cardiovascular System: A Scientific Challenge
Authors: Ballegaard Søren
Published: April 2009

In acupuncture research two main issues have to be addressed. One is whether the needle has a biological effect of its own. The other is whether acupuncture is of help to patients in their daily lives. With reference to this, acupuncture is a complex form of treatment in which the needles modulate physiological mechanisms of the body and the doctor supports the patient to achieve a life-style that assists with this.

To evaluate the biological effects of needling, a randomised, controlled trial group of 49 patients with angina pectoris had acupuncture while cardiological, neurophysiological and psychological observations were made in a mutually independent manner. Needling was found to improve the working capacity of the heart. In addition, acupuncture was found to activate cardiovascular autoregulatory mechanisms in 24 healthy persons.

To evaluate the effect of acupuncture in daily life, a controlled trial group of 69 patients with severe angina pectoris were followed for 2 years after treatment. The incidence of cardiac death or myocardial infarction was 7%, compared to 15–21% for the control group of published results concerning invasive treatments. Due to clinical improvement, surgery was postponed in 61% of the patients. The annual number of in-hospital days was reduced by 90%, leading to a US$ 12,000 saving for each patient.
Factors that Influence Outcome: An Evaluation of Change with Acupuncture
Authors: MacPherson Hugh , Fitter Mike
Published: April 2009

To evaluate change resulting from treatment by acupuncture, a multi-centre study of outcomes was undertaken involving 7 practitioners and 58 patients. The SF-36 was used for a base-line measure of health status. Assessment of outcomes was made using a number of measures. The results showed benefits from acupuncture which started to level off after the first seven treatments. Neither age nor gender of the patient is related to either initial ill health or rate of recovery. Statistically significant results showed that patients with more severe initial conditions, particularly bodily pain, tended to make more rapid improvements. The results also suggest that the shorter the duration of the patient's condition, the more rapid the recovery.
Traditional Chinese Medicine at Xian Medical University
Authors: Tsang Hoo Kee
Published: April 2009

One aim of the student elective during medical training is to see different cultural and social aspects of practice. This article concerns a student visit from the University of Wales College of Medicine to the Imperial City of Xi'an in China, which offers a medical school with teaching in both traditional Chinese medicine and Western medicine. The visiting student can learn of the traditional theories and methods of diagnosis and have a chance to see and use treatment techniques such as acupuncture, moxibustion, cupping, herbal medicine, Chinese massage and qigong. The Chinese people in general use both Western and traditional medicine, trying one and switching to the other if the first is ineffective, and Chinese traditional doctors make use of Western diagnostic techniques when necessary.
Acupuncture for Chronic Pain
Authors: Handy John L
Published: April 2009

Seventy-four patients having acupuncture for chronic pain were asked to complete a self-appraisal questionnaire and a linear-scale pain score in order to evaluate the efficacy of their treatment. The study revealed that 75% of patients had at least moderate symptom relief in 3 out of 5 parameters. In analysing the differing response of patients with various sites of pain, it was found that 95% of patients with chronic head, neck or arm pain obtained good symptom relief, 85% with migraine or facial pain and 63% with low back pain.

The response to the questionnaire was compared to the pain score for each patient, and the result was used to assess both the current response and the suitability of that patient for further treatment. It is hoped that this study will form the basis of further audits, in order that acupuncture treatment may be focused on those patients who need it most and who are getting maximum benefit from it.
Is Acupuncture Safe in Patients with Morphine Hypersensitivity?
Authors: Tillu Abhay , Gupta Sanjeeva
Published: April 2009

Acupuncture is a well recognised method of providing pain relief. The case of a known morphine-sensitive patient is reported, who apparently suffered a hypersensitivity reaction (nausea, headache and lethargy) to a single treatment with acupuncture, possibly due to the increased release of endogenous opioid peptides. It is suggested that acupuncture should either be avoided or administered with caution in patients known to be sensitive to morphine or opiate derivatives.
Electroacupuncture: An Effective Treatment of Some Visual Disorders
Authors: Galewski Ralph
Published: April 2009

Visual disorders present a special problem of treatment due to their frequent occurrence. The type and prevalence change according to the socioeconomic status of the country concerned and its health service development. Among these disorders, some involve the neurological system, such as: retinitis pigmentosa, Usher's Syndrome, premature retinopathy, amblyopia and congenital rubella.

These diseases are considered to have a bad prognosis, with visual acuity loss leading to blindness, and the neurological damage has been considered irreversible. The scientific literature has little to say about the physiopathological mechanism of their degenerative processes. However metabolic changes seem to be implicated. Similar metabolic changes have been investigated in sensori-neural hearing loss, where a metabolic acidosis due to increased levels of lactic and pyruvic acids, together with enzyme disorders of the cytochrome-oxidase system have been reported. Taking as a working hypothesis that the same type of metabolic disorder exists in these visual disorders, an electroacupuncture therapy was designed that aimed to produce visual improvement through metabolic rebalance.

Brief case histories are given of 44 patients having various visual disorders with neurological involvement who showed improvement with electroacupuncture. No side effects or adverse reactions were recorded following this treatment.

The author proposes that electroacupuncture should be considered as a suitable alternative treatment for visual disorders with neurological involvement. Also, the previously accepted irreversibility of these disorders must be seriously questioned.
Western, Minimal Acupuncture for Neck Pain: A Cohort Study
Authors: Ross Juliette , White Adrian , Ernst Edzard
Published: April 2009

Minimal acupuncture is easily incorporated into primary care consultations, but there is no rigorous evidence of its effectiveness. In a cohort study, minimal acupuncture was given to 32 patients with acute neck pain. Neck pain scores, measured by the Northwick Park Neck Pain questionnaire, fell from an average of 12.1 (±5.4) before treatment to 4.8 (±5.6) at 3 months (p<0.00l). Three months after acupuncture treatment 76% of patients reported themselves “much better”. Out of 18 patients who had had pain lasting less than 2 weeks, 16 required only one treatment. These results suggest that minimal acupuncture may be an effective treatment for neck pain and further definitive studies are recommended.
Protocols for Clinical Trials of Acupuncture
Authors: White Adrian , Park Jongbae
Published: April 2009

A written protocol is vital before conducting research, and should consist of sections on preliminary comments, subjects and methods, details of interventions and outcome measures, and methods of analysis. The process of developing the protocol provides a disciplined consideration of all aspects of the study.
An Evidence-Based Approach to Acupuncture
Authors: Ernst Edzard
Published: April 2009

Evidence-based medicine relies mainly on the findings from clinical trials, and to minimise selection bias such trials should ideally be randomised. As the results of clinical studies are rarely identical, the fairest judgement on the effectiveness of a therapeutic intervention is generated through systematic review of clinical trials. Systematic reviews have to demonstrate that all the available evidence that fulfils appropriate criteria has been considered. Once systematic reviews have established the current evidence on a given subject, this knowledge needs to be implemented in clinical practice.

Applying the rules of evidence-based medicine to acupuncture proves it to be effective for some conditions and ineffective for others, while its effects on many medical problems remain inconclusive: this indicates areas that require further research. Evidence based medicine should not be regarded as a threat to acupuncture, but as a challenge and an opportunity Importantly, this approach is strongly in the interests of patients.
Acupuncture and Alternative Therapies in Premiership Football Clubs
Authors: Stacey Richard A
Published: April 2009

A survey was performed by postal questionnaire to assess the extent of use of acupuncture and other complementary treatment modalities amongst premier league football clubs. The physical therapies of acupuncture, osteopathy and chiropractic were used by over half the clubs that responded. Other therapies such as homoeopathy and aromatherapy were less commonly used.
Frozen Shoulder: A Comparison of Western and Traditional Chinese Approaches and a Clinical Study of Its Acupuncture Treatment
Authors: Tukmachi Emad S
Published: April 2009

A pilot study using acupuncture in the treatment of 31 patients with frozen shoulder showed marked improvement in 24 and improvement in 6. Patients with idiopathic or arthritic frozen shoulder responded better than those with post-traumatic aetiology. There was no relationship between response to acupuncture and age.

Although this study involved no control group, the high level of improvement together with the author's clinical experience suggests that acupuncture should be considered an effective option in the treatment of frozen shoulder; the more so since conventional medical therapy has a low expectation of benefit. Aetiology pathology and clinical management are described in both Western medical and traditional Chinese terms and details of acupuncture treatment methods are given.
The Use of Acupuncture for Pain Relief in a Chinese Hospital Clinic
Authors: Yun Ip Vivian Hui
Published: April 2009

This study formed part of a medical student elective and was conducted over a six-week period from April to June in the Acupuncture Clinic of the First Teaching Hospital of Tianjin Traditional Medical College, China. It is a descriptive cross-sectional study investigating the painful conditions for which Chinese consult an acupuncturist. The effectiveness of acupuncture as an analgesic was assessed subjectively using a visual analogue scale to estimate the amount of pain before and after treatment. A significant improvement was seen following acupuncture. The patients’ own views on the efficacy of acupuncture in controlling their pain were also noted: this resulted in a mean effectiveness rating of 74.4%.
Development of a New Sham Needle
Authors: Park Jongbae , White Adrian , Lee Hyejung , Ernst Edzard
Published: April 2009

The problem of providing an acupuncture placebo that is indistinguishable from genuine needling has appeared insurmountable. However, the authors have developed an apparatus, the Park sham needle unit, which is intended to match what an acupuncture-naïve subject expects to see and experience with needling, but is intended not to produce the specific needling sensation (deqi) that is felt with true needling. This can still not be regarded as a true placebo since skin contact must be made for verisimilitude and there may thus be some physiological stimulation. Nonetheless this form of sham acupuncture should be considered an advance on all previously used methods.

The apparatus consists of a blunted needle, the shaft of which telescopes into the handle when tapped, so that, while the needle appears to have been inserted, it does not actually pierce the skin. The needle is held in place by a standard guide tube contained within a fitted sheath with basal ring that is secured to the skin with double sided sticky tape.
Acupuncture: Where to Place the Needles and for how Long
Authors: Campbell Anthony
Published: April 2009

There are many ways of choosing positions on the body to needle in acupuncture treatment. Similarly there are many ways of stimulating the points chosen. Despite the variety of acupuncture methods advocated, most good-quality trials seem to show a similar 70% success rate, suggesting that there is little clinical difference between techniques. In order to simplify the Western medical usage of acupuncture, the author offers a composite view of needling techniques in which the term “Acupuncture treatment area” (ATA) refers to any suitable site of needle insertion. This may be a single traditional point, it may be a local painful area, a distant strong point, the periosteum around a joint, or it could be a large area of subcutaneous tissue, as in the lower abdomen.

The author suggests that the concept of ATAs will allow acupuncture development free of theoretical expectations, and has the advantage that clinically most medical acupuncturists have already adopted this way of working.
Segmental Dysfunction
Authors: Watkin Hywel
Published: April 2009

Spinal segmental dysfunction, although used in clinical practice by medical acupuncturists, musculoskeletal physicians, physiotherapists and osteopaths, is not a concept which is familiar to the majority of medical practitioners. The concept implies that a problem in the function of a spinal segment may cause symptoms without necessarily being caused by physical pathology.

Studies of the dysfunctional spinal segment have shown that physical stress, emotional stress and visceral disease all cause a reaction at the dysfunctional segment more easily than at normal segments. In the same way that individuals may have asymptomatic latent trigger points which may later become symptomatic, so individuals may have asymptomatic dysfunction which later becomes symptomatic under the influence of appropriate stimuli.

There is some evidence that the clinical features of segmental dysfunction may be mediated by the sympathetic nervous system. The detection of segmental dysfunction is a clinical skill worth developing and the properties of the dysfunctional segment are worthy of further research.
Qi, Information and the Net of Life
Authors: Ralt Dina
Published: April 2009

There have been a variety of Western explanations for the Qi of traditional Chinese medicine, but all have essentially had to compromise between expression of energy, matter and flow. The author suggests that a non-linear, fractal approach, similar to that of Chaos theory, offers a tool to understand Qi; the yin-yang and five phases theories of Chinese philosophy can be regarded as fractals. Qi, as the “net of life”, can also be looked on as an information network with close parallels to the computer-based web of the internet. This article therefore suggests a new Western definition of Qi, proposing that: “The Qi of Chinese medicine is inter-cellular information communicated within the body: information which enables all bodily functions and is a key component in regulation”. Referring to Qi as information offers the chance to integrate Chinese medical philosophy with current biological research on cellular communication.
Acupuncture for Head and Neck Pain
Authors: Nesbitt Mary
Published: April 2009

Five case histories are presented featuring a variety of symptoms and aetiologies associated with head and neck pain. All responded well to acupuncture treatment. Headache is a commonly presenting feature in general practice and neck pain is almost as common as back pain, so reports of the successful use of acupuncture in these cases suggest a useful mode of treatment.
The Effect of Auricular Acupuncture on the Pulse Rate: An Exploratory Randomised Controlled Trial
Authors: White Adrian , Ernst Edzard
Published: April 2009

Advocates of auricular acupuncture believe that the internal organs are represented in the concha of the ear and can be affected by needling the appropriate area. These two areas of the body have a common innervation from the vagus nerve. The aim of this randomised, single-blind study was to determine whether stimulation of the ear produced changes in the pulse rate, an indicator of vagal tone. Doctor volunteers were needled in either the vagus area or a control area of the ear, and pulse rate changes were measured over the following 30 minutes. No significant differences were found in the pulse rate changes of the two groups. This study, which was limited in size and in other respects, found no evidence to support the concept that the body is represented on the ear.
Recurrent Herpes Simplex Infection from Western and Traditional Chinese Medicine Viewpoints
Authors: Stoyanov Peter , Iliev Emil
Published: April 2009

The authors have previously followed traditional Chinese acupuncture methods in the treatment of recurrent herpes simplex infection and have had moderately good results. However, following the successful treatment of a very severely affected patient who had suffered more than 15 recurrences per year, an alternative regime was instituted. This involved body acupuncture to immunomodulating points, direct irradiation of the herpetic lesions with He-Ne laser, daily application of aloe vera extract, and specific dietary restrictions.

Using this regime they report complete recovery, with no herpetic recurrence for more than a year, in up to 83% of their patients. They also measured immunological parameters before and after treatment, finding that: serum IgG, C3 complement fraction, and the protease inhibitors α1-antitripsin and α2-macroglobulin all increase, while secretory IgA and C3 complement fraction in urine normalise. These preliminary results have encouraged continuation of the clinical trials of this method.
Acupuncture in the Treatment of Hypertension and Stroke
Authors: Ren Yue Emily
Published: April 2009

This article identifies and comments on published studies of acupuncture treatment for hypertension and stroke. In all, 27 appropriate papers were analysed: 13 were hypertension papers with 3 being of controlled trials, and 14 were stroke papers with 5 controlled trials. The articles consisted of randomised controlled trials (RCTs), controlled trials, and case series studies. The hypertension papers also involved some cohort studies. In general, sample sizes of these studies were small.

Acupuncture in these papers was used as a secondary intervention for treating hypertension and as a tertiary intervention for stroke rehabilitation. The RCTs (the top of the hierarchy of evidence) of hypertension showed that acupuncture was not more effective than sham acupuncture or the anti-hypertensive drug, reserpine; however, all the case series suggested that acupuncture was an effective treatment. The RCT evidence for stroke showed that the effectiveness of acupuncture was similar to that of conventional treatment. The conclusion was that from the papers analysed there is insufficient evidence to show that acupuncture produces better results than other treatments for hypertension or stroke.
The Needle and the Lancet: Acupuncture in Britain, 1683–2000
Authors: Bivins Roberta
Published: April 2009

Although commonly regarded as a late twentieth century phenomenon, acupuncture use in Britain has a surprisingly long history, beginning with its seventeenth century transmission from China and Japan. Acupuncture was in use in the great hospitals of Paris before a second stage of transmission and translation brought it to nineteenth century Britain. Acupuncture's first wave of popularity and its results in British medical practice can be examined through examples drawn from the Lancet, the BMJ and other medical periodicals. This historical transmission of acupuncture to the UK can be fruitfully compared to its modern analogue, and historical patterns of acupuncture use can be compared with those displayed in contemporary Britain.
Developments in Veterinary Acupuncture
Authors: Scott Samantha
Published: April 2009

Veterinary acupuncture has been developing rapidly in recent years. Public attention has been focused on acupuncture as a possible therapeutic intervention for their pets by the media. Interest in acupuncture from the veterinary profession has therefore been primarily driven by owner demand. Veterinarians are now seeking courses in acupuncture that are relevant to themselves as general practitioners rather than as specialists in complementary medicine. Evidence of the efficacy of acupuncture in treating any of the veterinary species is limited, so it is significant that two acupuncture-related trials at Glasgow University Veterinary School are currently receiving funding.
An Audit of Acupuncture in a Single-Handed General Practice over One Year
Authors: Stellon Anthony
Published: April 2009

An audit was performed over one year on all patients undergoing acupuncture for a variety of conditions in a single-handed GP practice. The patients were observed for a further year to assess the effectiveness and duration of the treatment effect. Using the ‘measure yourself medical outcome profile’ (MYMOP) questionnaire, the effectiveness of acupuncture treatment was measured, and patients were categorised into no effect, improved or much improved. A total of 140 patients were audited over the one-year period. No effect was seen in 31% of patients, a further 31% were improved, and 38% were much improved. Those with a shorter duration of symptoms appeared to show the most benefit. During the one-year post-treatment observation period 50% of patients required further treatment.

In conclusion, acupuncture appears to have been an effective treatment in the author's General Practice population. In this audit acupuncture seems to have had a short duration of effect. It is believed that this has lead to an increase in workload, not only as a result of patient demand, but also due to recurrence of symptoms following the initial success of treatment.
An Audit of the Impact of Introducing Microacupuncture into Primary Care
Authors: Ross Juliette
Published: April 2009

In 1997, one of the partners in a general practice in NW London comprising 6700 patients began using microacupuncture - a very brief form of treatment described by Felix Mann. The computer system used for patient records was modified to allow easy recording of details of acupuncture treatments; the latter being performed opportunistically in standard 10-minute consultations. Over the course of three years, during which time a second partner began using acupuncture, referrals to acute physiotherapy (conditions present for < 3 months) fell by 86%, and referrals to outpatient rheumatology fell by 51%. This is likely to represent a considerable cost saving to the NHS.
Repetitive Epileptic Fits – a Possible Adverse Effect after Transcutaneous Electrical Nerve Stimulation (Tens) in a Post-Stroke Patient
Authors: Rosted Palle
Published: April 2009

A case of repetitive epileptic fits in a post stroke patient after transcutaneous electrical nerve stimulation (TENS) is presented. It seems more likely than not that the TENS triggered the repetitive fits in this patient. Although the risk of this adverse effect seems to be small, it should be borne in mind when TENS is used in a post-stroke patient. Since TENS is now used commonly in post-stroke patients, this problem is worthy of further study.
East and West See Eye to Eye – An Elective Report
Authors: Sistenich Vera
Published: April 2009

A summary of personal experiences encountered as a medical student on elective at an eye hospital in China. It bears witness to the possibility of seamless combination of western and traditional Chinese medical practices in the field of ophthalmology. Included are also the acupuncture points used in the treatment of optic atrophy at this particular eye hospital.

Address of eye hospital:

Zhongshan Ophthalmic Center

54 South Xianlie Road

Guangzhou 510060

China.

Period of elective:

5th January 2001 – 11th March 2001.
Travels in Japan
Authors: Curtin Michael
Published: April 2009

Following his attendance at the ICMART meeting, in Myasaki in 1988, the author, a BMAS member, resolved to revisit Japan. He found that acupuncture was widely practised throughout the country; although the patients were in the main elderly. The range of techniques used ranged from TCM to western, and broadly mirrored the styles practised in the West. Most young people in Japan considered acupuncture to be rather old fashioned, and it is postulated that this contrasts with the population seeking complementary medicine in the West.
Control of Infection in Acupuncture
Authors: Walsh Barry
Published: April 2009

This paper is an update on infections, and potential infections, related to acupuncture, and a brief review of the relevant infection control procedures.

There is no evidence at present to suggest that significant numbers of infections are being transmitted through standard acupuncture treatments in the UK. None the less, good infection control is essential. Like any other science, new research forces infection control to evolve and refine its procedures. Acupuncturists need to constantly review their standards as new viruses and risks are identified.
Moxibustion in Breech Version – a Descriptive Review
Authors: Ewies Ayman , Olah Karl
Published: April 2009

The management of breech presentation at term remains controversial. It appears logical that maternal and perinatal outcomes would be improved if breech presentation could be avoided. External cephalic version is considered a safe procedure if cases are selected appropriately and anaesthesia avoided. Moxibustion is a traditional Chinese method of treatment, which utilizes the heat generated by burning herbal preparations containing the plant Artemisia vulgaris to stimulate the acupuncture points. It is used for breech version with a reported success rate of 84.6% after 34 weeks gestation. Moxibustion technique is cheap, safe, simple, self-administered, non-invasive, painless and generally well tolerated. Although many studies give encouraging results regarding the use of moxibustion in inducing cephalic version of breech presentation, a definitive conclusion cannot be made as most involve small sample sizes and are not randomised. Moxibustion could be an extra option offered to women with breech presentation along with vaginal delivery, caesarean section and external cephalic version. This article discusses the possible role of moxibustion in correction of breech presentation in the hope that, some interest will be stimulated in what is a very interesting area for future research.
An Audit of the Effectiveness of Acupuncture on Musculoskeletal Pain in Primary Health Care
Authors: Kam Elisa , Eslick Guy , Campbell Ian
Published: April 2009

Little is known about the use of acupuncture in general practice. We performed a retrospective review of the use of acupuncture in relieving musculoskeletal pain, a condition that is commonly encountered in general practice. A sample of 116 patient records was reviewed, from which 92 patients (mean age 52 years; 64% female) met the inclusion criterion of musculoskeletal pain. Information obtained included age, sex, diagnosis, duration of the problem, length of treatment (weeks), number of treatments, duration of each treatment (minutes), number of needles used, level of benefit obtained from the treatment, and recurrence of pain. There were many different conditions encountered.

We found an association between the general practitioner using fewer needles and patients experiencing greater pain relief. This could be a reflection of treating myofascial pain syndromes, which often appear to respond well to a single needle in the key trigger point. Overall, we found that sixty-nine percent of patients had a good or excellent response to acupuncture treatment. We recommend acupuncture as a treatment option for patients who do not respond to the usual therapies (non-steroidal anti-inflammatory drugs) for musculoskeletal conditions.
Randomised Controlled Trial Comparing the Effectiveness of Electroacupuncture and Tens for Low Back Pain: A Preliminary Study for a Pragmatic Trial
Authors: Tsukayama Hiroshi , Yamashita Hitoshi , Amagai Hitoshi , Tanno Yasuo
Published: April 2009

The objective of this study was to compare the effectiveness of electroacupuncture and TENS for low back pain when the electroacupuncture is applied in a clinically realistic manner. The study was designed as an evaluator-blinded randomised controlled trial (RCT). The study was performed at the Tsukuba College of Technology Clinic in Japan. Twenty subjects, who suffered from low back pain (LBP) without sciatica, were recruited, using leaflets in Tsukuba city. Subjects were allocated to either an electroacupuncture (EA) group (10 patients) or a transcutaneous electrical nerve stimulation (TENS) group (10 patients). The procedure for EA was in accordance with standard practice at our clinic. The main outcome measures were a pain relief scale (100mm visual analogue scale: VAS) and a LBP score recommended by the Japanese Orthopaedic Association (JOA Score). Mean VAS value during the 2-weeks experimental period of the EA group was significantly smaller than that of the TENS group (65mm vs 86mm; 95% CI, 4.126 – 37.953). JOA Score in the EA group improved significantly while that in the TENS group showed no change. Although some placebo effect may be included, EA appeared more useful than TENS in the short-term effect on low back pain. We suggest that more realistic acupuncture interventions based on standard practice should be employed in pragmatic RCTs.
Neurogenic Pruritus: An Unrecognised Problem? A Retrospective Case Series of Treatment by Acupuncture
Authors: Stellon Anthony
Published: April 2009

Intractable localised segmental pruritus without a rash has been reported over the years under various titles depending on the area of the body affected. Notalgia paraesthetica and brachioradial pruritus are the two terms used for what is believed to be a form of neuropathy. The clinical observations reported here suggest that other localised cases of pruritus exist that share common clinical features, and the term neurogenic pruritus is suggested to encompass these under one clinical condition. Acupuncture has been used to treat skin conditions, of which pruritus is one symptom. This retrospective study looked at the symptomatic relief of neurogenic pruritus in 16 patients using acupuncture. In 12 cases the affected dermatomes of the body were innervated by cervical spinal nerves, seven innervated by dorsal spinal nerves and four innervated by the lumbar spinal nerves. Seven patients had areas affected by two different regions of the spine. Restricted neck or back movements were noted in patients as were areas of paravertebral spasm or tenderness of the muscles. Total resolution of symptoms as judged by VAS occurred in 75% of patients. Relapse occurred in 37% of patients within 1-12 months following treatment. Acupuncture appeared to be effective in alleviating the distressing symptom of itching in patients presenting with neurogenic pruritus.
Acupuncture Used in the Management of Pain Due to Arthropathy in a Patient with Haemophilia
Authors: Rosted Palle , Jørgensen Viggo
Published: April 2009

A case report is presented of a haemophilia patient, with pains due to arthropathy, being successfully treated with acupuncture. Acupuncture may have something to offer this type of patient in terms of pain management and reduction of strong analgesics. Treatment should be performed only by practitioners with special training in acupuncture, and close co-operation with a haemophilia clinic is necessary.
An Audit of Self-Acupuncture in Primary Care
Authors: Fagan Nigel , Staten Paul
Published: April 2009

This paper presents early experiences with self-acupuncture (i.e. patients treating themselves with acupuncture), in a medium sized, mainly urban, General Practice. It has been useful in allowing greater access to acupuncture in this setting. Fifteen conditions were treated; the majority of which were musculoskeletal. Ten out of fifteen reported their treatment to be successful. No adverse events were reported by any of the patients.
Referred Knee Pain Treated with Electroacupuncture to Iliopsoas
Authors: Cummings Mike
Published: April 2009

This is a case report of a 33-year-old woman who presented with an eight year history of deep left knee pain. The pain was originally diagnosed as deriving from osteoarthrosis of the hip secondary to dysplasia, however, the same pain returned at seven months, and again at 10 months, after successful hip resurfacing arthroplasty. Six to eight weeks after the start of the second relapse of referred knee pain, the patient sought acupuncture treatment at the British Medical Acupuncture Society's London Teaching Clinic. A single myofascial trigger point was found in iliopsoas that reproduced the patient's pain. It was successfully treated with two sessions of electroacupuncture applied directly to the point. Pain referral to the knee from trigger points in the upper part of rectus femoris is well recognised, however, this pattern of referral from iliopsoas has not been described previously.
Practising Acupuncture in the Developing World
Authors: Watkins Sarah
Published: April 2009

Historically a GP, Dr Sarah Watkins took up acupuncture relatively late in her career, but has taken it a long way since then. In this article she presents a vivid picture of what it is like to introduce acupuncture to remote rural populations in parts of the developing world. She describes the rapidly growing demand of the local populations following just word-of-mouth spread that a new treatment was available; the different needle length requirements of the impoverished locals compared with the average well-fed westerner; and the simple, safe and effective treatment regimes that she developed and introduced to the local trained nurses, in order to cope with the numbers of patients and to provide continuity of care after her departure. Sarah also comments on the emerging pattern of response that she has observed amongst her patients, and enters into a brief discussion of why this might be so. Early influences on her technique include Felix Mann, Chan Gunn, and a period of study at the Nanjing College of TCM in China. Whilst in the United Kingdom Sarah divides her time between private practice and working as a police surgeon, but is planning return trips to both Bangladesh and Ethiopia, plus fresh pastures in Vietnam and Kerala in south west India.
Myofascial Pain from Pectoralis Major following Trans-Axillary Surgery
Authors: Cummings Mike
Published: April 2009

This is the first reported description, to the author's knowledge, of myofascial pain occurring at a surgical drain site. The patient consulted a medical acupuncturist after suffering five months of continuous chest and arm pain associated with ‘tingling’ in the forearm and hand. She had undergone trans-axillary resection of the first left rib following a left axillary vein thrombosis 18 months previously. Her symptoms had been principally attributed to nerve traction at surgery or nerve root entrapment from scar tissue. However, the drain passed through the free border of pectoralis major, and the myofascial trigger point that appeared to develop as a result of the muscle trauma, or the pain at that site, presented as a chronic and complex post-surgical pain problem. The pain and tingling resolved completely after two sessions of dry needling at a single myofascial trigger point in the free border of the left pectoralis major muscle.
Anatomy for the Acupuncturist – Facts & Fiction 2: The Chest, Abdomen, and Back
Authors: Peuker Elmar , Cummings Mike
Published: April 2009

Anatomy knowledge, and the skill to apply it, is arguably the most important facet of safe and competent acupuncture practice. The authors believe that an acupuncturist should always know where the tip of their needle lies with respect to the relevant anatomy so that vital structures can be avoided and so that the intended target for stimulation can be reached. This article reviews clinically relevant anatomy for somatic needling of the chest and abdomen.
Acupuncture in Patients with Valvular Heart Disease and Prosthetic Valves
Authors: Stellon Anthony
Published: April 2009

Endocarditis has been reported in patients with valvular heart disease who have undergone acupuncture treatment, although most have been associated with the use of semi-permanent needles. This has led reviewers to suggest that acupuncture may not only be contraindicated in such patients but that prophylactic antibiotics should be given.

This study investigated the use of acupuncture treatment in patients with proven valvular heart disease and observed whether endocarditis developed in such patients. All patients in a single-handed GP practice with proven valvular heart disease, including those with prosthetic valves, were identified over a ten-year period. Those who had undergone acupuncture treatment underwent a clinical examination and diagnostic tests, which focused on the signs, symptoms and laboratory criteria for the diagnosis of endocarditis and included a transthoracic echocardiogram. Autopsy findings were reviewed in any patient who died.

Based on these clinical and laboratory data, using the modified Duke's criteria for the diagnosis of endocarditis, patients were identified as having definite or possible endocarditis, or the diagnosis was rejected.

All patients underwent brief acupuncture with no skin disinfectant and no prophylactic antibiotics were given. Semi-permanent needles were avoided. Thirty-six patients with valvular heart disease underwent a total of 479 acupuncture treatments over a ten-year period. The median number of treatments was 9 (range 1 – 72), with a follow-up after treatment of 5.75 years (range 0.5 – 10 years). Definite endocarditis was not found in any patient, but two patients had possible endocarditis, eventually discounted by both negative blood cultures and echocardiography.

In conclusion, brief acupuncture was safe in this small cohort of valvular heart disease patients and no case of endocarditis was detected over a ten-year period.
Anosmia Treated with Acupuncture
Authors: Michael Wevitavidanalage
Published: April 2009

This is a report detailing the successful treatment of a case of anosmia with acupuncture. The patient was managed conventionally for two years with no sign of improvement. She regained the sense of smell following one session of acupuncture. Such patients should be investigated for any detectable organic cause prior to treatment with acupuncture.
Acupuncture for the Treatment of Sweating Associated with Malignancy
Authors: Hallam Claudia , Whale Christopher
Published: April 2009

Acupuncture was used to treat a 60–year old woman with unexplained sweating associated with inoperable lung cancer that prevented her from sharing a bed with her husband. Other measures failed to improve her sweating, but she responded well to a course of acupuncture allowing her to continue sharing the marital bed.