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RF_DR.A_14_SUDHA
AUGUST 31. 1991

CUPRESSiJRE s umqua. It is a simple
SA treatment to
perfect
aheaith. De<endra Vora, a
-men! acuprsssunst based
embay. says that electric curchetsna, passes through
?cy. If this current does not
any oart of tre body, there
n or cisease ~hus if proper
?• is sent to the affected
ne can will subside or the
cured.
"switchboards" of this
circuit is on tne palms
~e sees of tna feet Treatmateiy means applying
.re or massagirg these
> P-essure s applied by
■ jmb and first finger on the
'or four to five seccnds at
: two-second interva’s —
repeated for one to two
es ip a pumping acton.
'ent can be taken iht.ee
a day for ary disease ano
.ed till the pam on mat
s gone cr the disease

Z

a was
a successful
essman bit "retied" to
e-t a himself to ns mission of
lating acupressure for
's wsfl-being. He s grate'ne Arya Samai in Santa
wmeh put is entire centre
ns dsoosal. No fees are
ad for treasnent, no aperrts are necessary A
Is. 25 is charged or clas10 ths is ccnater to the

Sama
ire’s
marvellous
- n ypur Herds o~

DEVEHDRA VORA: Acupressure is hs mission

These
main
switchboards. if I may say so,
and i property operated through
acupressure
drstnbute
this
elect ncty equally to all the or­
gans This results in good health
because "bad hea.m" or distur­
bance of any organs is an in­
dication ths electricity is being
unevenly distributed in the body.
From the age of 15 or so. I

I also visited Tulsa, in the US,
where my rrece resides Her
husband is an MD. yet their
daughter had for a long time
been suffering from bronchitis.
This was my first patient! I gave
her three sittings. after when she
vomited out asi the phlegm Her
fever came down and she was
ail right. Whan nor tamer checked
her up he found her cured and
encouraged me to cc<~- -„e the

each of these needes has to be
pricked Mos; patients say that
this treatment works only until it
is unoerway Thereater there is
no guarantae of him being
cured.

ft taxas sx to ten years for
any person to become an
acupuncturist, out even a kd can
®coma an acupressurist. rtere, I
ght mentioi that there s no

They were naturopaths, dis­
carded by the medical fraternity,
though one nad cured 50
patients at cancer and the other
about 150. I bended tneir treat­
ments wen acupressure and it
was jus: Ike Archimedes's dis­
covery'' New * is possible to
diagnose witnr. a few mmutes
whether a patient has cancer or
not.

aicn-J uiujixjii ; inxxjcnuj
cif i
yst insr
•res treatment wooes only until <i
inougn one hat cureo 50
acupressure
dstribute
thus I daughter had for a lo~g time
is uneferway Thereafter there is
parents cf career and the otneelectricity equally to all the or- i been suffering from bronchitis.
about 150. 1 blended their treat­
no guarantee of nim being
gans. This results m good hearth
This was my first patient' I gave
ments with acupressure and it
cured
because "bad health" or distur­
her three sittings, after which she
was just like Archimedes's dis­
it takas six to ten years for
bance of any organs is an in­
covery! Now t is possible tc
vomited out all the phlegm Her
any person to become an
dication that electricity s bang
fever came down and she was
diagnose w'itr»r. a tew minutes
acupuncturist. but even a kid can
unevenly distributed In the body
whether a parent has cancer or
ail right. When her father checked
become an acupressurlst. Here, I
her up he found her cured and
not
From the age of 15 c< so, I
might mention that there is no
encouraged me to continue the
was afflicted by coughs, colds
ssde-eflect if the wrong pant is
Under convent coal
diag­
treatment
He
was
the
first
mecSand tonsilitis. In 1977 I made a
pressed. I would say that this
noses it is not possicre to locate
cal practitioner to encourage me
trip to the' US and to Montreal
treatment has been put into the
the disease until it has devetn acupressure.
where I happened to read a
human body by nature This
book by Mildred Carter, entitled
diagnosis of cancer by acupres­
Q: WHAT about your work in
therapy is capable d solving the
Reflexology. The subject matter
sure takes a few minutes and it is
Bombay?
world's health problems.
possible to ccate the organ
caught my attention immediately
A: fT was after my return from
Ths is the easiest form of
I began trying out exercises as
which has been affected.
the US that the chairman of my
therapy as ycu can see, and na­
an antidote to insomnia I was
ture lis put this into our bodies •
Then muscular dystrophy
business council mentioned that
astounded with the results
Or WHAT Is acupressure and
hrs mother was lying paralysed
so that man. die supreme being ! Since this originates n the mind
how did you first come upon this
Then, while travelling from ■ in Harkissondas Hosptal and
cn earth, can remam healthy and i it becomes necessay to ' fine'
method of treatment?
Montreal to New York by bus. I j asked me to visit her I went over . happy. Acupressure cures per­
the mind of the patient. The late
to the hospital and after a diag- ! manently
awoke one night with a severe
■ Dr V. G. Rele wno vrote Secrets
At ACUPRESSURE s merely
toothache.
I,
once
agam.
nosis explained to those present
of the Mind sad that me Rigveda
pressure being applied to the
Q: 5 acupressure limited in
howthe treatment could be given
i carries an excellent analogy wit~
palms of the two hands and the
"treated" myself to one of the ex
ds scope?
i neurology, and reading this i was
ercises I had read about l
at home. Within ten cays of
soles of the feet. This entire treat­
A: I PUT two questions to my i able lo ,ccate the root cause of
pressed the little finger of r~y
acupressure being appied, the
ment is based upon bo-energy
students. The first. ted out which j this disease.
right hand, the sde on which i
lady began walking.
(pranshaktj or c he tana). Electri­
part of the human machine is
had the toothache I got relief
city flows throughout our bodies.
I have seen that the cay
Another friend s mother had i missing, and the second, find a i
within a short write In fact, for
through channels traveling from
had a heart attack t told him that | disease for the treatment o’ ■ following the corrv-iencemem
two months after that I had no
the tips of the fingers to the head
her hands should be pressed at ! which acupressure s not effec­ I of the treatment the muscuia'
and all the way down to the toes.
problem
specific points The day after the I tive
. dystrophy stops and within six
treatment was taken up, she was
■ months 80% to 90% of the prooLet me tell you tna it is effec­ i lem has been removed
discharged from the hosotal and I
tive fee dreaced cseases like I
Q: IS the-e anything in
she had no problems for me next ‘
cancer and ones which con­ • acupressure relating to the cnakeight years.
stantly harass people. the com­ ■ ras of the human body as idenWhan I returned to Bcmbay I j mon cafd. The WHO has said
i titled by yoga?
had begun handing out cyclosmat the cure for me common
A: THERE s Actually, there
tyled sheets with charts of the
cold wit not be avaiable tri the ’
pa'ms of the hand and dis- j end of the 21st century Astnma. ; is no difference between the
tnbuted them among my ‘trends ; muscular dystrophy drug addic­ I chakras and the endocrine
Seeing the tremendous results cf
tion. smoking anc alcoholism j glands focused on by acupresacupressure, the chairman of oucan be cured I would say that ■ sure Pam pressing not only
council, Manubha' Kothari, cr>cne of she biggest advantages of I revitalises the body but also a"
’ected these papers ard sent
acupressure s that it pre-vents ■ the encacnne glands begm
them to Rajkot where they were
tSseases. A mere ten-minutes of i functioning properly. I nave
published in newspapers
palm pressing dah revitalises i shown this in my atest Look
the body ard baances the ' Health in Your Hands.
d H is said that acupuncture
functioning or the organs You
Q: HAVE you discovered the
is extremely effective — is 4
can feel the difference r> 15 | pressure points in the palms
more effective than acupres­
days...
:
through
your own research?
sure?
Q: YOU hac merrtonec about
A: IN acupuncture there are ’2
A: NO These points were
acupressure curing cancer
nadis are.1 after diagnoss as to
discovered
ancestors
where the disturbance is in ary |
A: YES. Earlier, studied -wo j There is "
of the "se 'en seas ’ a needle a
be s r.ritte by e nent
wr 'gs c“
selected
copper, sftrer cr 1 *'
— one
Ge'—an ar.
ac
goYt Th
Ticacy of apjpunc- ; cn •' an A
car who were
volunteer applies pressure on a patient's forehead
e rSth century
ture
te depth to which j practising ir

Cruz which p
entre centre
al his dispos
No fees are
charged for t> :merit, no ap­
pointments ar' necessary. A
mere Rs. 25 is charged for clas­
ses and this is donated to the
Arya Samaj.
Vote's
marvellous
book
Health in Your Hands deals com­
prehensively with acupressure. It
is replete with charts, diagrams
and photographs, dwelfng on a
wide ranoe of ailments. ADRIAN
KHARE and N. S. MIRAJKAR
interviewed
Vbra recently
Reproduced below are excerpts.

)

aitu ii piv»prc»iy

BUTZ, AUGUST 31. 19-

■ PAGE 13

tne patient 6 in the terminal
stages of cancer but acupres­
sure can remove the pain and
tne patient can, .at least. die
peacefully.

hued from Page 9
-Rp.-—

§5
O
t.i M

? :6tn century pressed the
. as cf the' ‘eet to cure them;ur cwn time there is a

community
near
•ra m which tne average
55 years. Before gome to
. wash their hands t nc
■ ;te£~et pressing tr err
ocaner for a cene-n
jc'o: of time. Then, it s ocs. .c —a', the Chinese ano otne s
: tame to India took away
•’em "vs method of treating
• t?-s ■ s also possible mat
sv -cmedic Aryans took this
d m .y treatment from India
’cicss me -maLayas into China,
ie- •? Capa'’ and to Alaska and

s

believe
“Red
Indians" are ancient Aryans and
that they knew about acupres­
sure — ail we have done is to
put it on a more scientific foot­
ing Acupressure is very scien­
tific. if I may put it that way. Even
if your rrand suggests to you that
it will nos work, it WILL! It will
work because a power port is
being pressed Acupressure has
nothing to do with psychology
Q: WOULD you call acupres­
sure an unconventional form ol
medical treatment0
A: CERTAINLY the mind af­
fects the endocrine glands. but.
as I have said, when you prac­
tise acupressure, poszwe results
wi3 occur regardless of wtiat
your mind tells you!

Now. when any organ is over­
worked then a layer of carbon is
created arcund S and eiectnccy
cannot flow fresfy in order so
reach it. You see. diseases are
nothing but friends who come
and inform us that a certain
organ is damaged and that 1
needs attention Acupressure
breaks through this carbon to re­
store the flow of efectricsy Thus.
it is not wise to overdo acupres­
sure or else all tne carbon in tre
body will be 'broken" up and wit
reach the kidneys damaging
them
Acupressure works on the
battery of 'ha body, which is the
brain This battery is recharges
during sleep and if ri ts over­
charged then weakness results

Q: FINALLY,
have
you
received any aid from govern­
ment?

Q: HOW would you sum up

acupressure0
A: APART from there being
no expense (gold, silver anc
copper charged water s taken
only to empower the benery)
nothing else goes mto tne body.
as such. Acupressure is oasicai-

i

A: NONE a all The only one
■ to reaDy help me has been
Morarji Desai He tried tne
therapy when he was the Prime
Minister He was of the opinion
tnai the government should
propagae
acupressure
out
before he cbud act further his
government fat I met him in
bon, if you ike. to acupressure
1981 and he literally ordered me
are purely from nature For in­
to write my bosk. It took me two
stance amla powder has con­
and a half years and there are
centrated vnamin C 16 times
two chapters which tell how to
more man a 'emon Then certain
cure certain dseases, material
ciocnemical salts have so be
I
which
is not available in any
added as times, to temo»e the
other book. I have in my 14
problem If me root cause d
\
years
of
work examined 1,25.000'
the arment s removed and
persons and nave accurately
gold- and stiver-charged water
taken, along with a change m
| the only therapy where y<
i become your own doctor),

1'3 NOv
INDIAN EXPRESS
HOMUa Y)

cupuncture,

NEEDLING YOUR WAY TO HEALTH
Severely belaboured by the shortage oi western
trained doctors, Mao Tso Tung was compelled to
harness the resources oR China's traditional healers.
China's national pride remained intact. Fortunately
so did acupuncture.
\3\'\\AO
. Today acupuncture has developed into a wellestablished pan oi the Chinese traditional medical
system with its own hospital® manned by Hve-year
trained practitioners exclusively devoted to this form
of treatment, say jXJ F Mistry and W £•( Antto. Among
one of its more dramatic recent achievements is its
ability to induce anaesthesia for major surgery.

first
listed io the 26 AD col­
lection of Li-Chu-Ko ontitled' "tile Yellow Emperor's
classic of internal Medicine" is
an art of healing founded on
prolonged
ubservntiou
and
empiricism. It arose from "folk"knowlcdgc
dating
back
perhaps to the Chinese Stone
Age around the 2nd and 3rd.century BC when it was
'assumed that people discovered
points in the human body which
if pressed or punctured with
stone needles helped to alleviate
pain or produce other effects.
Through erv-ii csihinige and
widening of experience, more
and more poi ts were disco­
vered through which it was
possible to influence even the
functioning of internal organs.
Over a period of time new
connections
arose
between
these points and the internal
organs. In order to facilitate
engulfed ( tuna in the decades
memory, these points were
between 1920 and 1950s. Sev­
given names which in accord­
erely belaboured by the shor­
ance with the spirit of die times
were only partly anatomical.
Today over 722 points arc
generally acknowledged.
Of particular interest was the
fact that numerous widely sepa­
rated points affected 'a single
organ. Such intciconnectionti
between points were called
"ching" or "mdridians”. Such
knowledge of the interconnec­
tion between skin and inusClc on
one hand mid internal organs on
the other wos the unique and
special discovery of ancient
Chiire.se medicine.
Tire classification of organs
was based on philosphical pre­
cepts The storage organs wore
classified as the passive (yin)
organs and the avtivn .urea such
as tire stomach and intestine
were termed us rhe Yang (ac­
tive) organs. These organs worn
interconnected through vessels
through which passed the "chi"
or energy (literally meaning tor
or breath). This energy moti­
vated the ’Tao' (law of nature)
which was considered ns die
developmental lores behind all
phenomena. This energy con­
trolled circulation, ingestion
and autoprotection Imbalance
energy cither in the fonn of
excess or blockage resulted In
the ii ,(functioning of these
organs
‘■hough never redundant, th
resurj; ucc of traditional medi­
cine in 20th century China de­
pended on the outbreak of the
Second World War, the famines
\m> the political turmoil that

A

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*
tage of western trained doctors,
Mao Tse Tung was compelled io
harness the re ources ot China's

.

traditional
healers.
China’s
national pride remained cntiict,
Fortunately so did acupuncture.

. .• k
gg< g

Today acupuncture has de­
veloped into a well-established
part of the Chinese traditional
medical system with its own
hospitals manned by five-year
trained practitioneis exclusively
devoted to this form of treat­
ment Like the other forms of
traditional medicine, acupunc­
ture is losortod to extensively
even today by the Chinese pub­
lic as well us by the allopathic
doctors for cnndlllr>n» where its
efficacy
is
well
accepted.
Among one of its more dramatic
rqcotit ncliievmnorits l» Its ability
to induce anaesthesia for major

surgical procedure.
Even though a substantial
part of China was occupied by
five major western powers fur
two centuries', it is surprising
that acupuncture did not gain
their recognition. During the
Tang period acupuncture had
reached Japan. Korea and In­
dia. 'Hie first account of it to

kpjhMr fri"EtUGfte w£s |fr Lon ­
don in 1833 by tne Dutch doctor
Ten Rhyne However these and
other subsequent publications
were mere curiosities riulrei
Hum »«icntifie works lire first
scientific treatise was I’ Dabry's
book "Medicine Amongst the
Chinese" published In Paris' in
,1863.
(

Ils acceptance in the western
world however was completely
submerged duff to several
reasons such as the ascendancy

of lhe rapidly curative allopathic
*yrtcm of medicine, iU emphnrir
on anatomy and its rapid dis­
semination
into
the
East
through Westron Colonisation •
military, political And religious.
The inadevertent or deliberate
Mibjufjition of cultural nnd
ethnic identity of the colonized
world held at bay the develop­
ment of moM traditional art*
und practices of healing Indeed
in our country nt tfee turn of this
vrmun 'he ‘rnnshition of the
<,7wzaA; Jt nnd ‘lbe.. _ Susbjruhi

bey is highly instructive. Clo­
publication of Hatnlyn An Ulustrot cd history of Medicine. dis­ wn rd wiw one;'Of die first U.S
paragingly noted that
the
surgeons to visii.China after the'
“Chinese did not learn their
Second World War. He ack­
surface anatomy in a rational
nowledged that like his col­
leagues he also had disbelief in
way”.
Only the fpmiidability of Chi­ the claims made by these orien­
nn as it political und a military
tal practitioners who punctured
power opened up channels of the body with needles inserted
communication with the west­ at various anatomical points cal­
ern world nnd fuelled the in
led 'meridians'.
tercst of western medicine in
It neither fitted the anatomic­
acupuncture. Today committee'
al, pathological or neurological
sit in the WHO to formulaic
concepts o( the existing olio.rinusjLnmionnl
. ixcypuncture •' pbthie cdqcffptt^if the medicine
which Tbok over 15
nomoticlatbrcs
Uo
facilitate
based on existing western scien­
teaching research nnd clinical
years to accomplish was ordcied
tific knowledge and reasons and
destroyed by our colonial mas­
practice of acupuncture as well
was hence relegated to 'unscien­
ters
a monumental waste of
as exchange of information gio
tific oriental mysticism akin to
paper
bally Its recent popularity tn
yoga und tbe Indian rope ..trick.
India despite its loijc association
imagine his surprise and shock
Attempts to undersuind acu­
with China merely followed (hr
when he was demonstrated the
puncture on western framework
recognition awarded by western
of dcithci logic or experience
removal of a brain tumour with­
world
failed since the description of
out any anaesthetic aids except
the paints and meridians har­
The experience of Ralph Clo
the use of acupuncture His
boured no similarity ot refer­
story of the actual procedure
ward, an American neuro
ence iv anything described b>
goes us follow:
surgeon which was personalh
Western dissert iv<* anatom>
Conveyed 10 one of the authors
" Hie patient, a middle aged
I ven as late as 196b a reputed
during one of his visits io Bom
woman, was wheeled into the

gg'

operation theatre after, being
Informed that a foreign surgeon
"was going to be in the gallery to
observe her operation undci
acupuncture On entering the
theatre the padent looked at me
in the gallery nnd in the usual
Chinese manner greeied me
with the clapping of her hands
No injections, no drips or local
infiltration anaesthesia was used
except for an acupuncturist in­
serting needles into het
The surgeon opened the
skull, removed a large menmg
iQITtS (a tumour of the mening
es) and then closed the wound
The patient was conscious dur
ing the whole procedure bui
revealed no evidence of pain or
discomfort. At the end of thr
operation rind before the patient
was wheeled out of the opera­
tion theatre she looked up ot
me, smiled and clapped her
hands again to demonstrate her
pleasure "
Since thqm_ visuing surer-ons
C oitlin'urd on pagt]\ /

Need^mg your
page 1

have otxserved a variety of sur­
gical procedures under acupunc­
ture nnnmthcsia including open
ing of the chc.!>( for thoiuclc
surgery without any evidence of
paradoxical respiration di.c to
mediastinal shift. While no op­
eration
under
acupuncture
anaesthesia has been personally
observed by us in China, one of
the authors during a visit to that
country was shown a film on
thyroidectomy at the acupunc­
ture hospital in Chengdu in
which the patient couju speak
during the actual suigcry. lie
also observed Colonel Rao us­
ing acupuncture anaesthesia for
a hernia repair nt the Armed
Forces Medical College in Pune.
Whether acupuncture can re­
place modern anaesthesia is not
the contention. These experi­
ences have demonstrated that
acupuncture undeniably pro
duced remarkable effects which
could not be explained under
the then available western
knowledge of anatomy and
pharmacology of the nervous
system. That the scepticism of
western scientists could only be
dispelled after the discovery of
nature’s own pain relievers the
endorphins and enkephalins
(morphine like compounds) is
not only a reflection of the
limitations of western science in
explaining phenomena well de­
scribed and practised by other
races, but also on the scientists
themselves who fail to applet.

I
L

ate the limitations of then sc.
cnee.
The West has by and large
.faded

to

acknowledge

the

Joseph Needham, the scholar of
Chinese science has demons­
trated that possibly more than
half thr ba«i< Inventions and
discoveries upon winch the
modern world rests come from
Chinn

And

yet,

few

people

know this. Why? Their refusal
to a’cccpj and learn from thp far
oldai civilizations jiKt because
their explanations arc both literally as well as metaphorically in
u languawc different to their
own, is akin to the intolerance
which they themselves suite-red
at the hands of the Christian
church in the pre-Rcnaianunvo
period in Europe.
This altitude of the West is
contrary to the very essence of
the scientific thinking and cultine which it expounds. While
the narrow disscctivc and qunn
titative approach of western sci­
ence may now have provided an
explanation at the molecular
level as to why acupunture
works,- the holistic approach
based on the repetitive observa­
tions of an enquiring mind was
able to define as well as effec­
tively utilize this interesting
phenomenon
for
several
thousand years without wor­
rying about the molecular basis
of its action.
This is not to decry the useful­
ness of the disscctivc approach
but to emphasise that oreintal
science and scientists utilizing a
holistic approach could thiough
expri irnvntation combined with
vriicftil observation achieve pro- »
found
disc uvcii'A
in
ninny j

fields. Yoga and Asuiveda arc/
examples in our own country/

1
‘

[
1

‘

n
f
I
L

The therapy involves thftiJnsertion of very foe metal needles
into the skin at specuily desig­
nated points. Sceptics have of­
ten dismissed the treatment of
disease by acupuncture as
quackery . The same sceptics
have explained away verified
cures as the result of spontane­
ous recovery, good nursing or
psychological reaction. But
there are defimte areas where
even sceptics have to admit that
the system works. Prof Bhupuider Kumar Singh is the director
of the Indian Acupuncture
Centre a: Allahabad, which has
been in ecstence for about ten
years.
'My frst exposure to acu­
puncture came from an article
in the Reader’s D.j-esl ”, says 43year-old Singh S.ngh kept bus
in Brest a-veandaftcrcompletinghis M33S, began cor.cen trating on ths line of treatment.
Singh explains that there are
two approaches to acupunc­
ture. The first, the traditional
approach relies cc. the five ele­
ments theory. It is based on the

This ancient science of healing cousd be of great
use tn this country which has such a shortage of
trained medical personnel. TERESA VtJU JAMES
meets Dr BK Singh, the director of the Indian
Acupuncture Centre

Taoist pbajsopby according to
which gocc hcaltr depends or. a
free arcuation cf Teh: or life
force energy throughout all the
organs. Ths energy is either Yin
(negative) or Yang (positive), it
further propounds the belief
that the elements like ar, fire,
water, etc. arc related topartsof
the body and haveboth destruc­
tive and constructive centres.
Disease afreets the tree crculation and acupuncture restores
it The modern theory concen­
trates on the efficacy of acu­
puncture as an effective pare.
killer.
’There are naturally occur­
ring opiates in the body," ex­
plains Singh. ’This is releasee
into the system and the pain is
killed. Addicts take several
morphine derivatives; this
means that the body’s natural
opiates are stopped. This, ac­
cording to Smgh, is the reason

Vice president SD Shanna releasing Dr Singh's (right),
recent book on acupuncture

one of the problems very succcssrully treated through accupuncture. There is what is
known as the Gate Control
Theory in acupuncture. An in­
jury on any part of the body is
translated into pain when it is
received in the brain. The mes­
sage passes through ’gates’ to
reach the brain. In accupuncture we try to produce non­
painful stimuli by needling.
Thisblocksthegateand the sen­
sation of pain is not conveyed to
the brain.
Sangh has put forward sev­
eral new theories and presented
over 35 papers touching on
every sublet and to audiences
all over the world. His pct the­
ory centres around the state­
ment that aninunctv'O

One of these relics on the
Hindus opermdi of witch doctors
and ancient spiritual healers.
When a sick person was
brought for treatment to them
they beat the patient with some
twig or implement. The pos­
sible puncturing of the person’s
body and the repeated stimuli
brought about therapeutic re­
lief. Later on, the more intelli­
gent of the witch doctors and
medicine men developed the
traditional acupuncture pants.
There are about 800 acupunc­
ture points arranged along 14
lines or meridians running the
length of the body from head to
foot," says Singh. Most Chinese
books describe meridians un­
der five headings viz main,

and in the area of acuvacana- own pants ro the science. Two
ticc or prevention of disease. It cf these termed Bhupcndra’sTl ’
has been claimed that acupunc­ and T 2 prov.de cure for males .1
ture works by stimulating or whose semen contain nosperm. t
repressing the automatic nerv­ Bhupcrdra’s N is a nasafstim- —
ous system. Cases are on record uli used m the treatment of si- >
of British and American physi­ nusitis.
cians performing surgery on
The cffecs of treatment can 1
fully conscious pa dents capable be felt m 15 days," says Singh, i
of conducting a conversation. who runs btxh an out patient i
Like ail modern day acu­ and stay in hospital at Al- i
puncturists, Singh uses the dec- lahabad. "Most patients can be
tro-acupuncturescopc to acti­ treated as out patients," says i
vate a defective meridian. This Singh. Scngh’schargcs are mod­
Chinese made gadget is oper­ est by city standards and a .
ated with a nine-volt battery fortnights treatment with the I
and is capable of stimulating needles tasting 45 minutes a i
certain points. There are no session costs about Rs 1,500.
I
drugs used in acupuncture,"
What role docs acupuncture t
says Singh. On the contrary, play in a country where all the 1
patients who are on drugs like otter systems of medidne put i
steriods for long periods experi­ together barely cover a half of
ence delayed response from the population ?
To date the nearest the gov­
acupuncture. "It is essential for
me to taper the use of steriods, ernment has came to taking an
for acupuncture to begin to take interest in this area of medianc
effect. Ln cases tike these the was when Shr. Shankar Dayal
patient sometimes loses pa­ Sharma released Singh’s book.
"1 met Mohsina Kidwai, ministience in the treatment."
Thcrc is no ailment for ter of health and they wanted to
which a cure is not a vailablc in try it in government hospitals; 1
acupuncture," says Singh. refused because it is a system of
Certain diseases take a long medicine hke ayurveda and not
time to cure — like polio, pa­ something just to be tried."
Acupuncture has a long way
ralysis, progressive muscular
dystrophy, epilepsy, Parkin­ to go before it gams total accep­
son's disease and pigmentosa. tance in ths country. Itcertainly
Acupuncture has been put to seems worthwhile to explore
effective use in ailments like the areas where it is effective,
arteriosclerosis, hypertension, and put those to use in a counpv,
premature balding and spondy­ where there is an acu te shortage
litis." Singh has contributed his of trained medical personnel

CHAPTER 7

Acupuncture and moxibustion

I. Theory and practice

Wei Ru-Shu1

Acupuncture and moxibustion have been applied as therapeutic medical
techniques in China for at least 2000 years since the time when stone
knives and other sharp instruments were used. Because of the wide
indication of these therapeutic procedures, the simplicity of their
application, their minimum side-effects, and their low cost and rapid effect
they have permanently remained popular.
Acupuncture is an apparently simple clinical procedure for inducing
stimulation in various locations of the body to treat disease and alleviate
pain. The term itself is derived from the Latin words acus (a needle or pin)
and punctura (a pricking).

Channels, collaterals and acupuncture points
Acupuncture requires knowledge of the system of anatomy and
pathophysiology which is inherent in Chinese traditional medicine. The
human body is thought to be pervaded by a system of energy channels or
jing luo, in which vital energy or force circulates. The majority of the
acupuncture loci are in these channels, although systems of loci are also
located on the human ear, forming the basis of so-called auriculoacupuncture.
Some practitioners of acupuncture still adhere strictly to traditional
Chinese medical theory, while others use acupuncture empirically, without
reference to the Chinese theory, and strictly in accordance with Western­
style diagnosis and concepts of pathophysiology. Internationally there is a
diversity of opinions regarding the techniques of acupuncture, the
prerequisite qualifications of an acupuncturist, the usefulness of the notion
* Professor of Internal Medicine, Institute of Acupuncture and Moxibustion. Academy of
Traditional Chinese Medicine. Beijing. China.
76

ACUPUNCTURE AND M0XIBUST10N

77

of channels, and the specificity of acupuncture ..points in acupuncture
therapy.
In the network of channels and collaterals, the channels constitute the
main trunks which run longitudinally and deeply in the body and relate to
each viscus, while the collaterals which represent the branches of the
channels run transversely and superficially from the channels.
The system of channels and collaterals includes the 12 regular channels,
the 8 extra channels, and the 15 collaterals. A crisscross network of
channels and collaterals in which blood and qi (vital energy) circulate is
spread over the body. Internally they connect with the viscera and
externally with the four extremities and the superficial tissues and organs.
Their action is to regulate the function of different organs, transport blood
and vital energy and connect external with internal organs, thus making
the body an organic whole. Dysfunction of the channels and collaterals is
an important cause of disease.
An acupuncture point is the site where acupuncture and moxibustion are
applied. Points may be either on the regular channels or on the extra
channels; the latter are called ahshi points. Over 360 points have been
identified along the 14 channels. The points which are not on the 14
channels but have specific therapeutic properties are called extraordinary
points and number several hundreds. The tender or sensitive spots on
which acupuncture and moxibustion are applied are also termed ahshi
points. Points are not only the pathways for the circulation of nutrient qi
and defensive qi, and the focus of common vital energy, but also represent
the points of entry of pathogenic elements, the locus of response to diseases
and the site of treatment. Every point has its own therapeutic property.
Three indications are used for selecting points. First, the distal points;
according to the principle of minute differentiation of the symptom­
complex the points of some channels which are directly connected with the
affected viscus or have an interior or exterior relationship to the involved
part, named the distal points, are those most frequently used. Secondly, the
points which are at the site of the disease or adjacent to it and are termed
local points; and thirdly, the empirical points which are specific for certain
diseases and sometimes represent ahshi points. These three methods of
selection are often used in combination. The action at the point is to
remove any obstruction of the channels and collaterals, regulate the
circulation of vital energy and blood, and adjust the function of visceral
organs and the yin-yang balance. By this means bodily resistance to
exogeneous pathogens is enhanced and diseases can be combated.

Technique
Thin filiform needles are inserted into various parts of the body for the
intended treatment of a variety of disease states and. since 1958, for
inducing analgesia for surgical procedures. The needles are usually left in

78

TRADITIONAL MEDICINE AND HEALTH CARE COVERAGE

situ for 15-30 minutes or longer. They may be manipulated by hand in
twirling or push-pull movements and may be electrically activated by
pulsatile electrical stimulation. It has been claimed that an acupuncture-like
effect can also be obtained by deep finger pressure, so-called acupressure.
Other more recent approaches to the stimulation of acupuncture points
include the use of ultrasound and lasers.
Moxibustion represents a special form of point stimulation. The
procedure involves burning a piece of the Chinese drug plant, Artemisia
vulgaris, either on the head of the acupuncture needle so as to conduct heat
into the body, or in some cases actually on the surface of the skin. The
importance of this procedure can be seen from the Chinese term for
acupuncture, zhen diju, which literally means “needling-moxibustion”.
The therapeutic methods of acupuncture and moxibustion

There are many therapeutic methods which make use of acupuncture and
moxibustion. Beside the traditional ones which are still widely used today,
new methods developed by combining modern scientific techniques with the
traditional Chinese acupuncture and moxibustion are constantly being
introduced. These include electro-acupuncture therapy, low frequency
electric therapy, point injection with minimal doses of drugs, point
magnetic therapy, catgut imbedding into the point, and point laser
radiation. Some examples of the current practice of acupuncture therapy,
finger pressing therapy or acupressure, and moxibustion are briefly given
below:
Acupuncture needles. There are filiform needles, three-edged needles,
plum-blossom needles and ear needles, all generally made of stainless steel.
The filiform needle is the main one used in ordinary clinics and has various
lengths (1.0-15 cm) and diameters (0.27-0.46 mm).
The filiform needle is selected according to the depth of the site of the
disease, the thickness of the muscle and skin, and the required depth of
insertion. Depending on the degree of the sensation of soreness, numbness
and distension manifesting itself, either reinforcement is applied to xu or
the insufficiency syndrome, or reduction applied to shi or the syndrome of
excess. For those diseases in which neither xu nor shi is clear, both
manipulations may be used.
The three-edged needle is applied for purposes of blood-letting, and
often for patients with high fever.
The plum-blossom needle is used for tapping and exploring the skin of
the aflected area and its adjacent parts.
The ear needle is employed for press acupuncture at the sensitive point
of the corresponding region of the ear which is then compressed and the
needle fixed with adhesive plaster.
Finger-pressing therapy or acupressure. This method is used to treat
disease by pressing the points with the thumb or middle finger or with the

ACUPUNCTURE AND MOXIBUSTION

79

free edge of the finger nail. For example, pressing at renzhong may relieve
an attack of epilepsy, fainting and shock; pressing at hegu may stop
toothache and check an attack of asthma, pressing at fengchi may abolish
dizziness and peculiar sensations in the head.
Moxibustion. The main material currently in use is moxa wool or moxa
wool mixed with Chinese herbs which can stimulate the energy flow in
channels and collaterals, ameliorate syndromes arising from cold or wind,
and promote the circulation of blood and vital energy. The moxa wool,
shaped into a moxa stick (20 cm long and 1.4 cm in diameter), is made of
dry moxa leaves (Artemisia vulgaris) ground into a cotton-like substance
with any impurities removed.
The methods of application vary and are summarized as follows:

(a)
Moxibustion with moxa cone: there are two kinds, the direct and the
indirect; the smallest cone is like a grain of rice, with the diameter at the
base 0.4-0.7cm and the height 0.3-1.0cm. Direct moxibustion is
performed by placing the cone directly on the point and then igniting it.
Two varieties are used; scarring and non-scarring moxibustion. Indirect
moxibustion is also called partition moxibustion since some materials such
as ginger, garlic, salt, onion, aconite and monkshood are placed between
the cone and the point.
(b)
Moxibustion with moxa-stick: the ignited moxa-stick (2.0 cm long) is
placed on the top of the needle handle, or else a piece of moxa wool is so
placed, and when the needle has been inserted into the point the moxa is
ignited.
The indication for moxibustion is mainly “insufficiency xu syndrome"
and “cold syndrome”. Moxibustion at zusanli and guanyuan points is said
to improve general health.

The basic theory of acupuncture and moxibustion
Acupuncture and moxibustion are not only simple practical skills. They
are governed by a comprehensive theoretical system which guides the
clinical practice. The theories are based on the concept of yin-yang; the five
elements—viscera, channels and collaterals, qi (vital energy) and blood
The etiology derives from the theory relating to the viscera: channels and
collaterals constitute the core. A good clinician and practitioner of
acupuncture and moxibustion applies the above theories. In practice he will
ascertain symptoms and signs through a carefully taken case history and
appropriate physical examination. A review of the clinical findings enables
the practitioner to determine whether the ailment is exterior (muscle or
skin, collateral) or interior (yang, yin viscus; fu, yang viscus; or channel), in
the blood or qi; and to differentiate further the nature of the disease such
as xu or shi; cold or heat, yin or yang. By these means minute etiological

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TRADITIONAL MEDICINE AND HEALTH CARE COVERAGE

differentiations can be made and the practitioner can accurately treat the
disease and achieve a desirable result.

Indications
Acupuncture is used clinically in several ways, as a primary treatment or
in combination with other therapeutic methods, and as an adjunctive
treatment.
The textbook, An Outline of Chinese Acupuncture (/), gives a
comprehensive list of indications for the treatment of diseases with
acupuncture. These are listed as follows:
I a) Medical diseases. Common cold, influenza, bronchitis, bronchial
asthma, heat stroke, pain in the gastric region, spasm of the diaphragm,
infectious hepatitis, acute enteritis, dysentery, cardiac diseases, hyperten­
sion. shock, strained neck, malaria, arthritis.
(b) Surgical disorders. Lumbar pain, shoulder pain, elbow pain, tendon
sheath diseases, sprain of the lower extremities, acute appendicitis, diseases
of the biliary tract, mastitis, furuncle, acute lymphangitis, simple goitre and
hvperthyroidism, haemorrhoids, prolapse of rectum.

(c)
Gynaecological and obstetrical disorders. Irregular menstruation,
amenorrhoea, pelvic inflammatory diseases, prolapse of uterus, morning
sickness, malposition of fetus, prolonged labour, lactation deficiency.
(d)
Paediatric diseases. Whooping-cough, infantile malnutrition, acute
infantile convulsion, chronic infantile convulsion, parotitis, poliomyelitis.

(ej Diseases of the sense organs and neighbouring structures. Acute
conjunctivitis, photophthalmia, myopia, atrophy of optic nerve, tonsillitis,
pharyngitis, chronic rhinitis, chronic sinusitis, toothache, deaf-mutism.
tfi Nervous and mental disorders. Apoplexy, paraplegia, epilepsy, head­
ache. trigeminal neuralgia, facial paralysis, sciatica, multiple neuritis,
neurasthenia, hysteria, schizophrenia, intercostal neuralgia.
(g) Urogenital disorders. Enuresis, retention of urine, spermatorrhoea
and impotence, infections of the urinary tract.

The inclusion of specific diseases in the list is not meant to indicate the
effectiveness of acupuncture therapy, but rather the extent to which it is
currently being applied. Furthermore, this list of indications is based on
clinical experience and not necessarily on controlled clinical research.
There are certain specific contraindications to the use of acupuncture.
These include pregnancy when associated with diseases otherwise amenable
to acupuncture, needling of tumour sites, skin infections, presence of a
cardiac pacemaker, and coexisting haemorrhagic diathesis such as
haemophilia. The risks attendant to any kind of needle insertion into the
body are also acknowledged, particularly in areas where puncturing of vital

ACUPUNCTURE AND MOXIBUSTION

81

structures could inadvertently occur. Reliable diagnosis according to
general standards of medical practice is essential in the clinical application
of acupuncture therapy to ensure the appropriate treatment of disease.
Further research into the clinical indications and contraindications of
acupuncture is considered essential.
Particular note should be taken of the use of acupuncture to effect
anaesthesia. The term acupuncture anaesthesia is in fact a misnomer, since
the procedure produces an absence of pain sensation, but not other senses,
such as temperature, touch, and pressure. Acupuncture anaesthesia should
therefore be more correctly termed acupuncture analgesia. Both terms are,
however, freely applied.
In the People’s Republic of China, 15-20% of all surgical cases are said
to be performed under acupuncture analgesia. In other countries, including
Austria, the Federal Republic of Germany and the United States of
America, acupuncture analgesia has also been used in surgery with success.
The limits on acupuncture analgesia in countries other than the People’s
Republic of China seem to result from lack of suitably trained medical
specialists as well as some degree of opposition from the medical
establishment. The overall success rate with acupuncture analgesia in
diverse surgical procedures is said to be between 70% and 80%, thus
leaving a considerable number of patients who require Western-type
anaesthesia. Acupuncture analgesia is considered a valuable addition to the
therapeutic armamentarium of the qualified anaesthesiologist.

REFERENCE
(/) The Academy of Traditional Chinese Medicine. An outline of Chinese acupuncture.
Peking (Beijing). Foreign Languages Press. 1975.

82

TRADITIONAL MEDICINE AND HEALTH CARE COVERAGE

II. Research in
acupuncture

Robert H. Bannerman1

During the past decade, knowledge stemming from research in
physiology, biochemistry and pharmacology on the one hand and
knowledge from research into the mechanisms of acupuncture on the other
have tended to converge. It is interesting to note this convergence of
modern international science with traditional Chinese medicine.
Important advances have been made in our understanding of the
mechanisms of acupuncture, particularly analgesia. In terms of modern
medicine, the principal action of acupuncture and moxibustion is to
regulate the function of the human body and to increase its resistance by
enhancing the immune system and the antiphlogistic, analgesic, antispastic,
antishock, and antiparalytic abilities of the body.
In establishing future policy for research in acupuncture, it will be
necessary to consider the integration of basic and clinical research. Clinical
research requires the foundation provided by the basic sciences, while basic
scientific endeavours may be informed by clinical experience. Certainly
clinical trials, analogous to the procedures for testing new pharmacological
agents, are urgently needed to further the acceptability of acupuncture.
Great progress has also been made in clinical research on acupuncture
analgesia, which has been used during surgery on more than 2 million
patients in the People’s Republic of China. In over 100 different types of
operation, its effects have been found to be comparatively stable in 20 to
30 kinds of common operation. Generally, acupuncture analgesia is
thought to be more effective in head, neck and chest surgery It has also
been used with satisfactory results in subtotal gastrectomies, splenectomies,
total laryngectomies, and open-heart surgery under extra-corporeal circu­
lation. Large numbers of abdominal tubal ligations are done under
acupuncture analgesia, and over 80 7„ have been rated as very satisfactory.
* Formerly. Manager. Traditional Medicine Programme. World Health Organization,
Geneva.

ACUPUNCTURE AND MOX1BUSTION

83

Several animal experiments and clinical studies have been performed to
elucidate the mechanisms of acupuncture analgesia and advances have been
made in studying the role of the nervous system in such mechanisms. In
the past two or three years, Chinese scientists have succeeded in developing
techniques for the isolation, extraction and determination of endogenous
morphine-like substances, as well as for artificially synthesizing the highly
active substance encephalin and its derivatives. Experiments in both man
and animal have shown that the analgesic effect of acupuncture may be
partially antagonized by the morphine antagonist naloxone.
However, many problems concerning the mechanism of acupuncture and
acupuncture analgesia have yet to be elucidated. All of the above studies
point to the need for further exploration, application and research on
acupuncture. These are important not only for the health and welfare of
the people but also for the progress of medical science.

T raining
Since acupuncture may be considered as part of the practice of medicine.
it is necessary to define suitable standards for acupuncture training.
Training must be addressed to the different needs of various kinds of
trainees, i.e., basic scientists, primary care physicians, health specialists or
auxiliary health personnel. It has been estimated that a Western-trained
physician may require no more than three months’ training to learn
acupuncture in theory and practice. Those who follow the three-month
Chinese programmes in acupuncture are generally able to study the
identification and use of some 300 basic acupuncture loci. The programme
also covers the treatment of common ailments both in theory and in
practice as well as traditional Chinese medical theory, including yin and
yang and the theory of channels and vital energy. Some time is also spent
on scalp and ear acupuncture, on the pathogenesis of disease, and on
acupuncture mechanisms according to traditional Chinese concepts.
Internationally, acupuncture training is heterogeneous, reflecting different
views on what acupuncture is, how it should best be practised, who should
be authorized to practise it and under what circumstances. The country
reports from Asia and Europe give an impression of the diversity of
training policies and programmes. The more standardized pool of trainees
at present is composed of those physicians who have trained in the People's
Republic of China. It is generally felt that the traditional Chinese
techniques and theoretical approach must be combined with established
Western approaches to the diagnosis and treatment of disease.
In the People’s Republic of China, while medical school graduates
are given both theoretical teaching and clinical experience of tra­
ditional Chinese medicine, including acupuncture, they are also taught
Western-type concepts of the anatomy, pathophysiology, diagnosis and
treatment of diseases. It has been estimated, however, that approximately

ACUPUNCTURE AND MOX1BUST1ON

83

Several animal experiments and clinical studies have been performed to
elucidate the mechanisms of acupuncture analgesia and advances have been
made in studying the role of the nervous system in such mechanisms. In
the past two or three years, Chinese scientists have succeeded in developing
techniques for the isolation, extraction and determination of endogenous
morphine-like substances, as well as for artificially synthesizing the highly
active substance encephalin and its derivatives. Experiments in both man
and animal have shown that the analgesic effect of acupuncture may be
partially antagonized by the morphine antagonist naloxone.
However, many problems concerning the mechanism of acupuncture and
acupuncture analgesia have yet to be elucidated. All of the above studies
point to the need for further exploration, application and research on
acupuncture. These are important not only for the health and welfare of
the people but also for the progress of medical science.

Training

Since acupuncture may be considered as part of the practice of medicine.
it is necessary to define suitable standards for acupuncture training
Training must be addressed to the different needs of various kinds of
trainees, i.e., basic scientists, primary care physicians, health specialists or
auxiliary health personnel. It has been estimated that a Western-trained
physician may require no more than three months’ training to learn
acupuncture in theory and practice. Those who follow the threc-month
Chinese programmes in acupuncture are generally able to study the
identification and use of some 300 basic acupuncture loci. The programme
also covers the treatment of common ailments both in theory and in
practice as well as traditional Chinese medical theory, including yin and
yang and the theory of channels and vital energy. Some time is also spent
on scalp and ear acupuncture, on the pathogenesis of disease, and on
acupuncture mechanisms according to traditional Chinese concepts.
Internationally, acupuncture training is heterogeneous, reflecting different
views on what acupuncture is, how it should best be practised, who should
be authorized to practise it and under what circumstances. The country
reports from Asia and Europe give an impression of the diversity of
training policies and programmes. The more standardized pool of trainees
at present is composed of those physicians who have trained in the People's
Republic of China. It is generally felt that the traditional Chinese
techniques and theoretical approach must be combined with established
Western approaches to the diagnosis and treatment of disease.
In the People’s Republic of China, while medical school graduates
are given both theoretical teaching and clinical experience of tra­
ditional Chinese medicine, including acupuncture, they are also taught
Western-type concepts of the anatomy, pathophysiology, diagnosis and
treatment ol diseases. It has been estimated, however, that approximately

84

TRADITIONAL MEDICINE AND HEALTH CARE COVERAGE

20% of the students graduating from medical colleges are trained primarily
in traditional Chinese medicine. Doctors trained in traditional medicine
work throughout the Chinese health care system in hospitals, clinics and
specialty areas, and also in primary health care.
The Chinese health workers who haveubeen called “barefoot doctors” in
rural areas and “red medics” in urban areas are also taught acupuncture
for a limited number of common ailments such as the common cold and
influenza, common skin diseases, neuralgias, sciatica, etc. These health
workers constitute an extremely important link between the Chinese
population and the more specialized or institutionalized levels of the
Chinese health care system. It is significant that such health workers
practise an integrated form of medical care, including acupuncture.
In a few countries, training is provided for the most part in private
institutions, under the supervision of an ad hoc professional body involved
with acupuncture, or else on an apprentice/teacher basis. Most other
countries do not offer any significant form of acupuncture training at
present.

Technology transfer and impact on health care

The development of acupuncture as a safe and clinically useful technique
depends largely on international transfer and exchange of information and
skills. At present, scientific research and communication in this field are
still hampered by limited dissemination of information. For example,
acupuncture literature is only sporadically represented in standard
computerized medical information systems, such as medline. There is, as
yet, no centre where information on acupuncture from international
sources is stored and compiled for use by interested investigators.
Nomenclature is another important question. In many medical fields,
terminology has been standardized on an international basis as far as
possible. However, in acupuncture, a variety of systems are used in
different countries for the designation of acupuncture loci, and other
technical terms also are translated in various ways. This difference in
terminology hinders international scientific communication, and steps must
be taken to remedy it.
Most research efforts in the field of acupuncture have been made in the
People’s Republic of China, but access to Chinese literature is limited by
its relative unavailability in other languages. No concerted attempt has yet
been made to translate the bulk of this material into the major Western
languages.
Another serious obstacle to the transfer of knowledge about acupuncture
is the antagonistic altitude of many medical colleagues and allied health
professionals towards accepting acupuncture therapy as a medical practice.
This scepticism is paralleled by an ignorance on the part of the general
public which makes patients in search of treatment easy prey for

ACUPUNCTURE AND MOXIBUSTION

85

unscrupulous or uninformed practitioners of acupuncture. This difficulty is
compounded by problems of manpower development and the lack of highquality educational programmes which would ensure a consistently high
level of research and clinical care.
Clearly, educational programmes for the dissemination of available
knowledge and research data are of great importance; and here, napralert
(natural products alert), the computerized system for the surveillance of
world literature on the chemistry and pharmacology of natural products
that is described by Farnsworth in Chapter 18, could well make a major
contribution. Other programmes might be organized to reverse the
unfavourable attitudes of medical professionals and to educate the public
concerning the safety of the procedure, its indications and its limitations.
The elimination of quacks and unscrupulous or uninformed practitioners.
thus ensuring a high level of clinical ethics and practice, would do much to
make acupuncture respectable. Obviously, a greater degree of international
cooperation is required in teaching, education and research on this subject
and also in the control of acupuncture practice.
The problem of control concerns mainly the diversity of national
regulations dealing with the practice of acupuncture.1 In some countries.
acupuncture is prohibited. In others, regulations for its practice are
completely lacking. Some nations stipulate that only physicians may
practise acupuncture, while others consider it as suitable only for research
at the present time. Some countries license "doctors of traditional
medicine” regardless of whether they are physicians or not. Other nations.
such as the People’s Republic of China, recognize acupuncture as an
acceptable medical practice for all types of health care personnel. Clearly.
there is a need in many parts of the world for more careful formulation of
policies concerning the regulation of acupuncture.
The transferability of acupuncture to countries with differing social.
cultural, and medico-legal conditions requires careful consideration. Yet, as
described above, acupuncture has already attained a firm foothold tn
certain countries of Asia, Africa, Europe and the Americas. Established
international agencies could play an important consultative role in such
efforts.
FURTHER READING

Bannerman. R. H. Acupuncture: the WHO view. World Health. December 1979. pp. 24-29.
JAYASURIVA, A. & Fernando. F. Principles and practice of scientific acupuncture. Colombo.
Lake House. 1978.
Kao. F. F. & Kao. J. J., ed. Recent advances in acupuncture research. New York. Institute for
Advanced Research in Asian Science and Medicine. 1979.
Use of acupuncture in modern health care. WHO Chronicle, 34:294- 301 (1980)

See also Chapter 27. Legal aspects.

Vol. 18, No. 4
Printed in Great Britain

International Journal of Epidemiology
© International Epidemiological Association 1989

.

A Meta-Analysis of Acupuncture for
Chronic Pain
MAHESH PATEL,* FELIX GUTZWILLER,** FRED PACCAUD** AND ALFIO MARAZZI **
Patel M (Route de Saint-Loup 4,1290 Versoix, Switzerland), Gutzwiller F, Paccaud F and Marazzi A A meta-analysis of
acupuncture for chronic pain. International Journal of Epidemiology 1989, 18: 900-906.
Resultsof 14 randomized controlled trials of acupuncture for chronic pain were pooled in a meta-analysis and analysed
in three subgroups according to site of pain, and in two subgroups each according to type to trial, type of treatment,
type of control, 'blindness' of participating agents, t ria I size, and type of journal in which results were published. While
few individual trials had statistically significant results, pooled results of many subgroups attained statistical signif­
icance in favour of acupuncture. Various potential sources of bias, including problems with blindness, precluded a
conclusive finding although most results apparently favoured acupuncture.

While acupuncture is increasingly used by the general
public and treatment costs are often reimbursed by
health insurance companies, its clinical efficacy
remains scientifically unproven.12 This study was
undertaken to investigate the hypothesis that the indi­
vidually inconclusive trials performed to date might.
when their results were pooled in a meta-analysis
(MA), yield a more definitive result.

MATERIAL
This MA is based on results of all trials of acupuncture
for treatment of chronic pain, published in English.
listed in Index Mcdicus from 1970 onwards that were
randomized controlled trials (RCTs) of chronic pain
that measured outcome in terms of number of patients
whose condition improved The World Health Organ
ization s collection of (English language) Chinese, tra
ditional. and alternative medical journals and
literature yielded additional trials. References weie
obtained from ptevious reviews'-1 and from Catherine
Hill s. as yet unpublished, excellent and comprehen
sive bibliographx
IriaE wctc discarded it they were uncontrolled.
not randomized
oi did not measure results in terms
of numbers oi patients improved and provide the
number ol patients randomized.11 16 A complete list ol
excluded trials is not presented.
Published study plans of the selected RCTs arc sum
mari/ed in Table 1 lew published baseline data attci
‘Rouu de Sum: I ..up J ;.'»«> Versoix. Switzerland.
‘’Insitim Unix. isH.m, a \ledeeinc Soeialc cl Preventive. 17 R<.< .h
Bugn.m f.UOs I ,iux.mn»- Sxx ii/erland

randomization.’ Additional technical.1'' methodolog­
ical1'' and paradigmatic2' problems in evaluation of
alternative medicine have been reviewed elsewhere.
Formula acupuncture (FA) uses a set of fixed points
repeatedly. Classical acupuncturists (CA) traditionally
vary points used from patient to patient, and from
treatment to treatment. Most trials achieved 'Teh Chi’
or a 'needling' feeling, ie numbness in the area of the
needle, proof that a point has been located correctly.
The control’ was sometimes a continuation of
medical treatment. Although these RCTs t caused on
chronic rather than acute pain, thus reducing the probability of remission, use of continued conventional
treatment controls is still unsatisfactory. Transcutane­
ous neural stimulation (TNS) was often used, some
time' on acupuncture points. Treatment of chronic
pain with medical placebo (sugar pills) was not perloimcd Placebos most frequently used included
placebo acupuncture and mock TNS. Clearly, blindnc" ot patients was possible only when placebo acupunctuic was used. Relative costs were not mentioned
in an\ n nil.
Ml HIOD
Meta analysis’122 is a set of method ogical tech­
nique' used to define accumulated know ledge b\ pool­
ing ic'iills of studies.2' Methods used diltci according
to hom* igcneity of study outcome RC ”1' selected were
tc'ted tor homogeneity using the •(.)’ statistic 1 The
overall pooled risk difference and its ns confidence
n il (('I) between acupuncture and xontrol groups
was ex aluated on the basisof a 'random
•« > model,
ncvcss.iry as a result of the lack of under King homog-

Table I

Acupuncture studies

Treatment group

Site of pain

Experimental

Low back pain
Low back pain
Low back pain
Low back pain
Low back pain

CA. EA
FA
EFA
FA
CA

Control

Number in groups

Number pals belter

Rckm

Exper

Control

Exper

Control

nilicance

Blindness

Delayed acupuncture
TNS on acupuncture pls
Placebo acupuncture
TNS on acupuncture pts
Lidocaine injection
+ placebo acupuncture

25
50
15
12

25
50
15
cross over

19
29
6
8

5
23
5
6

No
NS
No
NS

NS
NS
NS

None
Patients
Patients + evaluators
None

95

cross over

26

22

NS

NS

Patients + evaluators

Placebo
Tender spots on neck
Inappropriate acupuncture

12
19
88

12
19
84

5
b
53

9
9
45

NS
NS
NS

NS
NS
NS

Assessor
Patients
Triple blind

Chronic facial pain
Neck pain
Headache
I leadachc
Cervical pain
Cervical spondylosis

Shoulder-cuff lesions
Pam below the waist
Musculoskeletal pain

FA
EFA
FA

»in Figure 1 Crossover studies summed over treatment order
re point selection varied according to the needs of the patient
cupuncture. □ standard set or sets of points applied to all patients
iicupuncturc or formula acupuncture in conjunction with electrical stimulation of the needles

ieous neural stimulation
><0.01 NS = no significant difference

902

INTERNATIONAL JOURNAL OF EPIDEMIOLOGY

encity of the studies. Cochran’s semi-weighted estima­
tor for the risk difference was used /1 The results of two
additional indicators, the logarithm of the odds ratio.
and the logarithm of one minus (1 — ) the relative differ­
ence. were also examined.'’'
Complete information on crossover studies was
unavailable in published trial reports, and these were
treated as two independent samples summed over
treatment order. If there is agreement between treat­
ments, this procedure simply loses power/' In order to
be certain that confusion was not generated by pro­
cedural differences between crossover and standard
randomized trials, these were also analysed as two sep­
arate subgroups for each pain site
For detailed evaluation, trials were classified (Table
2) into one of three subgroups according to the general
anatomical site of pain (lower back, head and neck.
and other sites) and into one of two subgroups accord­
ing the nature of the control (placebo or treatment).
Classical acupuncture was distinguished from formula
acupuncture. Trials in which any agents (patients, ther­
apists. or evaluators) were blind were identified. Large
trials 50 patients or more, were identified. Trials pub­
lished tn journals with the words 'Chinese' or 'acupunc­
ture' in their title were distinguished from those in
traditional western' medical journals
Due to the large number of these classification cri­
teria and the small total number of trials, subgroups
based on combined classification criteria (eg. partially
blind trials using classical acupuncture) were not
exhaustively analysed. There are 192 ways in which
Tabi.ii 2

Composition of subgroups

Study numbers

s ...lies numbered as in Table I
’ s-mhes mu homogeneous al p<0.05
Studies nol homogeneous al pcO.OI

two criteria could be combined. Hence residual, and
potentially relevant, heterogeneity within initial
groups could not be systematically avoided.
Editors may have been biased against publishing
inconclusive studies Pooling of published studies
would then obtain a biased result. The influence of
publication bias was evaluated by estimating the
number of unpublished randomized controlled trials of
acupuncture for the treatment of chronic pain with
inconclusive results that would need to exist in order to
negate the findings obtained1' (the ‘file drawer’
problem).
In order to ensure that MA methodology was com­
prehensively applied, the analysis was measured
against a list of qualities and a scoring system proposed
forXiedical MAs/

DATA
Five trials dealing with low back pain (trials 1 to 5 in
Table 1) met the selection criteria. Coan did not report
statistical analysis of results/' Results were statistically
significant though long-term follow-up showed regres­
sion of beneficial effects. Laiiinen’’'1 and Edelist'1 did
not attain significance. Fox' inserted only three
needles, unilaterally, for one minute at each point
sequentially. These third and fourth trials offered less
treatment than is conventional. In Mendelson.' both
patients and the final evaluatot of pain were blind,
potentially confusing effects of treatment order were
noted, and no statistically significant results were
obtained.
The second group treated headache, neck pain, cer­
vical pain, cervical spondylosis and chronic facial pain
and included six trials lhat met the selection criteria
(trials 6 to 11 in Table 1) In Hansen, placebo treat­
ment involved superficial mseition of acupuncture
needles at non-acupuncture points A pain index
yielded a Wilcoxson test with o t>5>p>0.025, and a
sign test of subjective prclctcmes ot patients yielded
p = 0.035, one-tailed, both in las out of acupuncture.33
Coan” and Loh" both attained statistical significance.
These latter results tn favoui oi .a upuncture may have
been pure placebo effects, ,i» • ontrol groups merely
continued medical treatment 'owson used a true
placebo (mock TNS.i. and did n- u obtain statistical sig­
nificance. Cervical pain icsponded significantly
(pCO.Ol) to acupuncture tn om small study” but not in
another.'”
Three trials (trials 12 to I -t m I able 1) treated varied
diagnoses. A single blind trial • multiple therapies for
shoulder cuff lesion is one ot two trials in which treat­
ment did worse than coiro
. tie second evaluated
acupuncture for chronic pain below the waist against

A V- I A- \NA1 YSIS OF ACUPUNCTURE FOR CIIKoMt PAIN

Tender area needling". (. ontroi did not explicitly
exclude classical acupuncture points
In Godfrey
'most appropriate’ acupuncture points, were com­
pared to ‘least appropriate points. Triple-blindness
may have been achieved. Direct, -is were given by an
acupuncturist who had evaluated the patient to
another who could not see the patent (whose head was
hidden by a screen). No statistically significant results
were obtained.:l

RESULTS
Individual Trials
A Chi-squared test on proportions of patients
improved in studies that had not published statistical
tests of results,> u " yielded values of p<0.01 'The risk
difference is illustrated in Figure 1 lor the 14 trials.
Only two out of 14 trials obtained the result that
patients treated with acupuncture did worse, on aver­
age. than the control group. Tin. 95”,. Cis for lour of
these 14 trials did not include the zero risk difference'
result. All four favoured acupuncture
Meta-analysis of Cumulated Trials
Studies were not homogeneous according to the
Q-statistic (p<0.01) The overall risk difference (indi­
cator ‘A’) between acupuncture and control groups
was 0.184 (SE = 0.062). in favour of acupuncture
(p<0.01). Acupuncture was also superior overall
according to the logarithm of the odds ratio (indicator
B’) and the logarithm of 1—the relative difference'
(indicator ’C’).

Coan
Laltlnen
Edeilst
4. Fox
Mendelson
1.

2.
3.

5.

sites.
Trials with at least one blind agent were less favour­
able to acupuncture than trials without blind agents
Trials with some blindness did not attain significance
for any indicator
ai I trials |
I
Standard trials
* J ’
I
Crossover trials I
1
I
low back pain Ail I
* 1
Low back Standard
Head/necR oaln; All
Head/neck Standard
Other pair' sde. All
Other site Standard

Hansen
7. Coan
8. Loh
9. Dowson
10. Petrie
11. Loy

Classic acupuncture
Formula acupuncture
Partially biinct

Berry

Largo trial (->50)
Small trial (<50)

6.

12.
vi

903

-

None of th. - subgroups ( Table 2) within which results
were cumulated were homogeneous according to the
'Q' test (,p<» * (>5 for all subgroups).
Ninety-fixc. per cent confidence intervals for the risk
difference c
(indicator “A') are presented a*
Figure 2. Th. results for all three indicators are pre
sented as Tabic >
There wa • quite good agreement between results
obtained from the three summary statistics used. In 14
of the 19 suf -croups analysed, indicators 'A'. B'. and
'C'_ provided the same result m terms of significance
(orinsignifk hkc; I the difference between treatment
and control . roups
Considering pooled results by site of pain, only the
subgroup ol trials for head and neck pain attained sig
nificance fo all three indicators. Low back pain
attained sigrificance in favour of acupuncture accord
ing to indi<. tors B and *C" if crossover trials were
included R suits lor other sites of pain showed an
insignificam result in favour of the control group.
Acupum re compared to conventional treatment
was more t. - >u ruble to acupuncture than trials against
placebo. Patients receiving classical acupuncture at
sites that vai ted from treatment to treatment did better
than patients receiving formula acupuncture at fixed

1

1
— r

Placebo control
Treatment control

No bilndnoatl

•
1

*

1

*“*“*
‘*"•____
*” ‘

*"

} 1
’
__

*

904
Tahi i. 3

INTERNATIONAL JOURNAL OE EPIDEMIOLOGY
Results obtained with meta analysis of results of all trials and subgroups oftrials defined, using the risk difference, the logarithm of the odds
ration, and the logarithm of'I—the relative risk difference', with fests of significance at V5% presented Cl

Weighted average
of risk difference

Trial group or subgroup
All trials
All standard trials
All crossover trials

0.184*
0.196*
0.147*

All trials for low back pain
Standard trials for low back pain

0.191
0.258

/Ml trials for head and neck pain
Standard trials for head and neck

0.303*
0.361 ’

All trials for other pain sites
Standard trials for other sites

-0.056
0.056

Placebo control group
Treatment control group

0.105
0.235'

0.329*
0.092

Classical acupuncture
Formula acupuncture

At least partial blindness
No blindness in the trial
50 subjects of more (large trial)
Less than 50 subjects (small)
Chinese or acupuncture journal
Mainstream medical journal

J

*

0.048
0.398’

0.183’
0.177
0.441 ’
0 109"

Large trials were more favourable to acupuncture
than small trials. Results published in journals that had
the word 'acupunctured! Chinese' in their titles were
significant!} superior to those reported in 'traditional
western' medical journals, but both these groups
showed results favourable to acupuncture according to
all three indicators.
The methodology ol MA was comprehensively
applied Issues were cov red in .ill six major areas of
quality control of medic?. MAs. Twelve out of 23 relc
vant items were addressed. The analysis would be
placed in the lop decile •! the 86 MAs reviewed b\
Sacks 1 hat review obtained a mean of 7.7 items add
rcssed with standard dev ition of 2.7.
While some weakness, s of MA may not yet be full}
appreciated.1' known pi - dems certainly include pub­
lication b.as iiul
.r self-selection bias' fhc
necessarv number of unpublished acupuncture RCTs
for chronic pain that h. I. on average, inconclusive
results t/cio risk dilleic ice) to negate the statistical
significance of the pook ' result in favour of acupunc
ture was d trials at p
01. and 67 trials at p -- 0.05

DISCI sslON
Blindiu - sth. onlv ’•
sol avoiding bias due to pre
conceived notions of iln superiority (or inferiority) of
a treatment 1 he os .. I for the subgroup of trials

with some blindness' includes the zero risk difference
possibility for all indicators. If the four trials with
statistically significant results are considered only one
common characteristic emerges. None had any degree
of blindness. According to Godfrey." full triple blind­
ness is technically feasible. If feasible, it should be
regarded as essential.
There are two potential explanations for the appar­
ent superiority of C A over FA. Either efhcacx of C A is
superior, ot the protocols of CA trials wci. interior.
Two out of six CA (rials, and six out of eight i A trials.
displayed some degree of blindness
The result that trials against conventional ’rcatmeni
arc more favourable to acupuncture than ire trials
against placebo may similarly be explained I ae out of
eight of the former had no blindness, and or \ one out
of six of the latter.
I'he superior results obtained by trials published in
journals oriented towards Chinese medicine or acu­
puncture m.iv indicate selective publication bias It is
possible that acupuncture treatment described in
specialist journals was superior, or that studv methods
differed between publication subgroups \ll RCls
published • journals with the words China »>: acupunc­
ture in tiu.i titles were trials against << iventional
treatment

I
A META-ANALYSIS OF ACUI’l st 1URE FOR CHRONIC PAIN

<'

It should be noted that, in MA, publication bias is
made explicit Individual studies that obtain positive
results do not conventionally stale that there may be
large number' of unpublished studies that obtained the
opposite com lusion The requirement that 67 incon­
clusive RCTs of acupuncture treatment for chronic
pain exist to negate statistical significance of the pooled
results is quite severe No unpublished randomized
controlled trials of acupuncture were discovered
despite numerous contacts with the limited numbersof
researchers in this area.

CONCLUSIONS
In pronouncing upon the eflicacy, or otherwise, of a
mode of treatment as contentious as acupuncture4'-15
one is advisedly cautious in distinguishing between a
statistically agnificanl and a conclusive, result
Results favourable to acupuncture were obtained
significantly more often than chance alone would
allow.
Publication bias may have influenced all the pooled
risk difference estimates. As a result the true pro­
babilities of type 1 and type II errors cannot be
assessed. It is nevertheless considered ‘very unlikely'
that the 67 inconclusive RCTs required to negate the
statistical significance of the pooled result exist.
Conclusive findings in favour of any new therapy can
only be obtained from adequate triple blind random­
ized clinical trials. I he published study plans of some
trials depict a variety of deficiencies and stricter plans
tended to yield less favourable results. The fact that
results for acupuncture vary greatly according to the
degree of blindness underlines this point.
Analysis of cumulated results of subgroups provides
useful guidelines for future research. It is also possible
that the choice between formula and classical acupunc­
ture may influence results. Preliminary indications are
that future trials should consider these as distinct types
of treatment
If acupuncture has a pain relieving effect, the mech­
anisms by which this effect could come about are. of
course, unknown However, while much more is
known about the mode of function of effective anal­
gesic drugs such as aspirin, the precise mechanism of
this commonly used drug has not yet been completely
understood Acupuncture has probably been used

_

905

comments and invaluable help with documentation.
Helpful comments were also received from Iain Chal­
mers. Guido Fisch. Bcngt Jonsson, Harry Osore and
Simon Page. No external funding was either requested
or utilized in the course of this study.
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‘ Gutzwiller F. Chrzanowski R. Technology assessment impact on
medical practice. Ini J Tech Assess Health Cure 1986. 2:
99- 11)6.
Patel M S Si Leger A S. Schneiden H Process and outcome in the
National Health Service. Brit Med J 1985. 291: 1365-6
' Mendelson G. Acupuncture analgesia I Review of clinical studies.
Amr VZ J Med 1977. 7: 642-8.
1 Richardson P H. Vincent C A. Acupuncture for the treatment of
pain A review of evaluative research. Pam 1986: 24: 15-40.
' Xu Benren. Ge Shuhan. Observation of the effect of acupuncture
treatment m 300 cases of primary trigeminal neuralgia J Trad
Chm Med 1981; I: 51-2.
'Laitinen I Acupuncture for migraine prophylaxis A prospective
clmieal study with six months follow-up. Am J ( hm Med 1975.

Levine J D. Gormley J, Fields H L Observations on the analgesic
effects of needle puncture (acupuncture) Pam 1976. 2:
149-59.
'Lee P K. Anderson T W. M fell J H, Saga S A rrcatment of
chronic pain with acupuncture. JAMA 1975. 232: 1133-5.
' Borglum Jensen L.Tallgren A.Troest T, Borglum Jensen S. Effect
of acupuncture on myogenic headache. Scand J Dent Res 1977.
85: 456-70
111 Spocrel W E. Yeung C Y. Acupuncture tn a pain clinic Can Anaesth
Sac J 1974.21:221-9
11 Sodipo J O A. Falaiye J M. Acupuncture and gastric acid studies
Am J Chm Med 1979; 7: 356-61
• Gunsberger M Acupuncture in the treatment of sore throat svmpto
matology Am J Chin Med 1973; 1: 337-40
“ Brattberg G. Acupuncture therapy for tennis elbow Pam 19x3, 16:
11 Gaw A C. Chang L W, Shaw Lein-Chun. Efficacy of acupuncture ot
osteoarthritiepain; A controlled, double-blind study A' Engl J
MedWS\ 293: 375-8.
Johansson V. Kosic O. Lindahl I.. Lindwall L.Tibbling L. Effect ot
acupuncture in tension headache and brainstem reflexes Ads
Pam Res I her 1986; 1: 839-41
■'•MacDonald A J R. MacRae K D. Master B R. Rubin A P. Super
licial acupuncture in the relief of chronic low back pain: A
placebo-controlled randomized trial Ann R Coll Surg Engl
1983; 65: 44-6.
” Ackermann-Liebrich U. Gutzwiller F. Keil U. Kunze M. Epidenu
ologie. Cham, Switzerland. Meducation Foundation.
Paccaud F I.evaluation systematique des procedures medicates a
propos de I’efficacne des ••medecines paralleles” Ret Med
Suisse Romande 1986; 106: 141-7
IM Patel M S Evaluation of holistic medicine Sac Sa Med 1987; 24:
169-75
■" Patel M S Problems tn the evaluation of alternative medicine Back
c —i *£
\'th International Conference

906

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•' FlcissJ L Statistical methods for rates and proportions. John Wiley &
Sons, 1981.
■'* Rosenthal R. the "file drawer problem" and tolerance for null
results. Psychol Hull 1979, 86; 638-11
■' Sacks 11 S.-Bcrriet J Rcilman D, Ancona-Berk V A, Chalmers TC.
Meta-analysis of randomized controlled (rials. A' /frig J Med
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"Coan R M, Wong G, Su Liang Ku, Yick Chong Chang. Wang L.
Ozcr F. Coan P L The acupuncture treatment of low back
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“ Edehst G, Gross A E. Langer F. Treatment of low back pain with
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puncture. Comparison of treatment for low-back pain Pain
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’’ Mendelson G. Seiwood T S, Kranz H, Loh T M, Kidson M A. and
Scott D S. Acupuncture treatment of low back pain A double­
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Hansen P E, Hansen J H. Acupuncture treatment of chronic facial
pain: A controlled crossover trial. Headache 1983; 23: 66-9.
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" Loh L, Natshan P W. Schott G D. Zilkha K J. Acupuncture versus
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” Petrie J P. Langley G B Acupuncture in the treatment ot chronic
cervical pain. A pilot study. Clin Exp Rheumatol 1983; 1:
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(Revised version received April 1989)

w

health cti-u
COr^‘ J!|Oor)St. N>arks fi°ad
^'^NGALOaE-SG0001

A NEW BREAKTHROUGH IN THE TREATMENT
OF CANCER WITH RADIO FREQUENCY
ACUPUNCTURE USING HYMNS FROM HOLY
QURAN.
BY
OSCAR
PROF. DR. AMAN
M.A.,M.D.C.M.,D.Sc. (Sweeden)., Ph-D (Switzerland).,D.F.Hom (London).,
M.A.M.S (Ophth) Vienna., Z.O.C (Vienna)., L.M (Dublin).,
D.Ped(Eire).,M.B.Ac.A (London)., M.B.F.P.A (London).,
F.Ac.F (Sri.Lanka)., M.S.A.F (Scandinevia).,
F.Ac.F (India)., Ph-D.Ac. (India).

Director:

Indo-American Hospital Trust & Research Training Institute of
Radio-Frequency Acupuncture.

N.R. Mohalla, Mysore-7

Visiting Professor and Director of Examination of International College of Acupuncture
Raipur (India) and Colombo (Sri. Lanka)., Consultant Research Board of Royal Faculty of
Homeopathy (London).,
Advisor: Korean Acupuncture Association (Seoul)., Consultant in RFA International
Institute of Medicine Rome (Italy).
Author:
Former :

Under
Publication:

MEDICINAL SECRETS OF YOUR FOOD.
Clinical Assistant to Sir Jhon Weir and E.Blakie. London.
P.G.R, R.L.H. Hospital London.
P.G.R, Coobe and Rotonda Hospital. Dublin
P.G.R, The Temple Street Children’s Hospital. Dublin.
P.G.R, llnd University Eye Hospital, Vienna.
Clinical Assistant to Dr. Helena Wright F.P.A London.
Specific Diet for Cancer patients
Specific Diet for Diabetic patients.

Research Paper Presented in The First International Conference on Holistic Health* Medicine
held during 8th to I2th November 1989 in Bangalore. Karnataka (India)
Paper read on 11.11.1989.

(WITH THE BEST COMPLIMENTS FROM URDU DAILY SALAR BANGALORE)

' DEDICATION
TO
•
CANCER SOCIETY OF INDIA
&
I)
2)

Dr. M.A. Kline. M.D; American Medical Society, Vienna.
Dr. Schade. W.H.O. Geneva.

3) Sir, Prof. Dr. Anton Jayasurya. International College of Acupuncture, Colombo. Sri Lanka.
4)
Ibrahim JChaleelulla Khan, Editor Salar Urdu Daily Bangalore.
5)
His Excellency HaSsan Omar Badogoon. Jeddah,.S.A.
6)
Dr. T.M. Manikam. M.S; DLO; (Late) Bangalore.
7)
Prof. Dr. R.M.Varma. F.R.C.S; Neuro Surgeon. Bangalore.
8)
Dr. V.Parameshwara. F.R.C.P; Cardiologist, Bangalore.
9)
Dr. S.Narayan Shetty. T.D.D; Wales. Mysore.
10)
Dr. S.Bhaskar. M.D; Cardiologist. Mysore.
11)
Prof. Dr. A. L. Agarwal. Acupuncture Foundation of India, Raipur.
12)
Dr. B.V. Raman. Bangalore.
13)
Prof. P.T. Muniappa. Bangalore.
14)
Dr. R. Voll. West Germany.

Acknowledgement to
I)

Dr. (Miss) Sarvar Taj. Secretary, Indo-American Hospital, Mysore. Bangalore.

2)

Mrs. Kamala Ramaiah. Mysore.

3)

Miss Syeda Umme Salma Aman, Bangalore.

4)

(Dr) Qurratul Ain. Bangalore.

A NEW BREAKTHROUGH IN THE TREATMENT
OF CANCER WITH RADIO FREQUENCY
ACUPUNCTURE USING HYMNS FROM HOLY
QURAN
BY
-AMAN
1.

INTRODUCTION

So far no scientific cure has been found towards the treatment of cancer in any medical
system. The author of this paper accidentally found that his newly invented method of
treating diseases with Radio-Frequency Acupuncture (RFA) has some curative effect in
controlling the pain and resulting in the regression of the tumor in a very' serious patient
suffering from throat cancer, when certain hymns were passed from Holy Quran-(verses
1 to 19- SURA YASIN Chapter 36) in the form of radio waves with the help of

transducers over the radio wave emitting acupuncture points of the patients noticing the
immediate relief in his pain after this treatment. The author continued the same treatment
over the same acupoints daily for ten minutes fora week. With this treatment the patient
swallowed food in an easy manner. Also the tumor in the neck began to shrink gradually
in three mohths time he showed significant improvement and then lived for more than
three years with out any complication.

2.

AUTHOR’S BACKGROUND

Encouraged by this method of treatment the author has been treating free of cost the
pathologically confirmed patients with the grants of American Medical Society of Vienna
and Indo-American Hospital Trust. The author is the recipient of “THE EURO—
OSCAR”A WARD in Rome in 1983 for his services to humanity and his internationally
famous book “MEDICINAL SECRETS OF YOUR FOOD". He was awarded
Post-doctoral degree of Doctor of Science in Stockholm (Sweden) in 1984, for his thesis
“Treatment of Cancer with RFA using the hymns from Holy Quran. At present he is
given a grant to do research in cancer with Prof. G. Monaco in Rome University.

3. METHODOLOGY OF RADIO-FREQUENCY ACUPUN­
CTURE (RFA) TREATMENT
In this new method of treating diseases the patients own unrectified biooscillations in
the form of radio frequencies are fed into a electronic rectifier. After the rectification, thesame rectified radio waves are passed back to the patient through his defective
acupuncture points. The technical explanation of these instruments is beyond the scope
of this paper. However, suffice to say that a healthy person does not emit high frequency
waves at the acupoints due to their low electrical impedence. If any organ is defective or
diseased the acupoints concerned with their specified organs are affected. The
microcirculation in these neurotransmitters gets reduced resulting in the high resistance
in the acupoints consequent in the dimunition of the microcirculation. Owing to this
increased resistance, bio-electro-magnetic waves are generated, subsequently, the
chronobiological biorythms are disturbed subsequently.

4.

BIORHYTHM’S CONCEPT:

Biorythms arc the basic characteristics of all living organisms. These rhythms
alterations occur in organisms with a super-sonic speed. The synchronised nature of
different rhythms in the organism creates a harmonious system establishing a perfect
homeostasis. The pioneering author of this paper discovered that the biorhythms in man
exist in the form of high frequency electro magnetic waves. These strictly rapid
momentary signals last only for a thousanth of a fraction of a second and its voltage is
several million fraction of a volt. With the help of his newly invented instruments the
author studied and recorded the biorhythms in the form of bioelectromagnetic waves
over the defective acupoints.

5.

BIOENERGY CONCEPT:

The bioenergy or “Chi” makes a complete circuit in all the meridions. in 24 hours
attaining a peak level for two hours in each meridian. During this process the radio wave
patterns are altered when the energy changes from one meridian to another meridian. It is
observed that energy remains at peak level between 8 to 9 AM., and 2 to4 PM. During
these peak hours the energy is found highly active over St-36, and small intestine 3
acupoints. The digestion and absorption of the food will be very quick during this period.

I aking vitamins, antiobiotics between this peak level of the energy. produces an optimum
therapeutic effect. But antihitamine drugs, steroids and anabolic drugs have greater
absorption between 2 to 4 PM. However, the energy antihistamine anabolic distributions
remains variable between 9 A M to 3 P M. Further the author has observed that the
biorhythm curve goes down to the lowest form from 1 to 3 A M. At this period the energy
is circulating in gall-bladder and liver meridians. The working capacity of the person is
found to be the lowest during the period. This is coroborated by the fact that the Russian
Scientists have noticed more automobile accidents occuring during the period at night.
When drivers were warned to be extravigilant during this hour of the night the accident
rate was nearly halved. After this period Brahma Muhartam commences.

6.

THE HOLY QURAN:

The Holy Quran is the scripture of muslims. The contents are in the form of Arabic
Poetry. When the versus recited accurately with correct intonation in a melodious voice it
produces tranquility of mind in both the recitor and the listeners. Quran speaks of its
usefulness in curing the sickness of the mind and body. The author used selected versus
from various chapters in treating different types of diseases and particularly the first 21
verses from 36 chapter Yasin and discovered the curative effect in the treatment of
different types of cancer with his newly found method. After 8 years of research the
author is convincingly found a definite healing effect by the use of Quranic hymns in
cancer and other diseases (diabetes, hypertension, brain tumors, functional cardiac
disorders, migraine renal failure, chronic skin diseases etc). The author also employed the
hymns from Holy Bhagwath Geetha and its 8,9 and 16 chapters are found to have
remarkable curative^effects in mental retardation, musculo-skeletol disorders, epilepsy.
It is infered by this research that the passage of these hymns in the form of radio waves
through the defective acupoints results in the cure of diseases as a consequence of
biophysical, and biochemical changes in the body at the cell level resetting the cellular
elements to function harmoniously. It is infered that this treatment resets the physiology
of erring ONCOGENES and prevent uncontrolled protein synthesis in cancer.

7.

MECHANISM OF CURE BY RFA EXPLAINED

It is interesting to find that all cancer patients treated'with RFA invariably emit
radio-frequencies at the FIRE and WATER element points in all the meridians.
However, the frequencies vary from person to person according to their general
condition. When the patients are treated through these points using their own’rectified
biooscilliations coupled with the hymns of Quran a definite beneficial change in them
namely immense relief of pain much quicker than the use of most potent analgesics. This
indicates that the body endorphins are quickly released in the brain by Quranic radio
frequency acupuncture treatment. The cheerful attitude, improved appetite and the
intense desire for living and getting cured may be a state of euphoria caused by the
biosteroids in the body. The fall in the blood pressure, sugar, cholesterol level are also the
indication of developing autonervo immunity in the body owing to this treatment. It is
found cancer patients live longer cheerfully, and fight the disease heroically after this
treatment, while, the other patients treated with conventionally with surgery, radiation
and chemotherapy were denied of these benefits and were greatly disappointed.

8.

PREWARNING OF DISEASES BY RFA:METHOD:-

Every illness needs time to develop. Our body and the reactions of the various life
proc, sses are constantly exposed to al! kinds of inflictions and disturbances. The body
car. ope with many insults by itself before the cells or cell compounds are damaged.
When this happens we usually react with a slight uneasiness to which we attribute no
major significance. Only when large number of cells is destroyed does our body react with
clinically manifest symptoms and we feel sick. In any case the least infliction cause
energetic alterations.
These energetic alterations can be detected by the new instruments in the very'
beginning much earlier before most of the clinical data can be obtained. RFA can come
up with results. Physician can innitiate counter measure to avoid severe illness or reduce
to it by a milder form. “Pre warn is Prearm” (Susrutha).

The superiority of this new method-that-is early diagnosis and specific theraphy that
can be used along with any method of treatment without side effects-should be taken
advantage of and put forth to best use. However, RFA must not be regarded as a
potential competor to established medicine but rather as a new and valuable means of
widening the scope of medicine and making up for some of its short-comings by
preventive and holistic approaches.

9.

LIMITATIONS OF RFA:

RFA has its own limitations because detection of effective acupoints and treatment of
the diseases without the help of sophisticated new electronic instruments is not possible
except at Indo-American Hospital. Mysore, and International Institute of Medicine at
Rome. It requires intensive training to operate and treat the patients with these
instruments. However, the author is giving training to the physicians under
Internationals college of Acupuncture
Switzerland at Mysore, Bangalore, Raipur,
Colombo, Rome and Vienna end making
earnest efforts to develop a simple easily
available instrument for the use of the trainee , vsicians.

Physicians who wish to examine our records of the treatment and learn the technique
of RFA are welcome to Indo-American Hospital Trust Shivaji Road, N.R. Mohalla
Mysore-7 or our extension at 96/56. 40th Cross, 6th Main 5th Block. Jayanagar
Bangalore-41 by prior appointment on Bangalore telephone No. 643427.

CLINICAL RESULTS OF THE AUTHOR'S TREATMENT FOR
CANCER SUM ARISES
A total number of 75 patients, both males and females between 2 to 80 years of age
sufferring from various types of cancer were- treated by the author with RFA
incorporating Quranic hymns during a period of 9 years. Out of these patients 64 persons
were in advanced stage of malignancy and had already been treated by conventional
method by oncologisis when these patients treated with RFA and special cancer diet rich
in Vt A, C. E it was found that most of the patients had significant symptomatic clinical
improvement in general as already indicated in earlier paragraph. Contrary to the
prediction of the oncologists RFA treated patients did live longer with greater comfort
and less pain.

The other eleven confirmed cases of cancer did not want to subject themselves to
surgery, radiation and chemotherapy (mostly breast and uterus cancer). These patients
were treated by the author with his new method incorporating Quranic hymns at the
defective fire and water element points. After a very significant clinical improvement they
were found to be free from cancer as tested by oncologist on negative biopsy results. It is
infered by this research that the Fire and Water element constitution in the body plays a
major role in the causation of malignancy by disturbing the cellular physiology.
However, this requires a further research “One of the primary tasks of some one entrusted
is to heal is to encourage the innate capacity for healing of the individual in distress. To
enable him to accomplish this task effectively, the healer to be aware of his own
multi-dimentional levels of existence and have some enterprise and ability inachievinga
state of balance and harmony within himself.” without self confidence in his own work.
results of this research remain questionable.” (Prof. Dr. R.M. Varma of Bangalore).

CONCLUSION

The author prays to the Almighty and hopes his humble efforts to wipe the tears of the
sufferring humanity will open a new chapter in Holistic medicine.
JA1 HIND.

REFERENCES.
1)
Aman :“Radio-Frequency Acupuncture Treatment”. Indian Journal of Acupunc-.
lure. P.99.Vol.l. No.3.1981.
2)
Aman /‘Medicinal Secrets of Your Food”. P.566, 593. Indo-American Hospital,
Mysore.Publication 1985.
3)
Aman : “Zodiac & the biorythm. The Astrological Magazine, Bangalore. P.766.
Oct. 1986 issue.
4)
Agarwal &
“Clinical Practice of Acupuncture”. P.388. Acv; uncture
Sharma G.N.
Foundation of India, Raipur. 1980.
5) Ahmed Deedat:
“Al Quran The Ultimate Miracle”, international Islamic
propogation Centre. Durban. IR.S.A. 1984.
6)
Hazralh Sayedena
“Gareeb Nawaz”. P. 174. Hameedia Book Depot, Chahtri
Muinuddin Chishti :
Gate, Dargah-e-Shariff Ajmer. 1975. (Urdu)
7)
Judith P.Smith /‘Computer Proves the Quran”. The Arizona Daily Star. Feb.5th,
1983.
8)
Jayasurya. A.&
“Ancillary Methods of Acupuncture”. Colombo S.General
Lasth.W. :
Hospital, Colombo, Sri Lanka 1980
9)
Krup Chetan : “Current Medical Diagnosis & Treatment”. P.554. Lange Medical
Publications, California.1983.
10)
Mohammed Ali :
“Translation of Holy Quran”. Lahore 1928.P.131.
11) Mann Felix:
“The treatment of Diseases by Acupuncture”. P.131. William
Heinamann Medical Books, London. 1972.
12) Mohammed Khadirn
“Muinul Arwah”. Sharab House, Jhalra, Ajmer, India.
Hussain : 5th Edition 1983. (Urdu).
13) Nanhe Mian : “Bimariyon ka Roohani Ilaj”. P.75. Siddiquee Isha at Ghar, New
Delhi. India. (.Urdu).
14) Omura. Y : “Electro Acupuncture, Its Electro Physiological Basis and criteria for
Effectiveness and Safety”. Journal of Acupuncture & Electro Therapeutic Research P.
164 Vol. 1. Paragon Press. Oxford U.S.A. Frankfurt 1976.
15)
- Rasheed Khalifa :“Quran the final scripture”. Islamic Publication. P.(2. 739, East,
6th Street. Tucson - Arizona.
16) Swamy Satyananda“Meditation from the Tantras”. BiharSchool of
Saraswati: Yoga. Monghyr. India 1981.
17)
Salim M :
“Introduction to Acupuncture ". P.102. Ajib Stores, 3rd Edition.
Sukkur Pakistan. 1981.

18)
Cancer society of India's facsimile earliest extent picture of the human Oesophagus and
Stomach. Photocopy of the illuminated manuscript (persian) presented by the Indian Cancer
Society in International Conference that was held in Bangalore during 3rd to 6th Nov. 1971.

Chronic pain: Use of TENS
in the elderly
GUDNITHORSTEINSSON, MD

Transcutaneous electrical nerve stimulation (TENS) can be an im­
portant adjunct to the management of pain in elderly patients.
Chronic neuropathy and postfracture recovery are the leading in­
dications for using the portable stimulative device, although it has
also been applied successfully in relieving low-back pain, postherpetic
neuralgia, myofascial pain, phantom-limb pain, and advanced, pain­
ful malignancies. However, TENS is rarely used alone in pain relief,
but instead should be part of a larger management program that may
include other modalities.
Thorsteinsson G. Chronic pain: Use of TENS in the elderly, geriatrics 1987; 42(Dec):
75-82.

ranscutaneous electrical nerve
stimulation (TENS) has been
used successfully to control chronic
pain in various conditions, and in
the elderly, certain specific indica­
tions have emerged.
The leading indications for using
TENS in older persons include
painful neuropathies (ie, in dia­
betics) and postfracture rehabilita­
tion. TENS can also be particularly
effective when used for mobilization
of a shoulder, either after a fracture
or when periarthritis or capsulitis
. causes joint pain and tightness.
Most recently, TENS has been used
to alleviate or diminish the pain of
) rib fracture in older patients, a tech­
nique that facilitates breathing and
lessens the complications of atelec­
tasis or pneumonitis.
Its use requires, of course, knowl-

T

Dr, Thorsteinsson is a consultant in the
department of physical medicine and
rehabilitation, Mayo Clinic and Mayo
Foundation, and an assistant professor of
'■ physical medicine and rehabilitation, Mayo
Medical School, Rochester, MN.

edge of optimal application, both by
physicians and patients. For exam­
ple, when mobilizing a shoulder,
TENS is best applied over several
muscles—anteriorly, posteriorly,
and laterally around the shoulder—
while range-of-motion exercises are
carried out. The treatment is fur­
ther enhanced by prolonged, gentle
stretching exercises. With respect
to rib fracture, the electrodes are
placed posteriorly at the origin of
the intercostal nerves, and the pa­
tient applies electrostimulation as
needed.
For a brief background on the
physiology of TENS treatment, see
The physiologic basis for TENS on
page 76.
Research has been conducted by
the author and others to clearly de­
fine successful uses of TENS in the
elderly.

Double-blind Mayo Clinic
trial
To determine the effect of the stim­

ulator and the indications for its
use, a double-blind trial was carried
out by the outpatient department of
Physical Medicine and Rehabilita­
tion at the Mayo Clinic.9 We also
analyzed the findings of similar
studies by other investigators.
Of the 107 subjects who entered
our study, 93 patients (53 women
and 40 men) with chronic pain com­
pleted the trial. Their mean age was
49 years (range, 22 to 88). Although
the patients had various pain-re­
lated diagnoses, the most frequent
were low-back pain (33 patients),
and neuropathy (24 patients).
Eighty-three of the 93 patients com­
pleted the Minnesota Multiphasic
Personality Inventory, and, on
analysis, 30 had normal personality
profiles. 30 had hysterical profiles,
and 23 had profiles indicating de­
pression.
The study format involved six
sessions for each patient: three peri­
ods with the live TENS generator
and three with a placebo device—a
TENS look-alike that emitted no
electrical impulse. Three sites were
stimulated with each instrument:
the site of pain, the site of related
nerves innervating the painful area,
and the site of unrelated nerves.
Sessions usually required 3 days,
in a randomized schedule known
only to the supervisor. Each treat­
ment session lasted 20 minutes, and
the six sessions were usually com­
pleted in 3 days. Patients used one
device for three consecutive trials,
then switched to the other instru­
ment to complete the series. Sub­
jects then indicated a preference for
the stimulator or the placebo device.
continued
Vol. 42 No. 12 December 1987 Geriatric* 75

Chronic pain

continued

*

Figure. Electrical stimulation for analgesia. Mechanisms of modulation are postulated to operate at the spinal cord
level or supraspinal level in the central nervous system. Lo-TENS is a low-frequency, high-intensity TENS; HiTENS is high-frequency, low-intensity TENS; NRM is nucleus raphe magnus; RMC is nucleus reticularis
magnocellularis; and DLFis dorsolateral funiculus.
From Thorsteinsson G. Electrical stimulation for analgesia. In: Stillwell GK, ed. Therapeutic electricity and ultraviolet radiation, 3rded. Baltimore:
Williams and Wilkins 1983:109-23. By permission of the Williams and Wilkins Co.

The physiologic basis for TENS
The reintroduction of TENS into clinical medicine resulted from the failure of
older sensory theories to explain the physiology of pain. One old but widely
held hypothesis, proposed in 1840, was the specificity theory. In 1965,
Melzack and Wall1 conceived the "gate-control" theory, and, in 1975, Kerr2
proposed the "central inhibitory balance” theory based on his anatomichistologic studies. Kerr's work lent significant support to the gate-control
theory by describing the factors involved in balancing (modulating) sensory
input from the periphery at the spinal-cord level.
This neuronal modulation is the balance between the large and small
fibers and reflects how their activities influence the gelatinosa neurons and
marginal cells.
Modulation is the physiologic basis for TENS' pain control. To decrease
or abolish the pain sensation, the pain stimulus is modified at some point
along the relay network of the central nervous system. Such noxious,
painful sensory input can be modulated at various levels within the central
nervous system, ie, the spinal cord, brain stem, and thalamus.3-4 The
modulation can be induced endogenously through processes like the en­
dorphin system,5-6 or exogenously as with electrical stimulation induced
with TENS.7 The modulation potential is summarized (see figure).8

76

Geriatric* December 1987 Vol. 42 No. 12

Results. Responses were re­
ported in four categories: complete
relief, partial relief, no relief, and
aggravation. Far more preferred the
TENS generator over the placebo,
both during and after the treatment
sessions (table 1). Patients also re­
ported successful responses (com­
plete or partial relief) more
frequently during and after treat­
ment over the center of pain than c
over related and unrelated nerves.
s)
Even so, patients found no dif­ p<
ference between the duration of re­ T
lief achieved with either the
stimulator or the placebo device. so
This same duration-of-relief phe­ Tl
nomenon has been observed in di<
other double-blind trials that evalu­ ter
ated pain relievers, including varif

TABLE 1

Patient preference by site both during and after TENS treatment*
During treatment

Treatment site

After treatment

M

P

0

M

Center of pain

31f

10

52

Related nerves

26

11

56

Unrelated nerves

24f

9

60

P

O

27f

8

58

28

12

53

22

10

61

*M = Prefer TENS stimulator
P = Placebo
O = No preference
t = Significant preference over use of respective placebo device (p < 0.01)
—

y

Source: Thorstemsson, Reference 9

ous drugs and other therapies.10
Analysis. Though analysis of
our data showed that TENS was
preferred when applied over the
center of pain, if ail painful condi­
tions were considered (table I),9
stimulation over related nerves was
favored by patients with neuropa­
thy (table 2).9
The study found no absolute con­
traindications to TENS. Allergic re­
actions to the conduction gel or
electrodes occurred occasionally,
but recent improvements in design
and composition of the electrodes
have made these complications rare.
Depression could be a relative
contraindication, because the study
showed that depressed patients ex­
perienced the least pain relief with
TENS use.
Patients who had depressed per­
sonality profiles also stopped using
TENS earlier and more often than
did patients with normal or hys­
terical profiles.11
Of the 93 subjects who finished

the trial, 43 started to use the stim­
ulator at home, 27 were still using it
after 3 months, and 21 were applying
the stimulator at our 6-month fol­
low-up. The site of pain was the
main target of stimulation during
the first 3 months, but at 6 months
patients had shifted toward apply­
ing the stimulator over the related
nerves.
This is not, however, a pattern
one sees routinely with TENS now,
since patients are usually directed at
the time of their evaluation as to
which site is the most effective.
Stimulation time per treatment
session averaged 42.5 minutes at 3
months and 36 minutes at 6 months.
Most subjects used the elec­
trostimulator twice each day. How­
ever, reports of complete pain relief
declined markedly for patients who
continued to use TENS for 6
months. Eleven patients reported
complete relief early in the trial, but
at 6 months, only one told of receiv­
ing complete pain relief.

Findings of other
investigators

Sjolund and Eriksson1213 showed
that high-intensity, low-frequency
stimulation, an acupuncture-type
method, activated endogenous mod­
ulation more than did low-intensity,
high-frequency stimulation, the tra­
ditional TENS approach. Thus,
they postulated that high-intensity
stimulation could be indicated for
patients with central pain.
Yet, Richardson et al14 were dis­
appointed by the lack of pain relief
in patients with the central-pain
syndrome. I also have noted a lack of
pain relief when using traditional
high-frequency TENS in patients
who had central pain from spinalcord injury.
In a retrospective analysis of
their 300-patient study, Long et al15
found that TENS was far more ef­
fective in certain disease categories
than in others. Positive and predic­
table responses were achieved with

Vol. 42 No. 12 December 1987 Geriatrics 77

For many patients with osteoarthritis

Clmoril...different enough to consider first
Contraindications: Hypersensitivity to this product; patients in whom acute asthmatic
attacks, urticaria, or rhinitis is precipitated by aspirin or other nonsteroidal anti­
inflammatory agents.

Warnings: Peptic ulceration and gastrointestinal bleeding have been reported. Fatalities
have occurred Gastrointestinal bleeding is associated with higher morbidity and mortal­
ity in labile patients, such as the elderly, patients with hemorrhagic disorders, etc. In
patients with active gastrointestinal bleeding or an active peptic ulcer, an appropriate
ulcer regimen should be instituted, benefits oftherapy must Be weighed against possible
hazards, and the patient's progress carefully monitored; in patients with a history of
either upper or lower gastrointestinal tract disease, CLINORIL® (Sul i nd a c. MSD) should be
given under close supervision and only after consulting the Adverse Reactions section.
Rarely, fever and other evidence of hypersensitivity (see Adverse Reactions), including
abnormalities in one or more liver function tests ano severe skin reactions, have occurred,
fatalities have occurred in these patients. Hepatitis, jaundice, or both, with or without
fever, may occur usually within the first one to three months of therapy Determinations of
liver function should be considered whenever unexplained fever, rash or other dermato­
logic reactions, or constitutional symptoms develop, if unexplained fever or other evi­
dence of hypersensitivity occurs, discontinue CLINORIL. Elevated temperature and
abnormalities in liver function caused by CLINORIL characteristically have reverted to
normal after discontinuation of therapy. CLINORIL should not be reinstituted in such
patients.
In addition to hypersensitivity reactions involving the liver, in some patients the findings
are consistent with those of cholestatic hepatitis. As with other nonsteroidal anti­
inflammatory drugs, borderline elevations of one or more liver tests without any other
signs and symptoms may occur in up to 15% of patients. These abnormalities may pro­
gress. may remain essentially unchanged, or may be-transient with continued therapy
The SGPT (ALT) test is probably the most sensitive indicator of liver dysfunction. Meaning­
ful (3 times the upper limit of normal) elevations of SGPT or SGOT (AST) occurred in con­
trolled clinical trials in less than 1% of patients. A patient with symptoms and /or signs
suggesting liver dysfunction, or in whom an abnormal liver test has occurred, should be
evaluated for evidence of the development of more severe hepatic reaction while on ther­
apy with CLINORIL Although such reactions as described above are rare, if abnormal liver
tests persist or worsen, it clinical signs and symptoms consistent with liver disease
develop, or if systemic manifestations occur (e g.. eosinophilia, rash, etc.), CLINORIL
should be discontinued In clinical trials, the use or 600 mg/day has been associated with
increased incidence of mild liver test abnormalities (maximum recommended dosage is
400 mg per day).

Precautions: GeneraZ-Although the effect on platelet function and bleeding time is less
than with aspirin, CLINORIL is an inhibitor of platelet function; therefore, patients who
may be adversely affected should be carefully observed when CLINORIL is administered.
Pancreatitis has been reported (see Adverse Reactions); should pancreatitis be sus­
pected. the drug should be discontinued and not restarted, supportive medical therapy
instituted, and the patient monitored closely with appropriate laboratory studies (e g.,
serum and urine amylase, amylase/creatinine clearance ratio, electrolytes, serum cal­
cium, glucose, lipase, etc.)-, a search for other causes of pancreatitis as well as those con­
ditions which mimic pancreatitis should be conducted. Because of reports of adverse eye
findings with nonsteroidal anti-inflammatory agents, it is recommended that patients
who develop eye complaints during treatment have ophthalmologic studies. In patients
with poor liver function, delayed, elevated and prolonged circulating levels of the sulfide
and sulfone metabolites may occur. Such patients should be monitored closely; a reduc­
tion of daily dosage may be required.
Edema has been observed in some patients taking CLINORIL Therefore, as with other
nonsteroidal anti-inflammatory drugs, CLINORIL should be used with caution in patients
with compromised cardiac function, hypertension, or other conditions predisposing to
fluid retention CLINORIL may allow a reduction in dosage or the elimination of chronic
corticosteroid therapy in some patients with rheumatoid arthritis. However, it is generally
necessary to reduce corticosteroids gradually over several months in order to avoid an
exacerbation of disease or signs and symptoms of adrenal insufficiency. Abrupt with­
drawal of chronic corticosteroid treatment is generally not recommended even when
patients have had a serious complication of chronic corticosteroid therapy.
Renal Effects—As with other nonsteroidal anti-inflammatory drugs, long-term adminis­
tration of suhndac to animals has resulted in renal papillary necrosis a nd other abnormal
renal pathology. In humans, there have been reports of acute interstitial nephritis with
hematuria, proteinuria, and occasionally nephrotic syndrome A second form of renal tox­
icity has been seen in patients with prerenal and renal conditions leading to a reduction in
renal blood flow or blood volume, where renal prostaglandins have a supportive role in the
maintenance of renal perfusion In these patients, the administration of an NSAID may
cause a dose-dependent reduction in prostaglandin formation and may precipitate overt
renal decompensation. CLINORIL may affect renal function less than other NSAIDs in
patients with chronic glomerular renal disease (see CLINICAL PHARMACOLOGY section of
Prescribing Information). Until these observations are better understood and clarified,
however, and because renal adverse experiences have been reported with CLINORIL (see
Adverse Reactions), caution should be exercised when administering the drug to patients
with conditions associated with increased risk of the effects of nonsteroidal anti­
inflammatory drugs on renal function, such as those with renal or hepatic dysfunction,
complications associated with advanced age, extracellular volume depletion from any
cause, congestive heart failure, sepsis, or concomitant use of any nephrotoxic drug. Dis­
continuation of NSAID therapy is typically followed by recovery to the pretreatment state.
Since sulindac is eliminated primarily by the kidneys, patients with significantly impaired
renal function should be closely monitored; a lower daily dosage should be anticipated to
avoid excessive drug accumulation
Use in Pregnancy—Not recommended for use in pregnant women, since safety for use has
not been established and because of the known effect of drugs of this class on the human
fetal cardiovascular system (closure of the ductus arteriosus) during the third trimester
of pregnancy.
Nursing Mothers-Nursing should not be undertaken while a patient is on CLINORIL
It is not known whether sulindac is secreted in human milk; however, it is secreted in the
milk of lactating rats.

Use in Children-Safety and effectiveness in children have not been established
Drug Interactions-DMSO should not be used with sulindac; concomitant administration
has been reported to reduce plasma levels of active sulfide metabolite and potentially
reduce efficacy and to cause peripheral neuropathy. Although sulindac and its sulfide
metabolite are highly bound to protein, studies with daily doses of 400 mg have shown no
clinically significant interaction with oral anticoagulants or oral hypoglycemic agents
however, patients should be monitored carefully until it is certain that no change in their
anticoagulant or hypoglycemic dosage is required Special attention should be paid to
patients taking higher doses than those recommended and to patients with renal impair­
ment or other metabolic defects that might increase sulindac blood levels. Concomitant
administration of aspirin significantly depressed the plasma levels of the active sulfide
metabolite. Although addition of aspirin did not alter the types of clinical or laboratory
adverse experiences, the combination showed an increase in the incidence of gastro­
intestinal adverse experiences; since addition of aspirin did not have a favorable thera­
peutic effect, the combination is not recommended Concomitant administration of
diflumsal in normal volunteers resulted in lowering of plasma levels of active sulindac
sulfide metabolite by approximately one-third Probenecid given concomitantly had only
a slight effect on plasma sulfide levels, while plasma levels of sulindac and sulfone
were increased; sulindac produced a modest reduction in the uricosuric action of pro­
benecid. which probably is not significant under most circumstances. Neither propoxy­
phene hydrochloride nor acetaminophen had any effect on the plasma levels of sulindac
or its sulfide metabolite.
Adverse Reactions: The following adverse reactions were reported in clinical trials or
have been reported since the drug was marketed. The probability exists of a causal rela­
tionship between CLINORIL* (Sulindac. MSD) and these adverse reactions. The adverse
reactions which have been observed in clinical trials encompass observations in 1.865
patients, including 232 observed for at least 48 weeks.
Incidence greater than 1%: Gas/ro/n/esrina/—Gastrointestinal pain (10%). dyspepsia.’
nausea* withor without vomiting, diarrhea* constipation* flatulence, anorexia, gastro­
intestinal cramps. Dermatologic—Rash,* pruritus Central Nervous SystemDizziness * headache* nervousness. SpecialSenses—Tinnitus. Miscellaneous—Edema
(see Precautions).
Incidence less than 7%.- Gastrointestinal —Gastritis, gastroenteritis, or colitis; peptic
ulcer; gastrointestinal bleeding, Gl perforation; liver function abnormalities; jaundice,
sometimes with fever; cholestasis; hepatitis; pancreatitis (see Precautions), ageusia­
glossitis. Dermatologic—Stomatitis, sore or dry mucous membranes, alopecia, photo^
sensitivity, erythema multiforme, toxic epidermal necrolysis. Stevens-Johnson syndrome.
exfoliative dermatitis Cardiovascular—Congestive heart failure, especially in patients
with marginal cardiac function; palpitation; hypertension. Hematologic—Throm­
bocytopenia; ecchymosis; purpura; leukopenia, agranulocytosis; neutropenia; bone mar­
row depression, including aplastic anemia; hemolytic anemia; increased prothrombin
time in patients on oral anticoagulants (see Precautions) Genitourinary— Urine discolor­
ation; vaginal bleeding; hematuna; proteinuria,- crystalluria, renal impairment, including
renal failure; interstitial nephritis,- nephrotic syndrome. Psychiatric—Depression: psy­
chic disturbances. including acute psychosis Nervous System-Vertigo, insomnia, som­
nolence, paresthesia, convulsions, syncope, aseptic meningitis. Special SensesBlurred vision, visual disturbances, decreased hearing, metallic or bitter taste. Respira­
tory— Epistaxis. Hypersensitivity Reactions-hnaphyiaMS, angioneurotic edema, bron­
chial spasm, dyspnea. A potentially fata-’ apparent hypersensitivity syndrome has been
reported; mis syndrome may include constitutional symptoms (fever, chills), cutaneous
findings (rash or other dermatologic reactions—see above), involvement of major organs
(changes in liver function, jaundice, pancreatitis, pneumonitis, leukopenia, eosinophilia.
anemia, renal impairment, including renal failure), and other less specific findings (ade­
nitis, arthralgia, myalgia, fatigue, chest pain).

Causal relationship unknown.- Other reactions have been reported in clinical trials or
since the drug was marketed but occurred under circumstances where a causal relation­
ship could not be established. However, in these rarely reported events, that possibility
cannot be excluded. Therefore, these observations are listed to serve as alerting informa­
tion to physicians. Card/wascu/ar-Arrhythmia. Me^abo/zc—Hyperglycemia. Nervous
System—Neuritis. Special Senses—Disturbances of the retina and its vasculature. Mis­
cellaneous—Gynecomastia.

Dosage and Administration: CLINORIL should be administered orally twice a day
with Food. The maximum dosage is 400 mg per day; dosages above 400 mg per day
are not recommended. In osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis.
the recommended starting dosage is 150 mg twice a day; the dosage may be lowered
or raised depending on the response. A prompt response (within one week) can be expected
in about one half of patients with osteoarthritis, ankylosing spondylitis, and rheumatoid
arthritis, others may require longer to respond In acute painful shoulder (acute sub­
acromial bursitis/supraspinatus tendinitis) and acute gouty arthritis, the recommended
dosage is 200 mg twice a day; after a satisfactory response has been achieved, the dos­
age may be reduced according to the response In acute painful shoulder, therapy for
7-14 days is usually adequate. In acute gouty arthritis, therapy for 7 days is usually
adequate.
Management of Overdosage; Overdosage has been reported, and rarely deaths have
occurred. In the event of overdosage, the stomach should be emptied by inducing vomit­
ing or by gastnc lavage, and the patient carefully observed and given symptomatic and
supportive treatment. Animal studies show that absorption is decreased by the prompt
administration of activated charcoal and excretion is enhanced by alkalinization of the
urine.
How Supplied: Tablets CLINORIL containing 150 mg or 200 mg sulindac. with cellulose.
magnesium stearate, and starch as inactive ingredients, in umt-of-use bottles of 60 and
100, unit-dose packages of 100. and bottles of 100.
•Incidence between 3% and 9% (Those reactions occurring in less than 3% of patients are
|\/| C l“)
unmarked )
IVI J
for mote detailed information, consult your MSD Representative or see
Prescribinglnformation Merck Sharp & Dohme, Division ofMerck i Co.
Inc. West Point. PA 1M86
aruKuni

M ERCK
SHARR,
DOHMt

Chronic pain

continued
TABLE 2

Patient preferences in major diagnostic groups by site treated by TENS*

Diagnostic group

Neuropathy

.ia'SP
lire! a

zdverw

1 epsia *
gastro

Low-back pain

Treatment site

DuringI treatment

Afteir treatment

M ~

p

O

M

P

O

9

2

13

9

1

11T

Unrelated nerves

13
11

1
1

14

10|
10

Center of pain
Related nerves

13
7

16
21

11

2

8

5

Unrelated nerves

6

23

6

5

Center of pain
Related nerves

3

4

5
4

2

12
15

20
20
22

'Ste~
-Ederra
k pep!*
jundice
ageusia

photo
•nd rone
pabents^^
-Throm
zine mar
thrombi^
discokr
including
>ion. psy
nia.som' Senses ' Respi^

*M = Prefer TENS stimulator
P = Placebo
O = No preference
t Significant preference over use of respective placebo devices (p < O.O1)
T Fisher exact test also used
Source: Thorsteins^on, Reference 9

l-na bron
I has been
zutaneous
I jor orga^
ismophiha
pngs lade
i al Inals or
al relation
possibility
iginlorma
a Nervous
ature M<s

jwice a day
mg per day
spondylitis
be lowered
beexpectd

rheumatW
(acute so.
commended
,ed.the dos
, therapy Io'
vs is usually

deaths have
.ucing vomit
ptomabc ano
jy the prompt
ization ol the
,ith cellulose
.ties ol 60 and

MSD

TENS in certain peripheral nerve
injuries, myofascial pain, amputa­
tion stump pain, postherpetic neu­
ralgia, and phantom-limb pain,
findings with which other in­
vestigators have agreed.1647
On the other hand, TENS ap­
peared to be relatively ineffective in
psychogenic pain, pain from periph­
eral neuropathies marked by a loss
of large afferent fibers, and—
again—pain secondary to injury of
the central nervous system.
Ostrowski,18 after reviewing the
usefulness of TENS in patients with
advanced malignancies, concluded
that electrostimulation was indi­
cated to relieve such pain.
My colleagues and I found10 that
TENS provided other excellent re­
lief for patients with the low-back
pain syndrome. We found, however,

that relief was not significant in the
low-back pain group, probably be­
cause we had few patients in this
diagnostic classification, and strict
criteria for determining signifi­
cance.
My subsequent clinical experi­
ence has shown that TENS is defi­
nitely indicated in patients with
myofascial pain, as well as those
with arthritis pain.
Sjblund19 reported good results
from applying TENS in various dis­
orders, including peripheral nerve
pain, central pain, bone metastases,
and rheumatoid arthritis. Yet his
results were poor in patients with
psychogenic pain, 50% of whom
continued to use the stimulator for
an extended time; three-fourths of
these patients claimed their pain re­
lief reached or exceeded 50%. This

improvement was evidenced by in­
creased social activities and de­
creased use of medication.
Finally, Hymes et al20 demon­
strated that TENS was useful in
controlling acute post-surgical pain.
In summary, TENS trial is indi­
cated in the elderly for the following
conditions:
■ chronic painful peripheral
neuropathies;
■ some postoperative and frac­
ture pain (rib, humerus);
■ periarthritis of the shoulder;
■ cancer pain; and
■ back and neck pain (myo­
fascial, degenerative joint disease).
Complete approach to pain

Regardless of the age group, TENS
is rarely used alone in managing

MERCK
SHARP'

dohme

Vol. 42 No. 12 December 1987 Geriatrics 81

Chronic pain

continued

VIEW
POINTS
Viewpoints is the place
where you can air
your comments on the
material presented in
GERIATRICS.
We invite you to
share your clinical
® experience in treating
the middle aged and
elderly, and express your
opinion on the care of
the geriatric patient
Please direct all letters to:

Robert N. Butler, MD
Geriatrics Viewpoints
. 7500 Old Oak Blvd.
Cleveland, OH 44130

chronic pain. Rather, it should be
integrated with an overall manage­
ment plan, which may include con­
ditioning exercises, relaxation
therapy, and other modalities of
pain relief, such as medication,
bracing, heat or ice, and nerve
blocks.
Relaxation techniques and bio­
feedback are important to consider
when designing a pain-management
program for muscle tension and my­
algia. This could be accomplished
by help of a physical therapist who
is experienced in biofeedback mus­
cle relaxation.
Because muscle contractures and
weakness from disuse also are com­
mon with chronic pain, particularly

among the elderly, specific re­
storative exercises are indicated for
patients with these conditions.
Such exercises would consist of a
gradual fitness exercise program (ie,
walking, stationary bicycling, etc).
For more than a decade, TENS
has been used as an adjunct to man­
age pain. Complete evaluation of the
patient is needed to establish the
indication. Proper application and
use is important. Usually, TENS is
but one of several factors used in
individual patients for the suc­
cessful management of pain. ®
Address reprint requests to Gudni Thorsteinsson, MD, Department of Physical Medi­
cine and Rehabilitation, Mayo Clinic, 200
First Street SW, Rochester, MN 55905.

References
well GK, et al. Transcutaneous electrical
Melzack R, Wall PD. Pain mechanisms: a
stimulation: A double-blind trial of its
new theory. Science 1965; 150:971-9.
Kerr FWL. Pain: A central inhibitory efficacy for pain. Arch Phys Med Rehabil
1977; 58:8-13.
balance theory. Mayo Clin Proc 1975;
12: Sjdlund BH, Eriksson MBE. Endorphins
50:685-90.
and analgesia produced by peripheral
3.
Basbaum Al, Fields HL. The origin of
conditioning stimulation. Adv Pain Res
descending pathways in the dorsolateral
Ther 1979; 3:587-92.
funiculus of the spinal cord of the cat and
Sjdlund BH, Eriksson MBE. The influ­
rat: Further studies on the anatomy of 13.
ence of naloxone on analgesia produced
pain modulation. J Comp Neurol 1979;
by peripheral conditioning stimulation.
187:513-23.
Brain Res 1979; 173:295-301.
4.
Kerr FWL, Wilson PR. Pain. Annu Rev
14.
Richardson RR, Meyer PR, Cerullo LJ.
Neurosci 1978; 1:83-102.
Neurostimulation in the modulation of
5.
Millan MJ, Przewlocki R, Herz A. A
intractable paraplegic and traumatic
non-fi-endorphinergic adenohypophysneuroma pains. Pain 1980; 8:75-84.
eal mechanism is essential for an anal­
Long DM, Campbell JN, Gucer G. Trans­
getic response to stress. Pain 1980; 15.
cutaneous electrical stimulation for relief
8:343-53.
of chronic pain. Adv Pain Res Ther 1979;
6.
Millan MJ, Herz A. The endocrinology of
3:593-9.
the opioids. Int Rev Neurobiol 1985;
16.
Swanson DW, Maruta T. Patients com­
26:1-83.
plaining of extreme pain. Mayo Clin Proc
7.
Wall PD, Sweet WH. Temporary aboli­
1980; 55:563-6.
tion of pain in man. Science 1967;
17.
Schuster GD, Infante MC. Pain relief
155:108-9.
after low back surgery: The efficacy of
8.
Thorsteinsson G. Electrical stimulation
for analgesia. In: Stillwell GK, ed. Thera­
transcutaneous electrical nerve stimula­
peutic electricity and ultraviolet radia­
tion. Pain 1980; 8:299-302.
tion, 3rd ed. Baltimore: Williams &
18.
Ostrowski MJ. Pain control in advanced
Wilkins, 1983:109-23.
malignant disease using transcutaneous
9.
Thorsteinsson G. The efficacy of trans­
nerve stimulation. Br J Clin Pract 1979;
cutaneous electrical stimulation. Mas­
33:157-62.
19.
Sjdlund B. Indikationer for behandling
ter's thesis, University of Minnesota,
med transkutan nervstimulering. LakarMinneapolis, 1976.
10.
Thorsteinsson G, Stonnington HH, Still­
tidningen 1980; 77:887-8.
Hymes AC, Raab DE, Yonehiro EG, et al.
well GK, et al. The placebo effect of trans­ 20.
Acute pain control by electrostimulation:
cutaneous electrical stimulation. Pain
A preliminary report. Adv Neurol 1974;
1978; 5:31-41.
11.
Thorsteinsson G, Stonnington HH, Still­
4:761-7.
1.

2.

82

Geriatric* December 1987 Vol. 42 No. 12

SK&F lab co. literature or PDR. The following Is a brief
summary.
Contraindications: There are no known contraindications to the use
of'Tagamet
Precautions: While a weak antiandrogenic effect has been demon­
strated in animals. Tagamet has been shown to have no effect on
spermatogenesis, sperm count, motility morphology or in vitro fertiliz­
ing capacity in humans

In a 24 -month toxicity study in rats at dose levels approximately 9 to 56
times the recommended human dose, benign Leydig cell tumors were
seen These were common in both the treated and control groups, and
the incidence became significantly higher only tn the aged rats receiv­
ing 'Tagamet'.
Rare instances of cardiac arrhythmias and hypotension have been
reported following the rapid administration of' Tagamet' HCI (brand of
cimetidine hydrochloride) Injection by intravenous bolus.
Symptomatic response to 'Tagamet' therapy does not preclude the
presence of a gasmc malignancy. There have been rare reports of
transient healing of gastnc ulcers despite subsequently documented
malignancy

Reversible confusional states ha ve been reported on occasion, predom­
inantly in severely ill panents
—
'Tagamet has been reported to reduce the hepatic metabolism of warfarm-type anticoagulants, phenytoin, propranolol, chlordtazepoxide.
diazepam, lidocaine theophylline and metronidazole Clinically signifi­
cant effects have been reported with the warfarin anticoagulants.
therefore, close monitoring of prothrombin time is recommended, and
adjustment of the anticoagulant dose may be necessary when
'Tagamet' is administered concomitantly Interaction with phenytoin.
lidocaine and theophylline has also been reported to produce adverse
clinicaleffects.
However, a crossover study in healthy subjects receiving either
'Tagamet' 300 mg. q.i.d-or 800 mg. h.s concomitantly with a 300
mg b i.d. dosage of theophylline (Theo-DuA. Key Pharmaceuticals.
Inc./, demonstrated less alteration in steady-state theophylline peak se­
rum levels with the 800 mg. h.s regimen, particularly in subjects aged
54 years and older. Data beyond ten days are not available (Note: AH
patients receiving theophylline should be monitored appropriately.
regardless of concomitant drug therapy.)
Lack of experience to date precludes recommending Tagamet' for use
in pregnant patients, women of childbearing potential, nursing moth­
ers or children under 16 unless anticipated benefits outweigh potential
risks; generally, nursing should not be undertaken in patients taking
the drug since cimetidine is secreted in human milk.
Adverse Reactions: Diarrhea, dizziness, somnolence, headacne.
rash Reversible arthralgia myalgia and exacerbation ofjoint symp­
toms in patients with preexisting arthntis have been reported. Revers­
ible confusional states (e.g. mental confusion, agnation, psychosis.
depression, anxiety, hallucinations, disorientation), predominantly in
severely ill patients, have been reported. Gynecomastia and reversible
impotence in patients with pathological hypersecretory disorders re­
ceiving 'Tagamet', particularly in high doses, for at least 12 months.
have been reported Reversible alopecia has been reported very rarely
Decreased white blood cell counts in Tagamet'-treated patients
(approximately I per 100.000 'patients), including agranulocytosis
(approximately 3 per million patients), have been reported, including a
few reports of recurrence on rechalie'nge Most of these reports were in
patients who had senous concomitant illnesses and received drugs
and/or treatment known to produce neutropenia Thrombocytopenia
(approximately 3 per million patients) and a few cases of aplastic
anemia have also been reported Increased serum transaminase and
creatinine, as well as rare cases of fever interstitial nephritis, urinary re­
tention. pancreatitis and allergic reactions, including hypersensitivity
vasculitis, have been reported. Reversible adverse hepatic effects.
cholestatic or mixed cholestatic-hepatocellular m nature, have been
reported rarely Because of the predominance of cholestatic features.
severe parenchymalinjury is considered highly unlikely. A single case of
biopsy-proven periportal hepatic fibrosis in a patient receiving
'Tagamet' has been reported

How Supplied: Tablets: 200 mg. tablets in bottles of 100. 300 mg
tablets m bottles of 100 and Single Unit Packages of 100 (intended for
institutional use only/. 400 mg. tablets in bodies of 60 and Single Unit
Packages of 100 (intended for institutional use only) and 800 mg
Tiltab'- tablets in bodies of 30 and Single Unit Packages of 100
(intended for institutional use only)

Liquid: 300 mg!5 ml. m 8 fl oz. (237 ml.) amber glass bodies and tn
single-dose units (300 mg /5 ml), in packages of 10 (intended for insti­
tutional use only).
Injection:
Vials: 300 mg /2 ml in single-dose vials, m packages of 10 and 30.
and tn 8 ml multiple-dose vials, in packages of 10 and 25
Prefilled Syringes: 300 mg 72 mt. in single-dose prefixed disposable
syringes

Plastic Containers: 300 mg. in 50 ml of 0.9% Sodium Chloride tn
single-dose plastic containers, in packages of 4 units No preservative
has been added

ADD-Vantage' • Vials: 300 mg./2 ml in sing<e-dose ADD-Vantage®
Vials, in packages of 25
Exposure of the premixed product to excessive heat should be avoided
It is recommended the product be stored at controlled room tempera­
ture Brief exposure up to 40°C does not adversely affect the ptemtxed
product
'Tagamet' HCi (brand of cimetidine hydrochloride) Injection premixed
in single-dose plastic containers is manufactured for SK&F Lab Co by
Traveno!Laboratories. Inc. Deerfield. IL 60015

BRSTGL73B

O First to Heat
Tttgamet
019cimetidine

Date ot issuance Apr 1987
TG-730A

SK&F LAB CO., Cidra. KR. 00639

© SKSFUb Co.. I9S7

uenaincs _______________________________
MEETING HIGHLIGHTS
15 th International Chemotherapy Congress, Istanbul, Turkey
Extended care program
reduces nursing home
mortality rates

An extended care program, which 30 received intravenous cefamantrains nursing home personnel to dole nafate (Mandol). No patients
recognize early symptoms of lower died in the cefamandole group,
respiratory infections and thus ex­ while two of the ciprofloxacin group
pedite referral for hospital care, has died. Another group of 64 elderly
been instrumental in achieving a nursing home patients, not included
30% reduction in the mortality rate in the randomized study for various
usually seen in this patient popula­ reasons, had a mortality rate of 10%
tion, according to Dr. Philip Peter­ after being treated with a variety of
son of the Hennepin County cephalosporins, resulting in an
Medical Center and the University overall mortality rate of 7.8% in the
of Minneapolis.
three treatment groups. In addition,
Dr. Peterson reported on a recent most of the patients were dis­
study showing that the mortality charged within the 7.5 day DRG
rate in nursing home patients (mean hospitalization period.
age 81) with pneumonia or bron­
Dr. Peterson suggested that al­
chitis who were treated at the hospi­ though choice of drugs is important
tal could be reduced from an for a good outcome, early diagnosis
expected 40% to less than 10%.
and treatment of pneumonia in
In one randomized phase of the nursing home patients was equally
study, 30 patients received the crucial in improving their prognosis
quinolone ciprofloxacin orally and so dramatically.

Peritonitis: Imipenem
monotherapy as effective
as multi-drug regimen

Use of the single agent, imipenem/
cilastin (Primaxin) is as effective in
the management of acute bacterial
peritonitis as the more complex
three-drug regimen usually em­
ployed, according to a study re­
ported by Dr. D. J. Leaper,
University Department of Surgery,
Medical School Unit, Southmead
Hospital, Bristol, U.K.
Imipenem/cilastin (500 mg qid
for a minimum of 5 days), was ad­
ministered intravenously to 19 pa­
tients (mean age 76) who had
moderate to severe acute peritonitis.
Clinical cures or improvements were
noted in 84% of the patients who
received the single agent.
Of 24 patients (mean age 68)
treated with a combination of am­
picillin, metronidazole, and gen­
tamicin in the standard IV regimen

for at least 5 days, 22 patients (91%)
were cured or improved and there
were two failures. None of the dif­
ferences was statistically signifi­
cant, Dr. Leaper said.
One patient in the imipenem
group suffered a drip site bullous
erythema, and one patient in the
combined therapy group developed
an allergic rash. Two mild cases of
injection site phlebitis and one se­
rious case were seen in the im­
ipenem and combined therapy
groups, respectively.
“There was a tendency for pa­
tients in the imipenem group to be
older, female, and to be suffering
with a more serious disease,” said
Dr. Leaper. “Nevertheless, the im­
ipenem group suffered no more dis­
advantages than the triple therapy
group,” he said.
continued

Vol. 42 No. 12 December 1987 Geriatric* 85

MEETING HIGHLIGHTS

continued___________

Aztreonam: Lowers
UTI incidence
during catheterization

The monobactam antibiotic 34 (6%) aztreonam treated patients.
aztreonam (Azactam) provides ef­
Microorganisms isolated after
fective prophylaxis against urinary catheterization in the placebo group
tract infections in elderly were Escherichia coli in- ten pa­
catheterized patients, according to a tients, Klebsiella in five, and Pro­
study by Dr. G. Romanelli and asso­ teus mirabilis in four patients, all of
ciates in the Department of Internal- .whom required treatment. In the
Medicine, University of Brescia, aztreonam group, two micro­
Italy.
organisms, (Klebsiella and group D
Sixty-two patients (mean age 76) Streptococcus), were found in the
with negative urine cultures were urine 3 days after catheterization,
randomly allocated to receive either Dr. Romanelli said.
aztreonam (2000 mg) or placebo in­
The researchers concluded tfcjt a
tramuscularly 3 hours before single 2 g dose of aztreonam given
catheterization. In the placebo intramuscularly is effective in pre­
group, 19 of 28 patients (68%) venting urinary tract infections in
showed positive urine cultures 1 the majority of patients requiring
week later, compared to two of the catheterization.

Teicoplanin: Effective
against resistant
gram-positive infections

Teicoplanin, a new antibiotic un­
dergoing clinical trials, could prove
to be a one-shot alternative to other
antibiotics commonly used to pro­
tect against frequently resistant
gram-positive infections in patients
unde jgoing hip or knee implants, re­
ports Dr. Richard Wall, Depart­
ment of Clinical Microbiology,
Northwick Park Hospital, Harrow,
U.K.
In a study of 176 patients (mean
age 69) undergoing joint replace­
ment operations, 72 patients re­
ceived a single, intravenous dose of
teicoplanin prior to anesthesia. Re­
searchers found the antibiotic to be
as effective ip protecting against
gram-positive Staphylococcus in­
fections as two doses (pre- and post­
op) of the cephalosporin cefuroxime
in another 74 patients.

86

Geriatric* December 1987 Vol. 42 No. 12

Dr. Wall suggested that since the
use of cefuroxime in the Harrow
hospital has been associated wnth
diarrhea caused by Clostridium di­
fficile in patients undergoing joint
implants, teicoplanin may be a
useful prophylactic alternative.
Other reports at the Istanbul
congress indicated that teicoplanin
is highly efficacious against gram­
positive microorganisms resistant
to most other antibiotics in the
treatment of infections of the skin,
soft tissues, the urinary tract, and
the respiratory tract, as well as sep­
ticemia and endocarditis, in both
young and old patient populations.
Currently, the studies have found
no evidence that any of the gram­
positive infections now prevalent in
hospitals worldwide have developed
resistance to teicoplanin. ®

— M4 MlKl-l z CMINJTTtMZlAJ, •

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Charts

RELATIONSHIP OF THE FEET TO THE SPINE & INTERNAL ORGANS

REFLEX ZONES OF THE DORSUM
Sinuses

Teeth

Nose, Mouth,Throat

3,2

Tonsil

5.4

Sinuses
2,3

4,5

Neck----

7,6

Teeth

Oesophagus,
/Trachea
Bronchi
Thyroid
gland

Sternum
Heart
(indirect)

Shoulder
girdle

Mammary
glands '
Gall
\ bladder

k

Shoulder
joint

Elbow

x Ribs
Abdominal
wall

Elbow

Shoulder
joint

Appendix

Pelvic
Area

Hip joint

Fallopian
tubes
Inguinal
Canal J

Left dorsum

Right dorsum

REFLEX ZONES OF THE HANDS

FACIAL REFLEX POINTS

Enforces
functioning of
Sympathetic nerves,
Internal & vital organs
of the body

Mental Energies

Mental Energies
Kidney action.

Mental Energies

Kidney action

Getting rid
of gases

Bowel
movement
Affects the

''IPS'
p

who‘e body ""til

Getting rid
of gases
Affects the
whole body.

Bowel
Movement
; Lymphatic

Stomach Digestion

Spleen
Lung disorders

Spleen
Lung disorder

Pancreas .Controlling
Bladder & Kidneys

Pancreas, Controlling
Bladder & Kidneys
Constipation

Liver

Genital Organs.

Genital Organs

Reflexology is one of the techniques gaining popularity
now-a-days all over the world, since it is not only easy
to understand but also to practice. Its philosophy and
practice are similar to those of Zonal therapy Accupressure,
Accupuncture and Polarity techniques

The Human body has a tremendous energy to heal itself.
This healing energy surges through the body in specific
pathways and could be tapped at different points which
are called Reflex Points
Reflexology is the technique of massage which has a
definite effect on the internal organs. When pressure
is applied on the Reflex points the functioning of the
corresponding internal organs could be rectified and
regulated. This treatment gives faster and amazing
results. Reflexology is not only a treatment but also
a diagnostic indicator of diseases in some cases, in
their early stages. This simple technique helps you
to maintain good health and vitality

Location of tender-points is an art which can be mastered
by practice. Press the reflex points gently with your
thumb and index finger. Blunt-end of a pencil could also
be used for the purpose. Feel the tenderness of Reflex
points. The tender points denote disorder or mal-functioning
of the corresponding internal organs. In these two charts,
the reflex points on feet, hands and face and their
corresponding internal organs are indicated
Pressure massage may be given over the tender point for
1-2 minutes. The pressure could be maintained either
constantly or intermittently. At the end of the treatment,
the entire feet or hand should be massaged. The treatment
should be continued for at least 10 days

After finishing the treatment, observe the beneficial
response and the respite you get

REGIONAL ENERGY RELATIONSHIP

Specific parts of the feet have specific
reflexes. The transverse arch of the foot has
a effecton diaphragm, ball of the foot on
chest. Pains inspecific parts of the feet
denote an impeded energy flow in the
corresponding reflex points & vice versa.
Positive, negative and neutral poles have a
definite energy relationship. Any influence
that has an effect on one pole will affect the
other two.

REFLEX ZONES IN THE OUTER & INNER SIDES OF THE FEET

Inguinal Canal
Inguinal Canal

Fallopian tube

Muscles and tissues
Fallopian tube

Appendix
Abdominal wall

Thigh and
pelvic area

•Xbdominal wall

Ribs

Ribs

Gall bladder

Hip joint

Ovaries,
Testes

Pelvic area
Elbow

Head

Upper arm

Knee (indirect)

Shoulder joint

Iliac crest

Elbow

Muscles
and
tissues

• ■ .

Abdominal wall

Thigh and
pelvic area

Abdominal wall
Head

.u

Shoulder joint

Inguinal Canal
Fallopian tube

Canal

Fallopian tube
Ribs, muscles
of thorax

- cu

Right outer side

Left Outer Side

Inguinal

Upper arm

Ribs, muscles of thorax

Head

Rectum
anus
Uterus,
Prostate,
Testes

Pelvic area

Cervical Vertebrae 1-7

Thoracic \ Sacrum
Vertebrae \
1-12
x---------

Lumber vertebrae

1-5

Right inner side

Thoracic
Vertebrae 1-12

Coccyx

Bladder

Sacrum
vertebrae 1-5

Cervical Vertebrae 1-7

Left inner side

REFLEX ZOb
Skull
Sinuses
Teeth

Temporal bone,
maxilla

Ear, Tonsils

Cerebrum
Pituitary' gland
Cerebellum

Eustachian tube

Base of Skull
Kidney

Heck

Cervical spine
Thyroid gland

Shoulder joint

Oesophagus
trachea, bronchi

Shoulder girdle —

Heart
Lung

- Thoracic spine
Pylorus

Adrenal gland

' Stomach

Solar Plexus

Pancreas

Diaphragm

Duodenum

Liver '
Upper arm

•Lumbar spine

Elbow
Gall Bladder —'

Transverse Colon.
•Ureter
Small intestine
(jejunum, Ileum)

Appendix, ileocaecal
valve

Ascending colon

Sacrum

Coccyx
Pelvic region

Pelvic region
(indirect)

Right sole

OF THE FEET
Skull
Temporal bone,
maxilla

Sinuses
Teeth

Cerebrum

Pituitary gland
Ear. Tonsils
Cerebellum
Eustachian tube

Base of Skull

Deck

Heart (indirect)
Uterus and Lower
Abdominal Organ

Cervical spine
Thyroid gland

Oesophagus
trachea,
broncm

Shoulder joint

Shoulder girdle

Heart

Thoracic spine

lung

Stomach

Solar Plexus

Diaphragm
Pane reas

Adrenal gland.

Duodenum

Kidney
Lumbar spine

Spleen
Upper arm

Transverse colon
Ureter

Elbow

Sacrum

Small intestine
(jejunum, Ileum)---Descending Colon

Coccyx
Rectum

Pelvic region

region
(indirect) ~

Left sole

SPECIFIC

PO/N iS
Face, points.- 4- to /Q

A C U P R E S S U R E

Introduction
'Acus' in Latin means 'point'. Acupressure is a system of health
care which uses pressure on particular points of the body to produce
relief from pain and other discomfort. The points are the same as

used in the Chinese system of Acupuncture, where needles are used
to stimulate these points.

So, Acupressure is Acupuncture without needles 1

been prevalent in the East since long.

This system has

It is called SHIATSU

(finger-pressure) in Japan, MARMA CHIKITSA (point-treatment) in

Ayurveda and VARMA KALAI (art of points) in Siddha systems of
medicine. It is interesting to note that all these systems use

similar points on the body to produce similar effects.
History

Acupressure and Acupuncture have been practised in India and
China for over 3500 years.

In India, it formed part of the

Ayurvedic and Siddha traditions of medicine.

In China the Emperor of Tsin dynasty brought together all

practitioners in China, to evolve a common system to be practised
in his empire. It spread to Japan, Korea and surrounding countries
from there.
This system did not progress much during the phase of colonisation
of the East by Europeon countries. It survived in pockets where

the influence of western systems of medicine was unable to reach.
During the decades between the 50's to 70's a revival of

Acupuncture and Acupressure occured in China along with the

cultural Revolution. Since then, it has spread to various parts
of the world, and is undergoing study and validation by the
western system of medicine apart from the people who are using

it for its benefits.

Community Health Cell,
No.367, 'Srinivasa Nilaya'
Jakkasandra I Main,
I Block, Koramangala,
Bangalore ~ 560 034.

2.

How and why does Acupressure work
The oasic principles are derived from Eastern Philosophy,
and rely on the concept of 'Life Energy1. This life enercy is
called 'Tehi' in Chinese, 'Prana' in India, and 'Bio-energy' by

the western systems. For convenience of our understanding, we
will refer to it as 'prana'.
Prana is the difference we see between the living and dead.

For

example, the tree has prana, while the table or chair made fromits wood (dead) does not have prana.
We cannot see prana, but we can see its effects in a living being,

in the form of growth, development, movement and reaction to

stimuli.

This disappears in death.

Prana extends all over the body and for a few inches beyond.

We

can feel the nearness of another person in public transports or
lifts, when we are close enough for the pranas to interact!
Prana has two aspects - the positive and the negative - called
'.YANG and YIN in Chinese.

This Prana is thought to circulate in the body along "meridians"
which are named after individual organs they are related to.
Pain or discomfort extends along its meridian, when any organ is
affected. For example, we have the heart, lung, stomach, liver,
kidney, intestine and other meridians, which reflect the function

of each organ. These meridians may be 'paired' i.e., are
available on both sides of the body, or 'unpaired', as in the
midline, or along the waist, wrist, neck, ankle etc., where it
encircles the body.
Acupressure / Acupuncture points are located on these meridians
and can modify the prana in them.

They are like switches which

control the electric current flow along wires. They are more like
the imaginary lines of Equator, latitudes and longitudes we draw
on the globe, or the boundaries which actually do not exist
between countries/states/districts.

All the paired meridians

begin or end at the fingers or toes.
So, we can manipulate the prana in the body through these

acupuncture points, bringing relief from pain and discomfort and
. .3

3.

helping in treating disease.

A number of traditional methods use

these points in various ways, eg., using of ear-rings/piercing of

nose, wearing of bangles, anklets and toe-rings.

These are

recommended for specific reasons by tradition, though the users may

not be aware of it.
Identification of Acupressure points
Acupressure points can be easily identified by the peculiar type
of pain they produce when pressed.

As seen earlier, the paired meridians begin or end at the fingers
and toes.

So, these are the best locations for us to find out how

they feel.

Experiment : Press any finger of your hand at various locations as

You will find that the 'quality' of pain at the base of the nail
is different when compared with other locations.

This is because

it is an acupressure point.

This "peculiar" quality of pain is described as a pleasurable pain

by the Chinese.

You will find a similar quality to all acupressure points we
It is very important to be able to identify this.
describe later.
Acupres sure M ethod
The thumbs and fingers are usually used for acupressure, thouch

objects made of wood and metal may also be used. The heels of
the palms are also used. While using the thumb/finger, the

.4

4.

therapist should take care to see that the pulp of the finger/thumb

is used, and not the tip, as shown in the illustration.

Also, the

therapist should not crow the nails, which may injure the oatients.

Duration of Acupressure:-

20 seconds to 1 minute of pressure and
massage.

Average 3 to 5 minutes.

Maximum 20 minutes.
ACUPUNCTURE POINTS

General Points
There are five (5) General Points which are always used in
Acupressure, which we will learn about first. One is on the head,
and two each on the hands and feet.

Then, we can move on to

points which are more specific in their action.

In brackets,

next to each point, are the Chinese names, and meridian numbers,
which are useful only to communicate to others about the points
used.

You need not worry about learning them to be able to do

acupressure.

Point No.l

Adhipathi

(BAIHUI / GV-21)

This is the most important point in the body that balances the
positive and negative aspects of the prana (the Yang and Yin) in
the body.

Always begin with stimulating this point for one minute and end
again with the same. This helps balance Yin end Yang both before
starting treatment, and on ending.
The point is at the junction of the line joining the two ears,

5.

and the midline going up from the nose, as in the illustration.
ALWAYS BEGIN AND END TREATMENT WITH - Adhipathil

It is like the Mains switch for the prana in the body.
Point No.2 : (HEGU / L.I. 4)

This point is located on the highest point of the buloe when the
thumb is held close to the palm. Press this point with the thumb
and forefinger held apart. Then, you can feel the peculiar pain

in the muscle mass - that is the point.

It is in both hands.

Use: It is a very powerful pain relieving point, especially for

the upper half of the body (above the navel1).

It is the next common point to be used for problems in the upper

half of the body.
Point No.3 (NETTING./_St-44)
Location
This point is located in the web-space between the second and
third toes of the foot.

Separate the toes and hold the web between

your fingers and thumb.
Use: It is a powerful pain-relieving point, especially for the

lower half of the body (below the navel).

It is on both feet.

It is the next common point to be used for problems especially
of the lower-half of the body.
SPECIFIC POINTS:

Now, having learnt the 5 General Points - One on the Head, and

two each on hands and feet, let us proceed to specific points from
Head to toe. For convenience, we will continue the numbering
beyond three.
Point Mo.4 :

(YINTANG /

Location: The central point, where the eye brows would meet.

When

you go up the nose-bridce, it strikes the point easily, as shown
in the figure.

Use: For frontal headaches and sinusitis especially due to a cold.
It is very useful for BLOCKED NOSE and BLEEDING from the nose.
. .6

6.

POint No. 5 :

(TONGZILIO / C-B-l)

Location: Where the eye brows end.

Different shapes of eyebrows

are common, where the eye brow ends, is a small pit.
This is the point - Look in the mirror to locate it on

yourself.
Use :

For Headaches, sinusitis, pain in the eye and eye-strain.

Point No.6 :

(RENZHONG / G.V.-26)

Location: It is in the midline, just below the nose.

You can feel

the nose none and the front of the upper jaw when you
press here. Remember the peculiar pain!

Use:

It's most important use
is as an Emergency point called JING-WELL point. It is used to wake-up a person

who has fainted.

running nose.

It is useful to stop sneezing and

It helps relieve pain in front upper teeth.

Location: Directly below the middle of the eye, at the level just
below the nose, as shown in the diagram.

You can feel

the depression below the cheeks.
Use:

In

tooth ache (uoper joint); cold with pain in cheeks;

and bleeding from nose.

Point No. 8:

(JIACHFNC JIANG /_ Ex-•5)

Location: On the chin, on either side of the midline.

If we hold

the chin side-ways with thumb and forefinoer, both
points are pressed together.
Use:

Pain, especially lower tooth-ache; and for excessive
salivation (drooling).
Children drool while teething and adults in paralysis

of face muscles.

It is helpful in both.

. .7

7.
Point No.9:

(ZIAGUAN / St-7)

Location: One finger space in front of the middle point of the ear,
just in front of the joint cf the lower jaw.

If you

open and close the jaw, you can feel the jaw-joint.
is just in front of it, felt as a small pit.

Use:

It

Toothache - upper back teeth; Ear ache, ringing in the
ears; pain in jaw-joint.

P0.-jnt_N0_. ip2_ (JIACHF / _St-.-6 )

Location: On the lower jaw muscle, just in front of the angle of
the jaw.

Use:

You can clench the teeth and feel the muscle

underneath.

Remember, don't press on the neck - it is

dangerous.

Press on the jaw-bone.

Toothache - lower back teeth.

Pain in tonsils and

difficulty in swallowing.
Point No.11 (FENGCHI / GB-20)

Location- Just below the occiput (back of skull) where the muscles
of neck meet the skull, two finger-width away from
midline.

Use;

Stiff-neck; Headaches

.with sinusitis; Hypertension.

Point No.12 (DINCCHUAN / Ex-17)

Location: Just next to the prominent spine where the neck
joins the body - on the back. This spine becomes
prominent when we bend our neck forward.
Use:

Neck pain, back-pain, shoulder pain; and Bronchial

asthma .
Point No. 13 (QIHAISHU / UB-24)
Location: One finger width away from midline on the back at the

level of the pelvic bone which can be felt on the sides
of the body - as shown in figure.
Use:

Low back ache; piles; pain in the pelvic organs,
especially women.
. .8

. .8

Point No.14 (TIANTU / Cv-22)

Location: At the centre of the notch above the sternum.
bone downwards.

Press on

Do not press into the neck - it may

choke a person.

Use:

Bronchial Asthma; Bronchitis; Release of mucus from
throat and lung; and difficulty in swallowing/breathing .

Point No.15 (SHANZHONG/CV-17)

vocation: On the midline, at the mid-point of the sternum.

Use:

Chest pain; Asthma; Bronchitis; cough; and especially
in deficiency of milk production for lactating mothers it is very useful. It does not produce milk in others-

so, don't worry.
Point No. 16 (JIUWEI / CV-151

Location: Below the lower end of the sternum in the midline.

Use:

Pain due to Gastritis; Hiccoughs; vomiting; chest pain,
especially in region of the Heart.

Point No. 17 (YUNMEN / L-2)
Location: Front of the chest, below the mid-point of the collar bone
Use:

Cough; Asthma; Arthritis of shoulder joint; Breathing
difficulty.

Point No. 18 (JIANJING / GB--21)
Location: Highest point on the shoulder - midway between the

prominent vertebra and acromion.

Use:

Frozen shoulder; back ache; stiff neck; pain and nerve

disorders of the upper limbs.

It is a dangerous point.

If too much pressure is used, a person

may faint or feel weak in the upper limbs.

It is a karate point

used to immonilize the hands.

. .9

9.
Point No.19:

(Abdomen points around navel)

Location: These are two sets of 4 points each around the navel.
The first (inner) set is two finger width away from the
navel, above, below and on both side.
set is four finger widths away).

Use:

The second(outer)

Inner-set for pain around the navel, usually due to
small intestine problems/colics/worms, etc.

Outer set

for pain from large intestine.problems and stomach.
PINCH the skin at these points with finger and thumb - do not press

into abdomen.

The finger width measurement is - patient's fingers.

So, for a child, use width of child's fingers - not yours 1

IN

ACUPRESSURE, WHENEVER FINGER-WIDTH IS MENTIONED,

IT IS ALWAYS THE PATIENTS' FINGERS.
Point No.20:

(NEIGUAN, P-6)

Location: 3 fingers above the wrist-crease on the front of
forearm between two tendons which can be felt when the

palm is made into a tight fist.
Use:

1. For nansea, vomiting and travel sickness.
2.
3.

For Hyperacidity, Gastritis, chest pain.

Anxiety, Asthma, and problems of joints and muscles
of the upper limbs.

REMEMBER - there is a point in each hand.
Point No.21:

(LIEOUE

L-7)

Location: 2 finger widths on the thumb-side edge of fore-arm-above

the thumb.
Pinch the skin between finger and thumb.

Use:

1. Asthma and Bronchitis.

2.

For pains/problems on back of head, neck and chest.

. . 10

in.

Point No. 22:

(QUCHI_ - LI-1,_1)

Location: Semiflex the elbow. The point is at outer end of the
elbow-crease. Straighten the elbow and press.
Use:

1. Improves immunity and Bomoeostasis.
2. Reduces anxiety, hypertension.

It brings back mental

balance in emotional states.
Point No. 23: (SHAOFU, H~8)

When you close the fist, it is between the tips of the
little and ring fingers.

Use:

1. Chest pain and palpitation.

2. Painful urination, bed-wetting.
Point_No . 24 :

(DADUN, Liv-1)

Location: At the base of the nail on the big-toe.

It is the first

point on the Liver meridian.

Use:

1. It is a JING-WELL point.

Yesl

Emergency point,

for all acute emergencies.
2. Itching genital area, excessive menstruation,
prolapse of uterus and bed-wetting.

Point No.25:

(YONGQUAN, K-l)

Location: In the hollow of the sole of the foot, in the middle,
just behind where the front part of the foot touches
the ground.

Uses:

1. It is a JING-WELL point.
2. Unconsciousness, convulsions, severe nausea,vomiting

painful urination.
3.
Point No.26:

Pain of feet and arthritis small joints of foot.
(SHENNAI, UB-62)

Location: On the outer aspect of the ankle, just below the

lateral malleolus.

Us e:

1. It is a powerful sedative point.
2. Psychological disturbances, lack of sleep, low back
ache.

12.
POINTS

WHILE

REMEMBER

TO

DOING

ACUPRESSURE

01. Do not press too hard and create pain.

Firm pressure is

adequate.

02. Stimulation ALWAYS starts with GENERAL points and again ends
with Adipathi (Point No.l).

03. Stimulate continuously for 20 seconds to 1 minute at each of
the points, and then repeat for a total period of 5 to 20

minutes.

Use points on both sides of body where possible.

If there is no relief in half an hour, try other points.
Repeat 2 to 3 times a day for 3 to 5 days.
04. Acupressure reduces PAIN - Find out the cause of the pain and

supplement with other methods you know.

Acupressure can

complement and supplement other methods of treatment.

05. The patient should be seated or lying down in a comfortable
position for best effect.

06. The patient should not be with full stomach or starving. A gap
of 1 hour to 2 hours before/after meals is adequate.

07. Do not use lower limb and abdomen points in pregnant women.
08. You can use pressure, or pinch the point between finger and

thumb for the same effect.
09. The Therapist needs to be healthy to be most effective.

10.

Maintain your health by pressing the points at the fingers and

toes daily.

11.

It wakes you up and makes you most effective.

TEACH the patients how to use these points and make them

independent in tackling their own problems.

12. You and the patient will not feel tired or exhausted if you do
acupressure properly. it does not harm your PRANA.
So, use your fingers and thumb - try not to use instruments
which do not have prana.

ALL THE

BEST
MAY

IN

GOD

YOUR
BE

HEALING

WITH

YOU.

EFFORTS

11.
Point No. 27:

(KUNLUN, VB-60 and TAIXI, K-3_)

Location; Hold the points on either side at ankle joint, between

Achilles tendon and the bone.

The outer point is Kunlun

and the inner is Taixi.
Use:

1. Foot pain, calcaneal spur, sciatica, low back ache.

2. Urinary problems, impotence qnd retained placenta.

Point No.28:

(SANYINJIAO, Sp~6)

Location: On inner side of lower leg, four fingers above medial
malleolus, where bone and muscle meet.
Kidney, Liver and Spleen channels meet at this point.

Use:

1. For all urinary, genital and pelvic organ disorders.

2. For reducing pain during delivery.
3. For retained placenta after delivery.

Point No.29 :

(CHENGSHAN, UB-57)

Location: In the middle of the calf where the calf muscle

becomes a tendon.
Use:

1. Sciatica, leg-cramps, pol io

2. Prolapsed rectum.
Point No.30 (WEIZHOND, UB-40)

Location: Mid point, hollow back of knee joint.

Use:

1. Sciatica, low back ache, menstrual disorder.

2. Arthritis of knee-joint.
Point No. 31:

(YIN MEN, TO • - 3 7_)

Location: Centre of back of thigh.
UseLow back ache, sciatica, paralysis, polio.

Point No.32:

(C'-IENGFU, UB--36)

Location: Mid point of gluteal fold.
Use:

1. Low back ache, sciatica, arthritis of hip.
2. Piles.
. . 12

12.
POINTS

TO

WHILE

REMEMBER

DOING

ACUPRESSURE

01. Do not press too hard and create pain.
adequate.

Firm pressure is

02. Stimulation ALWAYS starts with GENERAL points and aaain ends
with Adipathi (Point No.1).
03. Stimulate continuously for 20 seconds to 1 minute at each of
the points, and then repeat for a total period of 5 to 20

minutes.

Use points on both sides of body where possible.

If there is no relief in half an hour, try other points.
Repeat 2 to 3 times a day for 3 to 5 days.

04. Acupressure reduces PAIN - Find out the cause of the pain and
supplement with other methods you know.

Acupressure can

complement and supplement other methods of treatment.
05. The patient should be seated or lying down in a comfortable
position for best effect.

06. The patient should not be with full stomach or starving. A gap

of 1 hour to 2 hours before/after meals is adequate.
07. Do not use lower limb and abdomen points in pregnant women.
08. You can use pressure, or pinch the point between finger and
thumb for the same effect.

09. The Therapist needs to be healthy to be most effective.
10. Maintain your health by pressing the points at the fingers and

toes daily.

It wakes you up and makes you most effective.

11. TEACH the patients how to use these points and make them

independent in tackling their own problems.
12.

You and the patient will not feel tired or exhausted if you do
acupressure properly. It does not harm your PRANA.
So, use your fingers and thumb - try not to use instruments

which do not have prana.

ALL THE

BEST
MAY

IN

GOD

YOUR
BE

HEALING

WITH

YOU.

EFFORTS

L-Z-C'b'W't-

——-—-XA-,

CHW/M^W

ACUPUNCTURE - I•

I, Aldoms Huxlery in his forward to Felix Mann's "ACUPUNCTURE-:

CURE 6>F MANY DISEASES" says,

" that a needle struck into

one's foot should improve the functioning of one's liver is

obviously incredible.

It can't be believed, becaues in terms

of currently•accepted Physiological theory, it makes no sense
Within our system of explanation there is no reason why the
needle prick should be followed by an improvement of Liver

function.

Therefore, we say it can't happen.

The only trouble with this argument it that, as a matter
of empirical fact, it does happen."
In Latin,'Acus' means

'needle' and

’Pungure' means

'Puncture' - a western name for this oriental method of
therapy using needles to puncture the skin.-The Chinese name
for this is CHEN CHIU.
Historically, Acupuncture dates, back to beyond 35OOB.C.

/first systematised during the Tsin dynasty(A.D. 356 - 420V
survived many ups and downs till its revival as a matter of
cultural pride cat the dawn of the Peoples Republic of Chino.

After exposure to Western Medicine,

"Scientific" metho­

dology has been employed in observing, documenting, explain­
ing, researching and■exploring the horizons of Acupuncture -

since, as late as 1958'A ,ID ,

THEORIES OF ACUPUNCTURE:
I. Traditional

Chinese Theory:

This is based on the concept of

'Qi ' of 'Chi 1 - the life

energy - the invisible force present in all liYing forms of
life - Similar to the Indian concept of FRANA/PR ANAVAYU.

'Qi' consits of 2 aspects - 'YTN' & 'YANG'.
- Yin stands for all that is negative/female/moon/earth/cold/

weakness/etc.

- Yang stands for all tha£ is pjsitive/male/sun/sky/hpdt/
strength/etc.

f

2

Health is a state of balance between the two, end dis,ease - an

imbalance*
The channels through which

'Qi ' flows in the body are the

meridians - 12 paired & 8 Extraordinary meridians.
Also incorporated■in the traditional system is the five - eleR< ,'

j.

■* .

.

* '*‘J- "

• I "

ment theory(fire/oar^h/metal/wood/water ), governed by various laws

like mother and son .1 aw/Husband-wife law/Midday-mid nigh t law etc.
<

It seems fairly certain now that the meridian system is a
philosophic, not a medical entity.

It has served its purpose well,

but will soon be replaced by a sounder neurophysiologic theory,
"Peking Me dical Review" -• it was found that about half the
known acupunctural points are located right over various nerves and

the rest are within a half centimetre of one- or another nerve.

II. Theory of Hypnosis; KROGER -'1972.
We know that simple operations can be done by hypnosis alone 5 to 15% of subjects are susceptible.

Chinese statistics of greater

than 80% success, leaves a huge unexplained gap where some other
mechanism of analgesia is undoubtedly at work, and, the selectivity

and reproducibility is remarkable.
1
If there is a hypnotic element in Acupuncture it appears t^be

a corolary and not an essential part of the working mechanism(AC in
Children and nnimnlo').
III.

GATE-CONTROL THEORY OF PAIN - Ronald, Melzack & -Wall - 1972.

Pain impulses controlled and''modulated by:
I
II

IV.

functional gate - Substantia gelatihos'a of spinal cord.
functional gate - Opposite spino-thalamic tract,

VISCE RO-SOMATIC REFLEX THEORY - Felix Mann 1972

Rased on reflex called- 'Cutanco-Visceral reflex' on observation
of phenomenon of ■ 'Referred pain'.

v» THEORY OF DEFENCE MECHANISM & TISSUE REGENERATION - Cracum - 1973.
Through activation of neuro-endocrine system, and later the

Reticulo-endothetial system - based on :

3

a ) ACTH production
b) Leucocytosis sspedial of
neutrophils

i
on flCUPu|k|Cture stimulation.

|

5

- PLATT 1974 - q) Decreased serum triglyceride concentration
b') Serotonin and SRS-A production.

VI.

ENDCRFH5INE RELEASE THEORY ( E0MERANZ7t/I2?6 )

VII.

JrHALAMIC NEURONfe TJ-IEORY

■

■

■

i ’

•

-

•

~' 1977/70)'

"•

based on any pathological process setting up a focus of abnormal
enectrg. cherpical activity in the Hominculns,

.other Theories:
VIII,

THE KYUNGPANK SYSTEM THEORY:

proposed Ry a Korean team headed

by KUM RONS HAN who injected radlo-Luscent material at Acupuncture

points and demonstrated flow along specifier' meridians independent of
vascular/lymphatic/--nervous system channels.
A

KIRLIAN fflOTOGRAR-IT:

IX.

*

}

S.D. KIRLIAN & V KIRLIAN in 1939 -

Photographed living beings under high frequency high voltage electric

fields and showed an electric area around human beings with acupunc­

ture spots as bright spots. - Not

reproducible, hence unreliable.

METHODS' OF DIAGNOSIS
1. History taking - Past/present/Family etc.
2.

Physical examination - Inspection/palpation/percussion.

3.

Palpation of Alarm points 8. Ah-Shi points

4.

Pulse diagnosis - Rate/Rhyth,m/Volume/Chairnetor/Strcngth

’ v •

- 3 positions on Radial pulse-

First (Moat dista,l ) ~ Tsun
Second( middle) - Chin
Third (prqxirna 1) - Kuan.

'* •

Right Hand

Lp ft Ha nd

Posi
tion

Fbsi
tion

Superficial

I

Small intestine.

Heart

I

II

Gal1 Bladder
Urinary Bladder

Liver*;

P

Stomach

Kidney

III

Triple warmer

III'

Deep

Superficial

Large intestine

Deep

Lu ng
s pleem
pericar­
dium

4

ALL DEEP PULSES .ARE YIN PULSES - ALL SUPERFICIAL O.bES ARE'YA?^ PULSES
- For health and well being of the body and mind, there should be,

sufficient and equal energy in each of these meridians /puls-eS-y.T ";T\:
' 1' ’

•

I i ■ ' ■ ■

»>

.

-

\

iii

i.

, '

- The physician keeps, ;hls own/pulses beq'lth'y qqd/uses them’-a^^ft's^ard
■ ■■

'' ' l ?

■' 1 '

’

!I ■" ■

y

'' ’

j ’

- The patient should be relaxed/rested.
' XaA-';:'AA iuj'A.'-'R

■ ■

..

.o:,

,ji: ■:

■

- Surroundings should be quiet.

- Over 300 Qualities of the- pulse are described by traditional f>ract-

tioners and a trainee undergoes 3 to 5 years of training in pulse

;■

diagnosis alone,

ACUPUNCTURE - II

'

In the past, needles made of stone, bone, Bamboo etc. were us^
presently, only metalic needles made of tempered steel/gdld/silver/
copper/bronze are used.

The commonest types of

needles used are.;

A ■XM,XUif.2.gin n<?
-/Diameter is'Ara,y''i^‘blG - commonest'A-310-toy32‘funch'-gauge needles.
- Length variable - ICMto 15CMs. - The choice dependson location
and type of acupuncture point to be stimulated; A <■
' ■

2. The triangular needle:

used where.bleeding is reouired, since the

needle has three cutting, edges. ■

3. Steven star n<?r dips (plum bloc®bm. heedless') : Seven Small needles are
arranged like a star on the head of a hammer - used for superficial
light stimulation.

4.

firess needles :

1 mm in length with a button type of ba'oe - for

ear puncture and for retention.■

5.

Intra-her4” al’ needles : 2 to 5mm in length and extremely thin
(wire like - 30 size wire).
sterilization - with 7o& aJcbbol/not to bo boiled.

DIRECTION OF INSERTION:
A

'O

a J perpendicular - 20 ' o skin surface
b) slanting or oblique - 30° to 60°
d) Horizontal - JO0- - 2<p°

Type, of stimulation
a) up and down movements:
b) Rotation
c J Flicking
A
d ) Vibration
el Electrical stimulatio jn.

I

f

I

5

Duruxtion of stimulation:
A) Short - 20 Sec. to half minute.
b) Intermediate - 20 Secs, with stops for 2 to 3 mins.
- for 15 to 20 minutes.
c) Continuation - 1 tp 2 hrs - till relief/desired result is

.

-t

'■

obtained

What happens (subjective) when Acupuncture njeedle stimulation is don.

a) Sharp pain - when the noodle enters the skin((A* group of
delta fibres)
b') Soreness characterised .by dull pain-Stimulation of C fibers.

c)

Heaviness - Stimulation of presssure sensitive corpusclesj

■d) Feeling of distension/swell'ing-interforence with micro­
circulation and increased capplllary permeability.
e) Reddish corona - due to vasodilatPtion of arterioles.

f') Warm sensation-due to above and increased circulation.
g) Continued manipulation-increase in threshold(analgesia/
hypglgesia)
i

h) Further manipulation (45~60min's. )- numbness spreads and
a.ppears in areas distant from ppini(useful in surgery)

EFFECTS, PRODUCED:
1)

Relief from pain (Analgesia/hypalgcs la ')

ii)
iii)

Relaxation of spastic muscles.
Improved microcirculation locally

iv)
v)
vi)

Improved microcirculation as a distal effects
Lowering o.f a raised B.P.
Lowering of blood lipid concentration/stimulation of hypoly- .

vii)
viii)

ix)
x)

Relief from hypersensitivity of skin and muoua membrane) ■ ! ,
Sedation and relief from mental depression'.
... 'i ■'

Stimulation of hormonal release - ACTH like response
Increase in immune responses and resistance to hactbrial
infections (neutrophilia)

xi ) Hypnotic

A twpaAvx C-LwvP

<TA^ -

.^H/ATS-p

effect - as in any qthcr therapy.

Lo Q

Lko nAZ_l'Cu><ti

..V

Ia-cA. 1 ■4zVt

6

■ acupuncture, - m/iv/v

There aro 12 paired meridians and

extra-ordinary meridians according to

traditional ccncopts.r Wo will consider tho r.iost useful of those points as far
as practice isaoncornod.

Tho. .unit of nodsuronont usod to locate thoso points fieri anatomical landmo.rlcs
is tho ’T-sun’.
1 T-sun
,

k> a)

distance between palmar creases of tho proximal and
distal interpho.langoal. joints of tho middle finger
of tho patient when flexed at right angles.

or b) tho breadth of tho thumb at tho intorphalangoal joint.
Thus, point location.is individualised for each patient.

Width of 2 finders

= 1.5 T sun.

Width of 4 fingers

e>

3 T sun

The WHO roconmondod nmdndaturo is usod for description of points ns below. w

LUNG MTRID1AN;- Starts in 1st intercostal space in tho infraclavicular fossa

and extends to lateral side of the tlrunb close to tho root of the nail.
It lias 11 points. -

i

friportant point; L-7(58) LIG QUT
Location; 1 .5 Tsun proximal to distal, wrist oronso, on outer aspoct of foro arm.
(link both hands such that tho IV’ formed by tho index fingers and thumbs of

both hands touch nt tho base of the ’V - tho tip of tho index finger n^w
touches this point.
Popularity: It is a distal point for back of head, nock and. chest.

Indications; a) Local diseases of wrist
b) Asthma/Dronoh£bis

o) Cervical spondylosis/stiff nook
d) Hoadacho/roli’B palsy

W

Needling: 1 to 1.5 Tsun, slanting upwards.

IlARgTC IHTWTIOT MWRIDWI: Total no. of prints - 2n otaitri al; tip of Brw’ial side
of ind.ox fin.gor and tominatos botwoon naso-labial groove and ala-nnsi.

Important points;
a) LI - 4. (04) ir.GU

location- ’a) On tho highest point of tho bulge rvido wlvun tho thumb and ind.ox
finger are hold. close together in adduction - on dorsum.
b) On the dorsum of tho.hand at tho mid-point of 2nd metacarpal on
. -

the radial aspebt.-

Popularities- Distal point for faco, .front of nook and snooinl organs.
It is ono af the most powerful analgesic points of tho body.

7

Indications: Painful conditions of oyo/rrigoninal neuralgia/lower tooth
acho/pollls palsy/Fovor/Point used for analgesia in upper tialf of body.

Needling - 0.5 to 1 Tsun - straight
')|)

’

b) LI QUCIQL
Location - Semiflex the elbow,-. lateral end of elbow croase.

Peciliarities: One of the Lost immunity improving, tonification and
and homooootatio points,

Indicationst Malaiso /^onlnoss/Nourosthonia/jIyportonsion/bisordors

of upper limb.
Needling: 0.5 to 1 'gsun straight.

^7

L1~2o(1 op) roiGXIANG t
Location: Mid point botwoon highest point of tho ala-nasi and angle of

1

month in nas o-labial groove.

Indi cations: Trigeminal nournlgia/oomndih oold/uppor tooth aoho/
maxillary sinisitis and pbcinl Paralysis.
V'

lleodling: 0.3 to 0.5 Tsun straight
.......

- •••'-—; TS:j,U-

. .

X .

1

__

!

*

STOMACH MUI ID TAN i Total points 4.5’

7

V

Starts below oyo lateral to ala-nnsi and torminatie at D.storal sido of tip
of 2nd too near tho nail,
gw.Q/n) jjaoipHi

LfjC.atipn: Over massoter anterior to angle of mandible - clench tooth for
bottor location.

Indications; Tootliaoho/Barotitis/fncial norvo palsy/ Anaesthesia for
tooth extraction and tonuillootamy.
Noodling : 0,3 to 1 Tsun straight.

b) St-7 (149) XUOUAN
Location; Centre of depression nt lower margin of zygomatic arch,
anterior to Tomporo-5.1andibu.lar joint.

indications; Facial norvu palqy, Arthritis '|/M joint, Toothache,
tinnitus, trigeminal neuralgia.
oxtraction unpor jaw. ■
_ Npodling: 0.5 to 0.0 Tsun straight.
\y

Anaosthosia for tooth

c) st^ % (170) ZUSAMLI:

Location: Ono fingor breadth lateral to Tibj.nl LuLoreslty,
Indicationst Immunity improving and tonification. Polio/nyoputhics of
leg/Gastritis/musoa/vor.iitin;/conotipation/rAO/wric oso vein:
doodling: 1 to 1 .5 Tsun straight,

d) ^-ii UMLJlLIJJNG

Locat ion s Dorsum foot 0.5

S'

Tsun proximal to wsb-space bet wean 2nd &3rd toes

" Indicate Iona i Arthritia ankle and small joints foot,

for pain in lowor half of body.

Beat analgesic point

As a distal point for headache*

and toothache.

Needling1 0.2 to 0,5 Tsun straight or slanting.
SPLEEN MERIDIAN

. Total no. of pointe 21.

Sturts - medial,aide pF great - toe and ends at 6th

Lnteroostal space in mid-axillary lino.

||\j7|A0

Locations 3 Tsun proximal to tip of medial malleolus just behind medial bordi

and posterior surface of Tibia.

-------

Poculiarity t Distal point for urogenital disorders and diseases of pelvic
cavity.

Kidnoy /livor/sploen channels meet at this point.

Indications! Bladder & Bowel disturbances/diseasos of livor, spleen,kidnoy/
local problums/gunoral tonification/poinioss child birth."

Needling s 1 .5 to 2 Tsun straight.
■ HEART MERIDIAN!

Total No. of poihtee - ;9,, Starts from contero of”axillaj ehds on lateral sido of

littld finger proximal to- corner, of'nail.
H-B (79) SHAPED I
Locationi On palm botwoon Ath and Sth motaoarpels- close fist and mark point

between tips of little and ring fingers.
Indications t Local/Nourophiihica of hand/chest poin'/Enurosie i dysuria. ■
Need ling s 0,5 tsun or lotn-st might.

SMALL - INTESTINE MERIDIANi

Total No. of points - 19. St

- corner of nail of little fingur

in front of tragus.
51 - 16

(130) DIAN ZliUNLSI|U,

Locat ion; 2 Tsun lateral to op I noun process of seventh cervical
Indicat ionsi

Needling i

frozen shouldor/backacho/stiff-neck/Aethma.

0,5 to 1 Tsun straight.

URINARY - BLADDER,-MERIDIAN 1 Total points 67.

Starts medial canthus of pyuf

ends at latarnl aldo of tip <bf little too.

a) UB-24(255) qiHAISRU!

Location! Back, 1.5 Tsun latoral to tip of spinous process of 4th lumbar

.

vertebra.

Indicate ions : Hammorrhoids/Proinpso rc.ct urr/lumbago.

Needling! 0.5 to 1 Tsun slanting towards midlino.

.

9
b) A18T.36. ^?UII1ENCJ.U L
Locotion s Mid-point of flutcol sulcus.

Indicot ions ; low-back p.' ln/sclat ica/art hrit is hip/Hemorrholds.
Nppcjling?
\/

c)

1.5 to 3 Taun straight.

_8J..X28^_ DIENGSHAN;

Locat ion 8 On coif where 2 bellies of gastrocnomins meet.

'

Ind loot Iona 8 Soiotica/iug crumps/ Polio/ Prolopsu.. root um/Plant ar faapitis.
OJ9. ° 1 to 3 Tsun dt might.

V

d) UE) - 60 (291) KUNLUN?

Locat ion ; Mid point butwoun tendo-achilIt 0 and tip Of'lot oral mallcto.lua.

■Indicat ions r Polio/Paralysis lower

.limb/sc-iat ica/iumbago/calc-ancal spur/

retained placenta/ + local.
Noudling 1 0,5 to. 1 Taun, at might .

0) da ~ 62 (293) 5HENMAI ■
ifiPAf-Y °JT.

duter aspect anklo, 0.5 Tsun below tip of lateral malleolus.

Peculla rit y < Vary potent swdatur point.

.Indications ; Looal/low back ache/Insomnia.
Needling: 0.3 to 0.5 Tsun. straight.

KIDNEY MERIDIAN; Total points 27
Starts at Junction of anterior l/3rd and posterior 2/3rd of sole, end terminates
In infraqlaviculrjf region.

Lo£3ki2Q8 In hollow of solo at Junction of anterior l/3rd and posterior

2/3rds in depression between 2nd and 3rd metatarsophalangeal^joints- '
Utiat located when Laos arc flexed.
Powerful and offoctivu Ding-well point during emergibncies-

Unconsclousne-ss/epilepsy/ nausea/vomit Ing/ Pl sntar fnscit is .
]£uodJ_lrujj 0.5 - 1

b)

I'sun straight.

K ~3 (336) TA 1X1:

Loe mt ion 1 Mid-way butwuon tip uf inwdlnl m«i 1J ,e< 11 uu and Achl IJwo tendon
(opposite KUNLUN).
Indicat ions : Gunito-urinary problems/lower extremity diseasos/looal problems.

Noiadling; 0.5 to 1 Town straight.

■P&RfCARDIUM MERI-DJAN-i total'pointe 9

'

Starts 1 Tsun lateral to nipple - ends at tip of middle finger.

'

P - 6 (68) NEIGUAN
Locat ion: 2 Tsun abovu distal tranaverau cruaao of wrist, but wuon tundonci

of Flexor carpi radialis and palmaris longue.
Peculiaritles; 1) Distal point for abdominal and chest disorders.
2)

binci.connfictIng point of Pericardium with Triple-warmer
meridian.

10

Indicat ions ; Chest pain/Myopat hies/Gast rit is/Hiccough/Vomit ing/Ast hma/
Hyst aria.

Need ling t 0,5 to 1 Tsun straight
Acupressure point for vomiting and travel sickness.

TRIPLE-ldARML'R MERltllAN: Total points 23.
Starts corner of nail on ring finger un ulnar side, ends at lateral and of eyebrow.
TU) - 23 (123) SIZl-IUKONG;

Lo cat ion s Lateral end of* eyebrow

Indicat ions i frontal sinusitls/Mlgruine/Front aJ and temporal hoadachos/dLseasss
o f u y cj .
Need ling c 0.5 to 1 Toun slanting posteriorly.

C Aj. L - BL ADO G R MERIDIAN ; Total points 44,

_^tart-e - lateral canthus of sys and ends at tip of fourth toe.
s)

I

a) OB-20 (207) FENGCHI;
Location: Between insertions of trapezoid and stsrnomastoid muscles - in

hollow botwuon wxtornol occipital protrubiiranco and mastoid i^hceo
Ijndl.cnt ions : Stiff n.-ck/cervicB i «>|m milyloo j s/h cnida ch os/ vert 1 go/hypurt ension,
Noud11ng i 0.5 to (J.tl faun u lent it n i, iiiroct.tjd towards opposite uyu.

b) G8-3A (221) YANGLINGljUAN i

Looat ion i On antsro-latoral aspect of leg in depression in front uf an d
below head of fibula.

Indicat ions i Hemiplegia/lumbago/Gastrit is/Vertigo/Muscular dystrophies

LIVER MCRIDIANs Total points - 14
Starts at; dorsum or big ton anil ends in 6th intercostal opoetj buluw thu nipple.

Ux-J^201.DAQL^
p/s

Location;

Dorsum terminal phalanx big tow between inturphslungeal Joint and

>

lateral oorhar af noil.

Indicat ions z Ding-well point for acute abdominal emergoncies/Bnuresie/col^^'
Pruritis gonital area.

Needling. 0.3 to 0,5 Tsun, Blunting.
GOVERNING VESSELS Ml, RIOI AN* Total points 213.

Starts in perineum between coccyx and arms, and terminated at Junction of

upper lip and gum.
GV-20 (8) BAIHUI:

f

Locat ion i Midiinc scalp whom1 linn oonnocting both oars crosses,
^eculiarit y i It governs all Yang channels.

Has powerful sedative and

t ranquiHieing effect., jistal point for ano-rictal disorders.

Brings obout co-ordination amongst channels.
Chinesu - Baihui means meeting of 100 points

Srilanke- "Adhipathi" or Governor
Indictit ions t Hoadochoo/ Vert 1 go/ Insomnia/Pl los/Muinury losp/coordination of other
points.

Needling i 0.3 1'aun slanting posteriorly.

11
Locat ion > Midlino sternum at level of 4th intercostal space (Midway between the

'

two nipples).

Peculai rit yI Specific point for lung tissue.
Indicut Loris i Ast Inna/cough/ Chout pain/ Hiccough/Lact at iontd dufici oncy/acne
vulgaris
Need ling I

O.p to 1

faun, n 1 tint, I.ng upwards.

F/TRA - ORDINARY POINTS - that which du not. belong to any movIdina

-^^Cx-1 YINTANG s
.—Locat ion; Centre of glabella - midway between medial ends of eyebrows.

Indications: Front al sinus it is/headache/migraine/Phinit is/Epistaxis/Epilepsy/vert igo.

Need ling; 0.5 to 0.7 Taun horizontally downwards.
r x~ 5

Ji ACHENE JIANG|

.'-JO.c.ot..i3.n,1 1 Town lateral to inldlinri on prnininwioti of chin - (over the mantul foromtin)
Indications > Trigeminal neuralgia/facial p.nlsy/lower t oot hoche/oxc tisa i ve salivation.

fraud ling 8 0.3 to 0.5 Tsun, straight.

OTHER POINTS
a) FLOATING or AH-SHI POINTS
- become tender and are located around dieuosod parts.

Thwuo uro also effective

stimulation pointe.

b) DING-WELL POINTS
- to be used in acute emu/goncies like shock/convulsions/Ruspiratory failure/
cardiac failure otc.
eg S YONGKUAN (Kl)
REN ZHONG (UV 26)

OTHER RELATED METHODS OF TREATMENT ■

1) Point injection therapy? - with aqua/drugs.
2) Embedding therapyt- with cat-gut

3)

Moxibust ionMoxa (dried powder of leuf of Artemisia vulgaris) used to
stimulate with heat - Direct and Indirect,

4)

Magneto therapy;- Using magnets of strengths varying from 50 Gauss to 5000 Gauss.

5)

Homo eop un ct u r o »- Using homoeopathic medication to dip acupuncture neadlus in.

6)

Lasfcr beam acupunctures using laser beam.

7)

Electrical stimulation j-

a) Auriculo puncturo/Root pugeture/Scalp puncture etc.
9) ACUPRESSURE

(Japanese - SHIATSU)

- Use of fingers/thumb/huel of palrr/heel at Accupuncture points.

Technique to be demonstrated

Duration of utimutation

Use of rice groins/other seeds for prolonged stimulation.
»««****»*****♦»

References i Dr. Franz Warren/Felix Mann/Lawrohce and Mason/Anton Jaisuriya/
Agarwal/Bansal.

Voluntary Health Association, Karnataka
(Registered Under Karnataka Societies Act 1960 No. 185 of 1974-75)

Office at :
Rajini Nilaya, No. 13 (New No. 60)
Ramakrishna Mutt Road, Car Street, 3rd Cross
Ulsoor, Bangalore-560 008.

'HEALTH

IS

WEALTH

I

1

"HEALTH

FOR

ALL

BY

2000 AD"

"VHAK

ASSISTS

MAKING

IN

COMMUNITY

HEALTH

A REALITY

FOR

PEOPLE

OF

THE

KARNATAKA".

USE OF ACUPUNCTURE IN MODERN

HEALTH CARE
Acupuncture therapy was first developed in China
Today, as a result of its

over 2OOO years ago.

widespread use in the People's Republic of China,
its introduction to several countries in all parts

of the world, and considerable research on its

mechanisms and clinical application, acupuncture
is a subject of great interest to health workers of

different disciplines.

WHO’s involvement in the subject

is through its general programme on traditional medicine.

Thus a WHO Interregional Seminar on Acupuncture,
Moxibustion and Acupuncture Anaesthesia was held in

Beijing.

People's Republic of China, from 6 to 8 June

1973, immediately following the first National Symposium
on Acupuncture and Moxibustion and Acupuncture

Anaesthesia (Beijing, 1-5 June 1979), at which some 600
scientific and clinical papers were presented by participants
from 33 countries.

The purpose of the seminar was to

discuss ways in which priorities and standards could be
determined in the areas of acupuncture practice and
training, clinical work, research and technology

transfer.

Some 15 persons from 12 countries took part

in the Seminar and in a study tour of acupuncture

treatment and research centres in the cities of Nanjing,

Hangzhou and Shanghai*

Source : WHO Chronicle, Vol.34 No. 7/8, Page 294

“ardia, fullness in the chest, short
% palpitation and heart insufficienA improvement also appeared in
uand the longer the treatment, better

SUNDAY, JULY 14, 1985

Weekly Edition — 3

%lts.
juncture, according to the analy!,Voved the left cardiac function of
41 Scute and old myocardial infarction
In rheumatic heart disease, it imN clinical symptoms and signs to
5^ degrees. And in hypertension,
%cture brought down the diastolic

THE SBm. HINDU
India's National Newspaper

Printed at Madras, Coimbatore, Bangalore. Hyderabad and Madurai

^puncture, as an
'Wnative system for
during illness, has
Jained recognition at
■he hands of doctors.
^course in which
Chinese experts
Participated was held
'ecently in Madras. A
dozen medical

practitioners
including
neurologists,
surgeons and
physicians were
given training
and systolic blood pressure and especial­
Needles stuck to cure migraine.

Colour transparencies by our staff photographer

ly the latter.
Can acupuncture cure diseases such
as cancer of the lung? Madam Zhou ad­
Following good response to the ture and moxibustion to treat 43 diseases mitted that it was not a panacea for all
ESPITE best efforts in the last 35
years and more, admittedly, the be­ course. Mrs. Uma Narayanan of Cha- in all the countries.
ailments. "Acupuncture does not make
nefits of modern medicine are still tnath Trust, which sponsored the visit of
Prof. Xingnong, who has over 50 years tall claims. We cannot cure cancer but
to reach a sizeable section of the popula­ the Chinese team, says that an acupunc­
we can relieve the pain of cancer, which
ture centre will be set up at the VHS of experience in traditional Chinese medi­ is an important aspect particularly in term­
tion, particularly in rural areas.
by the Trust. The Centre will be provided cine. says that acupuncture could play
To make health delivery widespread, with facilities for both therapy and re­ the role of drugs and antibiotics, especial­ inal cancer."
States, such as Tamil Nadu, included in search.
ly for anti-inflammation. It is now used
In the light of tremendous progress in
their programmes the various systems of
in combination with surgery, for instance, :he field of modern medicine, how has
In the traditional Chinese view, acupun­ to treat acute abdominal pain and ap­ acupuncture advanced? The system has
Indian medicine considering their effica­
cy and the cost benefit. The curative cture is based on manipulation of the en­ pendicitis.
some a long way from the use of needles
values of decoctions and juices of medi­ ergy flow within the body through stimula­
A recent analysis of the effectiveness made of stones, bone and bamboo. Now
cinal plants and herbs have, gained much tion of meridians, or "energy pathways"
appreciation, yet they could not be carr­ to correct energy imbalances, which are of acupuncture on 871 persons with cor­ gadgets such as acupunctoscope have
Continued on next page
ied extensively as experts in the ancient regarded by acupuncturists as the root onary cardiac diseases shows that
systems are not numerous. Also, much of illness. The points selected for inser­ acupuncture can relieve and improve
of the old valuable literature have been tion of needles are decided according
• lost over the years and what remains are to diagnosis and the nature of the dis­
still to be studied in depth and the ease. The needles, made of fine stainless
method given a sound scientific basis, steel with copper handles, vary from half
evaluating the effects and clearing all inch to eight inches in size and after inser­
doubts.
tion they are left in position there for se­
veral minutes; in some cases for more
In the search for an alternative medic­ than
30 minutes. And the treatment is sp­
ine, acupuncture, the traditional Chinese
method of relieving pain and treating dis­ read over 15 to 20 sittings. In acute cases
the
needles
are retained even for an hour
eases, has fascinated several Indian doc­
tors. Significant in this context is the re­ or more. In the treatment, the acupunctur­
cently concluded three-month course at .ist relies on some 360 points of which
the Voluntary Health Services Medical the' ears alone are stated to harbour

D

Acupuncture treatment relies on the ear for diagnosis, for 60 points are harbour­

ed here.

Aavin presents
5 refreshing ways to enjoy

60 points, scarcely millimetres
Centre, Madras. A dozen modern medi­ some
apart,
cal practitioners Including neurologists,
According to Madam Zhou, who im­
physicians, surgeons, anaesthetists and
venereologist were given training by a parted the training at VHS, acupuncture
team of experts from Beijing in the art Is now used in conjunction with modern
of treating diseases by Inserting needles medicine and Its validity tested against
laboratory results. TVUs is tKe Hrst time
Into various parts of the body.

the goodness of milk!

An acupunctoscope, a diagnostic equipment to find out the points of therapy.

“The effect of this therapy is amazing"
said a lady librarian whose face was turn£^)into a pin cushion with hair-thin needl­
es inserted on her forehead. "Until a
week ago, I cannot concentrate on my
work even for 10 minutes, but thanks to
these miraculous people. I now feel
wonderful and the treatment has allowed
me to read even for eight hours without
any headache."

that the Beijing Academy of Traditional
Medicine has conducted the certificate
course on acupuncture outside China.
And in the last ten years, the Centres
at Nanjing, Shanghai and Beijing have
trained over 1,000 doctors from 103 coun­
tries on acupuncture and moxibustion,
another therapeutic method under which
diseases are treated by application of
heat of burning maxawool, a plant pro­
duct. over the acupuncture points.

This woman, with a complaint of migra­
ine for nearly six years, was one of over
Prof. Cheng Xingnong. Vice-Director
200 persons benefited at the clinical prac­ of the Beijing Institute, who was in
tice sessions conducted by the Chinese Madras at the time of the inauguration
team. Almost all the patients said that of the course, said that acupuncture and
they noticed considerable improvement moxibustion therapy could cure over 300
even in two or three sessions of therapy diseases. Of these, more than 100 could
and felt greatly relieved of their ailments be treated without combining Chinese
such as asthma, arthritis, back pain, scia­ herbal medicine and western medicine
tica and breathlessness. Although in or other therapy. These include infecti­
some cases the reduction of pain was ous diseases, disorders of internal medic­
only marginal, the doctors considered ine, surgery, gynaecological, ENT, paedi­
the treatment response significant be­ atric and dermotological problems.
cause these patients could find no re­ Acupuncture could also be applied for
medy in other systems of medicine, in­ preventive purposes. The WHO had re­
cluding allopathy.
commended the application of acupunc-

crush the crystallin’’ waste deposits which have ac< urmilatcd «i e-e nerve
endings, pulverizing them so that they can he earned away by the b'ood to
points ol elimination if your thumb does not rema n cm slant at the pom!
pl pressure, but slips or glides even slightly, you miss the >eHe» pomt and
pull the slr'i’ over the deposits instead ol crushing them Lven'i' cfeposi's
me partly broken up in a gliding motion, it is a cardinal prrrvpple o( reflex
compression massage that the pressure c*. a given point is the stimulus
initiating the impulse winch travels through the zone and reaches each
organ in the zone This results tn the completion of the retie, response
Thus, the points must be precisely pinpointed So please remember, the
pressure point is not the gliding point

3

5

6

7

8

Fig 5: Foct Diagram (Sequence of areas to work on)
(Same sequence applies on right foot)

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mira sadgopal
ph: 0212 - 470314
FAX: 0212-476451

.■

-14- ■

renuprakash-a, 3rd floor
817 sadashiv peth
pune411030
15 November 1996

To SHODHINI Collective Members & Friends:

Exploring Marma Chikitsa
with Groups of Women Healers
Two gatherings of groups of local women healers associated with SHODHINI are planned in the
near future, at AIKYA near Bangalore (21-23 November) and MASUM near Pune (7-9 January).

I was thinking about what might be offered as part of the programme for these women healers
from diverse regions and representing five or six different language groups. Of course, there will
be sharing and celebrating - and that deserves justice from the organisers and supporters like us
in terms of facilitating simultaneous translation, good quality photo-documentation, etc.
However, it struck me as I was thinking, since these groups have in common the experience of
extended exposure to feminist self-help work, wouldn’t it be possible for them all together to take
hold of a new skill and develop it in the context of women’s healthwork? But, what skill? It then
struck me that Marma chikitsa would be just such a ‘new-old’ skill. I’ve spoken briefly with a few
others since then about it - Manisha, Sabala, Renu, Sarojini, Philomena. I’m sorry not to have
prepared this note earlier to share with you so you could think about it before the first Gathering.
WHAT IS THE IDEA? Well, Marma is just such an area of skill, that it is likely not only to appeal
to women healers, but to be quite useful to them, too. My guess is that quite a number of them if not all - will already have conscious or unconcious knowledge of Marma. From my own
experience in M.P. and other rural areas, I know that people use some of the Marma points in
both human and animal healing work. At the first Women Healers' Gathering, this whole unique
‘group of groups’ could have the opportunity to pool prior traditional knowledge of Marma and to
learn and think about what the indigenous medical systems teach about Marma.

Since there is to be nearly a six-week gap between the two Gatherings, the groups would then
have time to go back and collect more knowledge and feedback from their communities. Hence,
at the second Gathering in January, the groups could all put their synthesis into draft form for a
Marma Pustika (small handbook with versions in each of the five/six languages). Of course, some
members of the SHODHINI Collective & Friends would be needed for co-ordination & editing.

But, some of you will be asking, WHAT IS MARMA? So I’ve prepared a note on the topic with two
supporting tables, attached herewith. Please try to give it and the accompanying Tables some
solid attention and thought. It will certainly require some demystifying. You may be able to add to
this effort from your own up-to-now unknown knowledge recesses!
Let’s not forget to work out the extra expense factors and financing arrangement.
Hoping you will become as excited and intrigued about this exploration as I am, and as we think
the women healers will be,
Copies to:
SHODHINI Collective Members: Anu, Bharati,
Philo, Renu, Rina, Sarojini, Smita, Uma
MASUM (& IWID) People: Kranti, Manisha, Sabala, Vrunda (plus Chandra, Hema, Sunita)
OTHER FRIENDS (in touch with friends... friends... friends...) f£>r Support & Future Involvement:
Abha, Anita, Anuradha, Arti, Aruna, Asha, Ashvini, Beena, Celine, Deepti, Devaki, Gabrielle,
Gauri, Gayatri, Hema, Ilina, Imrana, Indu, Janet, Jaya, Jo, Kalpana, Kameshwari, Karen, Kishwar,
Kusum, Lakshmi, Lorry, Madhulika, Malika, Marie, Mira, Nagmani, Nancy, Neela, Neelam,
Nirmala, Nitya, Pilar, Pramila, Razia, Rohini, Sadhna, Sathya, Shashi, Shubhada, Silvy, Sulabha,
Swati, Swatija, Taranjit, Teji, Thelma, Tripura, Tultul, Ujwala, Usha, Vanaja, Varsha, Vasantha,
Veena, Vidya

WARNING ; This matter is

under criticisim, testing &
development - not to I?q
produced in print.
Marma Chikitsa (or Varma Kalai)
(a note by Mira Sadgopal - 15/11/'96)

The ‘marmas’ are vital pressure points in the body. Knowledge about Marma Chikitsa
(healing by marma) is codified in ISM (formal 'indigenous systems of medicine'). It is also carried
on through the local health traditions without written record. Marma is useful in bonesetting and
animal healing in particular, but also in relieving ordinary or acute human problems like abdominal
pain, headache, menstrual cramping and so on. Marma knowledge may be used while massaging
children and adults.
Use of Marma points arose under both Ayurvedjc and Siddha systems. They are referred to
in the Atharva Veda. The ancient surgeon Sushruta described them in detail. To understand
anatomy from an indigenous perspective, study of Marma is essential. The points demarcate
zones of energy, and their stimulation can release or regulate the flow of energy to various body
organs. Knowledge of Marma was applied in war, for killing an enemy or protecting oneself, and it
became essential in the training of surgeons, as injury to certain points can cause death or
disability. It was later developed as massage to stimulate internal organs.

Marma Chikitsa is similar to the Chinese system of acupressure & acupuncture. The relative
size and location of Marma points are measured in finger units (anguli) relative to each person,
just as in the Chinese system. Some feel that the science may have originated in India.
There are 107 Marma locations that Sushruta described, classified according to
• the areas of the body where they occur, or
• the tissue of which they are composed, or
• the effect if a particular point is injured.
The 122 varma points (Siddha) are classified into six groups according to whether they are
influenced by injury, touch, blow, massage, sight or licking!

Varma points are used for inducing anaesthesia by traditional bone-setters in Dt. Tirunelveli,
Tamilnadu.
I have prepared two Tables, adapting the information given in Chapter 6 (Marma - Vital
Anatomical Points) of AYURVEDA, THE ORIENTAL HEALING SCIENCE (1991) by Vaidyas

Subhash Ranade & M.H. Paranjape, teachers at Ashtang Ayurvedic Medical College in Pune.
TABLE 1 details the ways in which Marma points are classified according to Ayurveda.
TABLE 2 gives details about individual Marma points listed in Body Region-wise fashion.

After studying these Tables, some question would naturally occur to us - the following questions
occurred to me.
SOME QUESTIONS ARISING WITH REGARD TO MARMA & WOMEN HEALERS:
Description of a number of points belies the bias towards male anatomy and function. Likewise,
description of other points relating to women’s bodies and physiology is absent. Does this
information exist?
There are other gaps in the information as it stands (15/11/96). Where is it to be found in Ayurvedic texts in Sanskrit, Marathi, Hindi and & other regional languages?

in Siddha texts in Tamil, Malayalam, Kanada? Tibetan?
in the local and oral folk traditions of diverse parts of our country?
The folk traditions contain numerous Marma-influenced practices, like
•

tying something around various parts of the body to relieve pain in that or other part,

•

pressing particular spots of the body to obtain specific effects which may be remote,

•

vacuum cupping, branding, applying irritants at particular points (easily interpreted as
‘counter-irritation’ by allopathic doctors), etc.

How much of this is already on record (and where)? How much is there to be recorded?
In what way could this subject be taken up and handled by Women Healers, as in SHODHINI?

TABLE 1: Ways of Classifying Marma Points
By Region
of the Body
(107?)

Upper Limbs

22

(Names with asterisk’
are in Lower Limbs, too)

Talhridaya’, Kshipra’, Kurcha’,
Kurchashira', Manibandha, Indrabasti",
Kurpara, Ani", Urvi", Lohitaksha",
Kakshadhara
All * plus Gulpha, Janu
Vitapa, Guda, Basti, Nabhi, Hridaya,
Stanamoola, Stanarohita, Apasthambha,
Apalapa
Katikataruna, Kukundara, Nitamba,
Parsvasandhi, Brihati, Amsaphalaka, Amsa
Mani, Neela, Sira Matrika, Krikatika,
Vidhura, Phana, Apanga, Avarta, Shankha,
Utkshepa, Staapani, Shringataka, Simanta,
Adhipati

Lower Limbs

22

Abdomen & Chest

12

Back & Buttocks

14

Head & Neck

37

By Structural
Composition
(108)

Muscles (Mu)

11

Talahridaya, Indrabasti, Guda

(Initials in
Brackets
are used
in Table 2)

Blood Vessels
(BV)

41

Ligaments, Tendons
(LT)

27

Joints (Jo)

20

Urvi, Lohitaksha, Hridaya, Stanamula,
Apasthambha, Apalapa, Parsvasadhi,
Brihati, Mani, Neela, Sira Matrika, Phana,
Apanga, Sthapani, Shringataka
Kshipra, Kurcha, Kurchasira, Ani,
Kakshadhara, Vitapa, Basti, Nabhi, Amsa,
Vidhura, Utkshepa
Manibandha, Kurpara, Janu, Kukundara,
Krikatika, Avarta, Simanta, Adhipati
Katika taruna, Amsaphalaka, Shankha

By Effects
if Injured
(97?)

Bonos (Bo)

8

Sudden Death

9

Guda, Basti, Nabhi, Hridaya, Sira Matrika,
Shankha, Shringatka, Adhipati

33

Talhridaya, Kshipra, Indrabasti, Stanamoola,
Stanarohita, Apasthambha, Apalapa, Katika
taruna, Nitamba, Parsvasandhi, Brihati,
Utkshepa (if foreign body like arrow, bullet is
removed...), Sthapani
Kurcha (with tremors), Kurchasira,
Manibandha, Gulpha

(Sadyaha Pranahara)
Slow Death

(Kalantara
Pranahara)
Death if Pierced

3

(Vishalyaghnakara)
Painful (Rujakara)

8

Disabling, Crippling

44

(Vikalatvakara)

Kurcha, Indrabasti (anaemia), Kurpara,
Janu, Ani (with swelling), Urvi (with wasting
of thigh muscles, anaemia), Lohitaksha
(with paralysis; from blood loss),
Kakshadhara, Vitapa (with impotence),
Kukundara, Amsaphalaka (with wasting of
shoulder muscles), Amsa (with frozen
shoulder), Mani, Neela, Krikatika, Vidhura
(deafness), Phana (loss of smell), Apanga
(blindness), Avarta (blindness)

Compilation from Source: Chapter 6: Marmas - Vital Anatomical Points, AYURVEDA, THE
ORIENTAL HEALING SCIENCE,Vds. Subhash Ranade & M.H. Paranjape, Pune, 1991, pp 81-90.

TABLE 2: Marma Points by Name and Body Region, with Locations, Size (in Anguli units), Healing Importance & Effects if Injured
Body Region

Sanskrit Name
of the Point

Num­
ber

Meaning of
Name

Location of Point

Hands
& Legs

Talahridaya

(4)

'heart of flat
space’

Kshipra

(4)

'quick'
(effects)

Kurcha

(4)

'knot' (of
tissues)

Kurchasira

QUESTION:
ARE POINTS
ON BOTH
BACK AND
FRONT
COUNTED
AS ONE
OR TWO?

(4)

Manibandha
Gulpha
Indrabasti

(2)

Kurpara

(2)

Janu

(2)

Ani

(4)

(2)
(4)

Size* (In
Anguli)

Compo­
sition

Importance in
Healing

Effect if Injured

at the centre of palm or sole

two

Mu

Stimulation of
Lung

Slow Death

skin fold of thumb & index
fingers, 1st & 2nd toes
at root of thumb or big toe,
2 Anguli above Kshipra

one

LT

Slow Death

one

LT

Stimulation of
Heart
On sole: controls

just below wrist joint; at
centre of heel below Gulpha

one

LT

kurcha'
'bracelet'
???

on wrist joint
on ankle joint

one

Jo
Jo

‘Indra’s
bladder’

at mid-forearm,
at mid-calf

two
one

Mu

Stimulat. of Agni
(digestive fire)‘&
Small Intestine

Anaemia &
Slow Death

at elbow .... point?

one

Jo

Disability

on knee joint... ?

one

Jo

Stimulation of
Liver, Spleen
Stimulation of
Liver, Spleen

arms, thigh - 3 anguliabove

one

LT

one

BV

'head of

'knee'

alochaka pitta

Disability & Pain
with Tremors
Pain

Pain
Pain

Disability
Disability & Swelling

Kurpara & Janu
Urvi

(4)

Lohitaksha

(4)

Kakshadhara

(2)

(wide,
broad?)

mid-upper arm & mid-thigh

'red-eyed'

in middle of each arm-pit &
groin

one

BV

Disability & paralysis

on arm, 2 anguli above

one

LT

Disability

Stimulation of

Disability, wasting of

Udakavaha Srotas thigh & Anaemia

Lohitaksha

(TABLE 2, continued, p.2)

Perineum &
Abdomen

Chest

Vitapa

(2)

2 anguli below Lohitaksha,
at root of scrotum....

one

LT

Guda

(1)

around the anus
(-1st or muladhara chakra)

four

Mu

Stim. 1st Chakra:
sex-gen-urin. syst.

Sudden Death

Basti

(D

four

LT

Controls kapha

Sudden Death

Nabhi

(D

'navel'

over the bladder, between
pubic rim and umbilicus
around umbilicus

four

LT

Contr. Sm.Intest.

Sudden Death

Hridaya

(D

'heart'

middle of sternum

four

BV

& pachaka pitta
Contr. of sadhaka Sudden Death
pitta & vyana vayu

Stana mula

(2)

'root of
breast’

around the nipples

two

BV

Slow Death

Stana rohita

(2)

one

Mu

Slow Death

Apa sthambha
Apalapa

(2)

incline of breast,
2 Anguli above Stanamula
below middle of collar bone

Slow Death

middle of arm-pit, outside

one
one

BV

(2)

BV

Slow Death

Disability &
Impotence

Sthanarohita
Back &
Buttocks

Katika taruna

(2)

on buttocks, centre of hip

two

Bo

Control over fatty
tissue

Slow Death

Kukundara

(2)

at joint of buttocks...
(Post. Superior Iliac Spine)

one

Jo

Control over 2nd

Disability

Chakra

Nitamba

(2)

hip crest, 4 anguli above &
lateral to Kukundara

two

Bo

Slow Death

Parsvasandhi

(2)

below last rib, 2 anguli
above Nitamba

two

BV

Slow Death

Brihati

(2)

scapula tip , 2 anguli lateral
to spine

one

BV

crest of scapula bone,
above Brihati
betw. shoulder & neck, 4
anguli above Amsaphalaka

two

Amsaphalaka

Amsa

(2)
(2)

Control over 3rd

Slow Death

Chakra
Bo

Control over 4th

Chakra
one

LT

Control over 5th

Chakra

Disability & wasting of
shoulder muscles

Disability & frozen
shoulder

(TABLE 2, continued, p.3)

Neck

Head

Mani (plural:
Manya)
Nila
Sira Matrika

(D
(8)

Krikatika

(2)

'bead' 'gem'
(of necklace)
'blue'

four

BV

Control over Blood

Disability

point of throat

four

BV

side of neck... etc?

four
???

BV

Disability
Sudden Death

(2)

side of vertebra, at joint of
back & neck

one to
two

Jo

n

Disability

Vidhura

(2)

below & behind earlobe

one to
two

LT

Disability (Deafness)

Phana

(2)

side of nose

1 -2

BV

Disability (Loss of
Smell)

Apanga
A varta

(2)
(2-6)

outer corner of eye

1 -2

BV

Disability (Blindness)

1 -2

Jo

Disability (Blindness)

Shankha

(2)

outer part of eye-brow; also
inner, middle ?
temple - between ear &

two

Bo

1 -2

LT

exactly between the
eyebrows
tips of nose, chin, soft
palate & point between
nose + upper lip '

1 -2

BV

one

'mother blood
vessels’

'serpent's
hood'

'conch' shell

Apanga
above Shankha

Control over
Large Intestine
Control over •
Large Intestine
Control of Mind &
Nerves (apply oil)

Sudden Death

BV

Control of Nerves

Sudden Death

Utkshepa

(2)

Sthapani

(1)

Shringataka

(4)

Simanta

(5)

'summits'

on skull bone joints: brow,
parietals, ant. & post.
fontanelles, occiput (???)

???

Jo

Control of Nerves

Slow Death

Adhipati

(D

'overlord'

top of head, vertex

four

Jo

Control of Mind &
Nerves

Sudden Death

'thrown
upwards'
'which gives
support’

Death if Foreign Body
Removed
Death if Foreign Body
Removed

THIS MATERIAL IS UNDER DEVELOPMENT FOR REFERENCE OF TRAINERS & HEALERS. There is contradiction among sources consulted regarding
the size (in anguli units) and other aspects of Marma points. The primary source for this Table is Chapter 6: Marmas - Vital Anatomical Points, from the book
AYURVEDA, THE ORIENTAL HEALING SCIENCE by Vaidyas Subhash Ranade and M.H. Paranjape, Pune, 1991, pages 81-90.
(15/1 ir96)
To question, suggest or discuss, kindly contact Mira Sadgopal (Phone: 0212 - 470314; 3rd Floor, Renuprakash A, 817 Sadashiv Peth, Pune 411030.

Adhpati.
athapami

Utkahcpa
Ahanka
ARAJslOA
phama

VtnmiPAM

MllA Z Manva
Ampastampha

Lohitak.sha
____URVX

r

Kashaomara

-&IXMA RPHITA J
APAlAW.frU-n.llld /
rSTXMZA M11LA

Hridk/a

—iJbiz______

Kiirpara

Ku*PARA

JNbRAVAjrrr.

NARMT

141RCHA SJRAH

Mandtvanpht

.Vaait
Lomitakaha<

3Atapa

. Guda
_U1VZL

lTANLL

■KunrwA

-K8HTPRA

ftTBAH

r^-6 <yz<^rrt-i_

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