Preface to Second English Edition .............................. xv
Preface to First English Edition .............................. xxi
Preface to Anatomical Acupuncture ........................... xxiii
Author ........................................................ xxv
Chapter 1 Introduction ......................................... 1
References ..................................................... 10
Chapter 2 Anatomy in Acupuncture .............................. 11
2.1 General Consideration ..................................... 11
2.2 Identity of Acupoints ..................................... 11
2.3 All in the Sensory Nerves ................................. 12
2.3.1 Organization of the Nervous System ................. 12
2.3.2 The Peripheral Nervous System ...................... 13
2.3.3 The Neuron ......................................... 13
2.3.4 Histology of Nerves ................................ 14
2.3.5 Divisions of the Nerves ............................ 16
2.4 Efferent Fibers ........................................... 16
2.4.1 Efferent Fibers to Skeletal Muscles ................ 16
2.4.2 Autonomic Nervous System ........................... 16
2.5 Afferent Fibers ........................................... 16
2.5.1 For Special Senses ................................. 17
2.5.2 For General Senses ................................. 17
2.6 Muscular Nerve Branches ................................... 18
2.7 Cutaneous Nerve Branches .................................. 19
2.8 Anatomical Features Contributing to the Formation of
Acupoints ................................................. 19
2.8.1 Size ............................................... 19
2.8.2 Depth .............................................. 19
2.8.3 Penetration of the Deep Fascia ..................... 19
2.8.4 Passage through Bone Foramina ...................... 20
2.8.5 Motor Point ........................................ 20
2.8.6 Concomitant Blood Vessels .......................... 20
2.8.7 Nerve Fiber Compositions ........................... 21
2.8.8 Points of Bifurcation .............................. 21
2.8.9 Sensitive Points on Tendons and Ligaments .......... 21
2.8.10 Suture Lines on the Skull ......................... 22
2.9 Discussion and Conclusion ............................ 22
References ................................................ 23
Chapter 3 Acupoints of the Cranial Nerves ..................... 25
3.1 Cranial Nerves without Acupoints .......................... 25
3.1.1 Afferent Fibers Only ............................... 25
3.1.1.1 Olfactory Nerve ........................... 25
3.1.1.2 Optic Nerve ............................... 25
3.1.1.3 Statoacoustic Nerve ....................... 25
3.1.2 Efferent Fibers Only ............................... 26
3.1.2.1 Oculomotor Nerve .......................... 26
3.1.2.2 Trochlear Nerve ........................... 26
3.1.2.3 Abducens Nerve ............................ 26
3.1.2.4 Hypoglossal Nerve ......................... 26
3.2 Cranial Nerves with Acupoints ............................. 26
3.3 Trigeminal Nerve .......................................... 26
3.3.1 Acupoints of Cutaneous Branches .................... 28
3.3.1.1 Supraorbital .............................. 28
3.3.1.2 Supratrochlear and Infratrochlear ......... 28
3.3.1.3 Lacrimal .................................. 29
3.3.1.4 Infraorbital .............................. 29
3.3.1.5 Zygomaticotemporal and Zygomaticofacial ... 29
3.3.1.6 Mental .................................... 29
3.3.1.7 Auriculotemporal .......................... 29
3.3.1.8 Paranasal ................................. 30
3.3.2 Acupoints of Connective Tissue ..................... 30
3.3.2.1 Bregma .................................... 32
3.3.2.2 Pterion ................................... 32
3.3.2.3 Nasion .................................... 32
3.3.2.4 Coronal Suture ............................ 32
3.3.2.5 Temporomandibular ......................... 32
3.3.3 Acupoints of Muscular Branches ..................... 33
3.3.3.1 Masseter .................................. 33
3.3.3.2 Temporalis ................................ 34
3.3.3.3 Anterior Auricular and Superior
Auricular ................................. 34
3.4 Facial Nerve .............................................. 34
3.5 Glossopharyngeal Nerve .................................... 35
3.6 Vagus Nerve ............................................... 35
3.7 Spinal Accessory Nerve .................................... 36
References ................................................ 37
Chapter 4 Acupoints in the Neck Region ........................ 39
4.1 Boundaries of the Neck .................................... 39
4.2 Formation of the Cervical Plexus .......................... 39
4.3 Acupoints of the Cutaneous Branches ....................... 40
4.3.1 Greater Auricular .................................. 40
4.3.2 Lesser Occipital ................................... 40
4.3.3 Transverse Cervical ................................ 41
4.3.4 Supraclavicular .................................... 42
4.4 Acupoints of Muscular Branches ............................ 42
References ................................................ 42
Chapter 5 Acupoints in the Upper Limb ......................... 43
5.1 Topography of the Upper Limb .............................. 43
5.2 Organization of the Brachial Plexus ....................... 43
5.3 Acupoints on the Pectoral Region .......................... 44
5.4 Acupoints over the Scapular Region ........................ 45
5.4.1 Dorsal Scapular .................................... 45
5.4.2 Supraspinatus or Suprascapular II .................. 46
5.4.3 Infraspinatus or Suprascapular I ................... 46
5.5 Arm and Forearm ........................................... 47
5.5.1 The Muscular Branches .............................. 47
5.5.1.1 Musculocutaneous or Biceps Brachii ........ 47
5.5.1.2 Median .................................... 47
5.5.1.3 Axillary .................................. 47
5.5.1.4 Teres Minor ............................... 48
5.5.1.5 Deltoid ................................... 49
5.5.1.6 Radial .................................... 49
5.5.1.7 Deep Radial ............................... 50
5.5.1.8 Posterior Interosseus ..................... 50
5.5.2 Cutaneous Branches ................................. 50
5.5.2.1 Posterior Brachial Cutaneous .............. 50
5.5.2.2 Lateral Brachial Cutaneous ................ 50
5.5.2.3 Medial Brachial Cutaneous ................. 51
5.5.2.4 Lateral Antebrachial Cutaneous ............ 51
5.5.2.5 Medial Antebrachial Cutaneous ............. 51
5.5.2.6 Posterior Antebrachial Cutaneous .......... 51
5.5.3 Acupoints over Tendons and Ligaments ............... 51
5.5.3.1 Tendon of the Biceps Brachii .............. 52
5.5.3.2 Lateral Epicondyle of the Elbow ........... 52
5.5.3.3 Flexor Retinaculum over the Wrist ......... 52
5.6 Wrist and Hand ............................................ 52
5.6.1 Muscular Branches .................................. 53
5.6.1.1 Recurrent of Median ....................... 53
5.6.1.2 Ulnar ..................................... 54
5.6.2 Cutaneous Branches ................................. 54
5.6.2.1 Superficial Radial ........................ 54
5.6.2.2 Interphalangeal Points .................... 54
References ................................................ 54
Chapter 6 Acupoints in the Body Trunk ......................... 55
6.1 Defining a Typical Spinal Nerve ........................... 55
6.1.1 • Two Roots with One Ganglion ...................... 55
6.1.2 Two Primary Rami ................................... 55
6.1.3 Muscular Branches without Anatomical Names ......... 55
6.1.4 Three Cutaneous Nerves with Six Terminal Branches .. 55
6.2 Composition of Fibers in the Typical Spinal Nerves ........ 57
6.2.1 Efferent Fibers to Skeletal Muscles ................ 57
6.2.2 Autonomic Nervous System ........................... 57
6.2.2.1 Sympathetic Nerves ........................ 57
6.2.2.2 Parasympathetic Nerves .................... 58
6.2.3 Afferent Fibers for General Senses ................. 58
6.3 Distributions of Acupoints ................................ 59
6.3.1 Back of the Body Trunk ............................. 59
6.3.2 Front of the Body .................................. 59
6.3.3 Lateral Side ....................................... 59
6.4 Acupoints on Back of the Neck ............................. 60
6.4.1 Greater Occipital ................................. 60
6.4.2 Third Occipital .................................... 61
6.5 Acupoints on the Dorsal Surface of the Chest .............. 61
6.5.1 Posterior Cutaneous Points ......................... 61
6.5.2 Acupoints of the Thoracic Spinal Process ........... 63
6.6 Acupoints on the Lumbar and Sacrum ........................ 63
6.6.1 Posterior Cutaneous of the Lumbar Spinal Nerves .... 64
6.6.2 On the Lumbar Spinous Processes .................... 65
6.6.3 Posterior Cutaneous of the Sacral Spinal Nerves .... 65
6.6.4 Superior Cluneal ................................... 65
6.7 Acupoints in the Front .................................... 65
6.7.1 Anterior Cutaneous ................................. 65
6.7.2 Xiphoid Point ...................................... 66
6.7.3 Angle of the Chest Cage Point ...................... 66
6.7.4 Umbilical Point .................................... 66
6.8 Lateral Side of the Chest Cage ............................ 66
6.8.1 Lateral Cutaneous .................................. 66
6.8.2 Intercostobrachial ................................. 67
References ................................................ 67
Chapter 7 Acupoints in the Lower Limb ......................... 69
7.1 Regional Anatomy .......................................... 69
7.2 Lumbar Plexus ............................................. 69
7.3 Sacral Plexus ............................................. 69
7.4 Acupoints of the Lumbar Plexus ............................ 71
7.4.1 Cutaneous Branches ................................. 71
7.4.1.1 Iliohypogastric ........................... 71
7.4.1.2 Ilioinguinal .............................. 72
7.4.1.3 Genitofemoral ............................. 73
7.4.1.4 Cutaneous of Obturator .................... 73
7.4.1.5 Lateral Femoral Cutaneous ................. 74
7.4.1.6 Anterior Femoral Cutaneous ................ 74
7.4.1.7 Parapatellar .............................. 75
7.4.1.8 Saphenous ................................. 75
7.4.2 Muscular Branches .................................. 75
7.4.2.1 Obturator ................................. 75
7.4.2.2 Rectus Femoris ............................ 75
7.4.2.3 Vastus Lateralis .......................... 75
7.4.2.4 Vastus Medialis ........................... 76
7.4.2.5 Sartorius ................................. 76
7.4.2.6 Femoral ................................... 76
7.5 Acupoints of the Sacral Plexus ............................ 76
7.6 Distributions to the Thigh ................................ 76
7.6.1 In the Posterior Compartment ....................... 76
7.6.1.1 Gluteal Fold Point ........................ 76
7.6.1.2 Posterior Femoral Cutaneous ............... 77
7.6.1.3 Inferior Gluteal .......................... 77
7.6.2 In the Lateral Compartment ......................... 77
7.6.2.1 Greater Trochanter Point .................. 78
7.6.2.2 Iliotibial Tract Point .................... 78
7.6.2.3 Biceps Femoris Point ...................... 79
7.7 Distributions in the Popliteal Fossa ...................... 79
7.7.1 Sciatic Point ...................................... 79
7.7.2 Lateral Popliteal Point ............................ 79
7.7.3 Medial Popliteal Point ............................. 79
7.8 Acupoints on the Posterior Compartment of the Leg and
Ankle ..................................................... 79
7.8.1 Medial Sural ....................................... 80
7.8.2 Sural .............................................. 80
7.8.3 Medial Achilles .................................... 80
7.8.4 Lateral Achilles ................................... 80
7.9 Acupoints on the Lateral Compartment of the Leg ........... 80
7.9.1 Peroneus Longus .................................... 80
7.9.2 Peroneus Brevis .................................... 81
7.9.3 Peroneus Tertius ................................... 81
7.10 Acupoints on the Anterior Compartment of the Leg .......... 81
7.11 Acupoints on the Foot ..................................... 82
7.11.1 Dorsal Surface of the Foot ......................... 82
7.11.1.1 Superficial Peroneal ...................... 83
7.11.1.2 Deep Peroneal ............................. 83
7.11.1.3 Metatarsal ................................ 83
7.11.1.4 Talus ..................................... 83
7.11 1.5 Cuneiforms ................................ 83
7.11.1.6 Dorsal Digital ............................ 83
7.11.1.7 Lateroinferior Malleolar .................. 83
7.11.1.8 Lateroanterior Malleolar .................. 83
7.11.1.9 Lateral Calcaneous ........................ 83
7.11.1.10 Cuboid ................................... 84
7.11.2 Plantar Surface of the Foot ........................ 84
7.11.2.1 Tibial Point .............................. 84
7.11.2.2 Medioanterior Malleolar ................... 84
7.11.2.3 Medioinferior Malleolar ................... 84
7.11.2.4 Medioposterior Malleolar .................. 84
7.11.2.5 Medial Calcaneous ......................... 84
7.11.2.6 Navicular Point ........................... 85
7.11.2.7 First Metatarsal Point .................... 85
7.11.2.8 Flexor Digitorum Longus ................... 85
7.11.2.9 Plantar Point ............................. 85
7.11.2.10 Medial Plantar Point ..................... 85
7.11.2.11 Lateral Plantar Point .................... 85
7.11.2.12 Calcaneus ................................ 85
References ................................................ 85
Chapter 8 Physiology in Acupuncture ........................... 87
8.1 Electrical Phenomena of the Body .......................... 87
8.1.1 Excitability ....................................... 87
8.1.2 Polarization and Action Potential .................. 87
8.1.3 Threshold .......................................... 88
8.1.4 Conductivity ....................................... 88
8.1.5 Fatigue ............................................ 88
8.2 Electrical Activity in Acupoints .......................... 88
8.3 Dynamic Nature of Acupoints ............................... 89
8.4 Three Phases of Acupoints ................................. 90
8.4.1 Latent Phase ....................................... 90
8.4.2 Passive Phase ...................................... 90
8.4.3 Active Phase ....................................... 91
8.5 Physical Properties of Acupoints .......................... 92
8.5.1 Sensitivity ........................................ 92
8.5.2 Sequence ........................................... 93
8.5.3 Specificity ........................................ 93
References ................................................ 94
Chapter 9 Biochemistry in Acupuncture ......................... 95
9.1 Biochemistry in Relation to Acupuncture ................... 95
9.2 Terminologies in Neurotransmitters ........................ 95
9.2.1 Neuroreceptor ...................................... 95
9.2.2 Agonist and Antagonist ............................. 95
9.2.3 Synapses ........................................... 96
9.2.4 Granules ........................................... 96
9.2.5 Neuromuscular Junction ............................. 96
9.3 Relevance of Neurotransmitters ............................ 96
9.4 Importance of Endorphin ................................... 97
9.5 Other Neurotransmitters ................................... 98
9.5.1 Catecholamines ..................................... 98
9.5.2 Serotonin .......................................... 99
9.5.3 Histamine .......................................... 99
9.5.4 Neuroactive Peptides .............................. 100
9.5.5 Amino Acids as Neurotransmitters .................. 100
9.5.6 Adenosine ......................................... 101
9.6 Immediate Acupuncture Reactions .......................... 101
9.6.1 Atopic Erythroid Skin Change ...................... 102
9.6.2 Sweating .......................................... 102
9.6.3 Syncope ........................................... 103
9.7 Reactions after Acupuncture .............................. 103
9.7.1 Flare-Up of Pain .................................. 104
9.7.2 Drowsiness and Sleeplessness ...................... 104
9.7.3 Parasympathetic Enhancement ....................... 106
References ............................................... 106
Chapter 10 Pathology in Acupuncture ........................... 107
10.1 Conventional Wisdom in Pathology ......................... 107
10.2 Pathological Origins ..................................... 107
10.3 Endogenous Origins ....................................... 107
10.3.1 Hormonal Imbalances ............................... 108
10.3.2 Poor Blood Circulation ............................ 109
10.3.3 Degeneration ...................................... 109
10.3.4 Infections ........................................ 110
10.4 Exogenous Origins ........................................ 110
10.5 Modes for Trigger Points to Appear ....................... 11l
10.5.1 Systemic ......................................... 112
10.5.2 Regional ......................................... 114
10.5.1 Combination of Systemic and Regional
Appearances ...................................... 115
10.7 A Special Case ........................................... 118
10.8 A Few Conclusions ........................................ 118
References ............................................... 119
Chapter 11 Psychology in Acupuncture .......................... 121
11.1 Psychology of Pain ....................................... 121
11.2 True or False ............................................ 123
11.3 Historical Prospect of Pain Perception ................... 124
11.4 Mental Attitude toward Pain .............................. 125
11.5 The Vicious Cycle of Pain ................................ 127
11.6 Rebutting Acupuncture as Placebo ......................... 128
References ............................................... 128
Chapter 12 Pain and Measurement ............................... 129
12.1 A Challenge and a Puzzle ................................. 129
12.2 Measurements of Pain ..................................... 129
12.3 Subjective Pain versus Objective Pain .................... 130
12.4 Ranking the Trigger Points ............................... 131
12.5 Trigger Points in Four Groups ............................ 132
12.5.1 Primary Points .................................... 133
12.5.2 Secondary Points .................................. 133
12.5.3 Tertiary Points ................................... 135
12.5.4 Nonspecific Points ................................ 136
12.6 Trigger Points on the Spinous Processes .................. 136
12.7 Results of Pain Measurement .............................. 139
12.7.1 Pain Measurement by Counting Trigger Points in
the Thoracic Vertebrae ............................ 141
12.7.2 Pain Measurement by Counting Trigger Points in
the Body .......................................... 143
12.8 Acute versus Chronic Pain ................................ 146
References ............................................... 147
Chapter 13 Good to Excellent Applications ..................... 149
13.1 General Guidelines ....................................... 149
13.2 Samples of Pain for Demonstration ........................ 150
13.3 Defining Good to Excellent Results ....................... 152
13.4 Pain in the Face and Head ................................ 152
13.5 Pain in the Neck and Shoulders ........................... 155
13.6 Pain in the Upper Limbs .................................. 158
13.7 Pain in the Body Trunk ................................... 159
13.8 Pain in the Lower Limbs .................................. 163
13.8.1 Meralgia Paraesthetica or Bernhardt Disease ....... 164
13.8.2 Pain in the Region of the Knee Joint .............. 164
13.8.3 Pain in Other Locations of the Lower Limb ......... 166
References ............................................... 166
Chapter 14 Applications with Mixed and Limited Results ........ 167
14.1 Defining Mixed and Limited ............................... 167
14.1.1 In Terms of Patient Profiles ...................... 167
14.1.2 In Terms of Number of Treatments .................. 168
14.1.3 In Terms of Pain Relief and Relapse ............... 168
14.2 Irrelevant to Pain ....................................... 168
14.2.1 Weight Reduction .................................. 168
14.2.2 Infertile Pregnancy ............................... 170
14.3 Subjective Pain Perceived ................................ 172
14.4 Pain in the Face and Head ................................ 174
14.4.1 Migraine .......................................... 174
14.4.2 Trigeminal Neuralgia or Tic Douloureux ............ 177
14.4.3 Postherpetic Neuralgia in the Face and Head ....... 179
14.5 Pain in the Neck and Shoulder ............................ 182
14.5.1 Whiplash .......................................... 182
14.5.2 Arthritic Neck .................................... 183
14.6 Pain in the Upper Limb ................................... 184
14.6.1 Biceps Tendinitis ................................. 185
14.6.2 Carpal Tunnel Syndrome ............................ 186
14.7 Pain in the Body Trunk ................................... 188
14.7.1 Postherpetic Neuralgia ............................ 188
14.7.2 Lower Back Pain ................................... 190
14.8 Pain in the Lower Limb ................................... 193
14.8.1 Knee Pain ......................................... 196
14.8.2 Pain in the Foot .................................. 197
14.9 Diffuse Pain ............................................. 198
References ............................................... 199
Chapter 15 Difficult Patients with Poor Results ............... 201
15.1 Connecting Difficult and Poor ............................ 201
15.2 Profiles of Difficult Patients ........................... 201
15.3 Pain in the Face and Head ................................ 203
15.3.1 Migraine .......................................... 203
15.3.2 Postherpetic Neuralgia ............................ 203
15.4 Difficult Pain from the Neck to the Fingers .............. 206
15.4.1 Torticollis in Perpetual Motion ................... 206
15.4.2 Severe Arthritis inside the Shoulder Joint ........ 207
15.4.3 Carpal Tunnel Syndrome ............................ 207
15.4.4 Deformities and Pain .............................. 208
15.5 Pain after Surgery ....................................... 209
15.5.1 Lower Back Pain after Surgery ..................... 210
15.5.2 Pain after Hip Replacement ........................ 212
15.6 Phantom Limb Pain ........................................ 213
15.7 Spondylitic Abnormalities ................................ 214
15.8 Reflex Sympathetic Dystrophy ............................. 217
15.9 Tailbone Fracture ........................................ 217
15.10 Difficult Patients with Different Results ............... 218
15.11 A Few Afterthoughts ..................................... 218
15.12 Editor's Afterword ...................................... 220
References .................................................... 220
Index ......................................................... 223
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