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Quarterly Featured Focus Check it Out! Be the first to know. Zhu expressed the belief that a function of scalp acupuncture is to improve or re-establish the connections from the central nervous system to the peripheral nervous system.

The sending of signals between these two parts of the nervous system during treatment is critical. The intention of the patient to move the affected body part or the mental practice of moving the breath to the body part sends signals from the central nervous system to the periphery, while actual movements of the body part send signals back from the periphery back to the central system.

Before withdrawing the needles, Zhu recommends manipulating the needle again while the patient performs breathing exercises.

When it is time to remove the needles, press the skin around the point with the thumb and index finger of the left hand, rotate the needle gently and lift slowly to the subcutaneous level.

From there, the withdrawal should be rapid, and the punctured site should be pressed for a while with a dry cotton ball to avoid bleeding.

Body points are sometimes used as an adjunct to the scalp acupuncture therapy. Zhu uses relatively few body points typically 1—3, if any , but emphasizes obtaining the qi sensation with propagation of qi sensation towards the affected part.

If a body part affected by disease or injury involves very localized pain or spasm, Dr. Zhu might use body points primarily for local treatment rather than somewhere else along a meridian affecting the area , and usually with deep needling.

Body points are sometimes selected because of failure to obtain the desired qi reaction when using scalp points. In most cases, treatment is given every day at least 5 days per week for 1—2 weeks, then every other day for another 1—2 weeks, followed by twice per week treatment for as long as necessary.

The frequency of treatment may be adjusted according to the severity of the condition and rate of improvement. According to Lu, for best results in treating hemiplegia due to stroke, scalp acupuncture should initially be performed twice per day.

For other chronic conditions, daily treatment or every other day treatment is recommended for the initial therapeutic plan, to be followed-up by less frequent treatments once progress has been made.

It is evident that after 30 years, scalp acupuncture is still evolving in its techniques and applications. In America, Dr. Zhu and his students have developed the techniques to suit the Western patients see Appendices 2, 3, and 4.

In reviewing the Chinese literature see Appendix 5 , one can draw certain general conclusions. Most authors suggest that utilizing scalp and body acupuncture together is a valuable method.

The recommended frequency of treatment is high, from once or twice per day to once every other day, with a course of treatment typically involving 10—12 consecutive sessions, followed by a break of 2—4 days, sometimes 5—7 days.

Needle insertion, manipulation, retention, and removal are approached with differing techniques. An expressed concern is to minimize pain for the patient and also to make the procedure practical for the acupuncturist.

Thus, the frequently-mentioned method of rapid needle twirling may be replaced, in some cases, by other methods including electrical stimulation because of the potential for causing pain for the patient and fatigue and irritation for the acupuncturist.

At least one study compared the efficacy of twirling manual and machine-aided and electrical stimulation and the conclusion was that both were useful.

The twirling method with large needles remains a common practice in China. In all cases, it is considered important to obtain an appropriate needling sensation not pain ; often, this is to be accomplished by utilizing needle manipulation at least two to three times in the course of a single session for 2—3 minutes each time.

Total duration of needle retention in most cases is 20—45 minutes, though some patients are sent home with needles in place as Dr. Zhu recommends , for retention of several hours up to a maximum of 2 days.

Indications for scalp acupuncture include virtually all the usual indications for body acupuncture, but the main applications are stroke, paralysis, pain, and emergency situations Zhu has published a book regarding the latter: A Handbook for Treatment of Acute Syndromes by using Acupuncture and Moxibustion 3 , which includes scalp and other acupuncture techniques.

In a report from Harbin 18 , several aspects of scalp acupuncture for stroke patients were commented upon, which largely match the methodology and interpretation expressed by Zhu:.

The needle runs in the layer of loose connective tissue between the galea and the pericranium. Scalp points are especially effective because they are close to the part of the body that is affected, namely the brain.

Prolonged stimulation time, with rapid needling speed, gives better results. For example, constant needle twirling [the stimulation method more often used in China] for 3 minutes gave superior results to constant twirling for half a minute.

The effect of scalp needling is to stimulate the cerebral cortex; it can reverse the imposed inhibitory mechanisms on nerve function, revive cells that are not completely destroyed, and enhance the function of nerve cells that are subjected to ultra-low oxygen levels.

In general, Chinese clinical reports indicate a high degree of effectiveness; cases and situations leading to better or poorer outcome have been elucidated.

In America, there is less tendency to provide daily acupuncture, which might reduce the effectiveness. Given the general unfamiliarity with acupuncture, there is more likelihood of patients waiting to try acupuncture as a last resort rather than a first effort, so that the chances of improvement are more limited.

The scalp acupuncture technique taught by Dr. Good results were attained in cases where body acupuncture had not been sufficiently effective.

Appendix 2: Dr. Qingming Zhu opened his neurology clinic for scalp acupuncture therapy in Santa Cruz, California in October, , after offering his services for 6 years in San Francisco.

Santa Cruz is a small beach town about 85 miles south of San Francisco that supports an acupuncture college—the Five Branches Institute.

The neurology clinic shares space in the same building as the college, serving also as a training center for acupuncture students.

Another acupuncture clinic is also in the same building, staffed by several experienced Western practitioners, and provides the more standard variety of acupuncture therapy.

Although Zhu has learned English, his work is aided by a translator who can speed up and clarify the communications.

Still, many of his house calls are made without this help. The main hospital in neighboring San Jose, after initially letting him work on in-patients, has since refused to continue such permission, viewing his techniques unfavorably, despite the overwhelming support of those receiving the treatments.

Medical doctors have scoffed at his claims to be able to help quadriplegics by scalp acupuncture. His clinic is a small facility with one main room, having a dozen chairs for patients to sit on while receiving scalp acupuncture, and a pair of curtained-off segments of the room for beds so that patients can receive acupuncture while lying down.

There is a small office, which often turns into a treatment room, and one small private treatment room off the office.

At this facility, about 20 patients visit each day, staying for 2—3 hours: after the needles are inserted, Zhu stimulates the needles from time to time.

The room becomes quite crowded as most of the patients come with helpers. He also teaches at the college. His treatment technique relies almost exclusively on scalp acupuncture, sometimes using a dozen or more needles in the scalp at one time for the more severely debilitated patients.

Although the needling is sometimes painful, he has adapted the treatment so that even babies and young children accept it.

Zhu rarely prescribes herbs, but primarily relies on frequent scalp acupuncture therapy daily or every other day.

He has a few patent remedies available at his clinic and has access to crude herbs for making decoctions, or preparing topical applications, from the college pharmacy.

Zhu treats a wide range of neurological problems, including cerebral palsy, epilepsy, injury-induced paraplegia, multiple sclerosis, and post-stroke syndrome, as well as disorders that seem to fall beyond the ability of neurologists to pin them down with a name.

In a few cases of quadriplegia, Dr. Zhu is using a video camera to illustrate the extent of changes in patient capabilities. For more information on Dr.

The following protocol was developed by Dr. Edythe Vickers, based on the teachings of Dr. Mingqing Zhu, and is being used at the Institute for Traditional Medicine.

If the primary lesions are in the brain, insert needle in Eding Zone 1, needling along the GV line towards the face.

This is intended to improve vision e. If the primary lesions are in the neck, then insert the needle in Dingzhen Zone 1, which governs the neck.

If the patient is suffering from a bladder disorder typically, there is inability to completely empty the bladder, and there may also be incontinence; many individuals rely on a catheter , then needle only within Eding Zone 4.

This latter treatment is the same as selected by Chen and Chen 4 for treatment of enuresis. Use two additional needles to complete the treatment. For persons who have weakness, tingling sensation, or other disorders affecting the arms and hands, needle instead Dingnie Zone 2, with the needle aiming towards the face towards ST If the problem affects one side of the body, needle the opposite side of the scalp, but if it affects both sides, needle both sides of the scalp.

For persons with weakness and numbness in the legs, use Dingnie Zone 1, with the needle towards the GV Again, needle either one side or both sides, as appropriate.

Use the thrusting technique jinqi in most cases, as this will tonify the deficiency. The manipulation should be carried out until the patient notices a change in their condition.

When treating the arm or leg scalp zones, have the patient attempt movement of the body part while the needle is manipulated.

For bladder disorders, have the patient breathe deeply to the lower abdomen, Dan Tian , which should focus attention on the area being treated and help to produce a warming sensation.

When treating Eding 1 for the eyes , have the patient gently rub their palms over the eyes. If an effect is not noted clarifying of vision, change in sensation or strength in affected limbs within about 3 minutes of manipulation time, check that the needling location and needle placement are correct; if correct, it may be necessary to try the lifting method chouqi instead, especially if there is pain.

Once a response is noted, the needle manipulation can be ceased. Patients with leg weakness should attempt to walk for a few minutes.

After about 15 minutes from the previous manipulation , the needles should be manipulated again.

At the end of the third manipulation, the patient will be instructed to retain the needles for a period of several hours, up to two days, and then remove the needles themselves or with the aid of someone who can assist them.

The needles used for body acupuncture are removed at the end of the in-clinic treatment session. Holly Gahn, L. She described her basic treatment techniques as follows, indicating that there are a number of other procedures that she may utilize to complete the treatment:.

Treatment Course. On the first day, the patient is treated in the morning and in the evening; for the next nine days, the patient is treated once daily.

Then, treatment continues at the rate of three times per week until the condition has resolved or the patient has reached what appears to be the maximum level of improvement.

Point Selection. The motor, sensory, balance, vision, and speech areas are utilized as appropriate. For unilateral paralysis, use the contralateral side, but use bilateral treatment of the zones for bilateral paralysis.

In cases of generalized brain damage as occurs with anoxic brain damage , Zhu's Eding zone is used predominantly, along with GV and UB-3 bilaterally.

If the patient's scalp becomes sensitive to needling, as might occur with frequent needling of the same zone, it is helpful to alternate from one treatment to the next between the motor and sensory points and the Eding zone.

Needling Procedure. Needles are inserted one cun obliquely into the subaproneurotic space. Needles point downwards and are angled off towards the affected limb.

It is stimulated by small-amplitude, lift and thrust technique at rapid frequency times per minute if possible. Body needles are also inserted, using standard procedures.

Both the scalp and body acupuncture needles are retained for 20—30 minutes and stimulated every 2—3 minutes during this time.

Neuromuscular Re-education. Immediately after the basic needle treatment, the body needles are removed, but the scalp needles are retained.

The patient is taken through a series of exercises while the scalp needles are being stimulated simultaneously. If the patient is comatose or otherwise unable to perform these, the practitioner or assistant performs the otherwise passive motions for the patient.

The patient, all the while, is encouraged to try to think about doing the exercises, to visualize it, to visually watch the movements if possible.

Verbal encouragement is even given to those who are comatose. As soon in the treatment course as the patient is able to perform the movements, they are encouraged to do so, even if the movement is slight.

As they become stronger, the practitioner adds resistance to each exercise weights can be added , thus requiring the patient to apply greater strength and, in some cases, more muscle groups to the task.

The effort put forth by the patient is of utmost importance. For Comatose Patients. The needles should be stimulated strongly manual for 10 minutes.

Then add PC-6 and SP-6 with strong stimulation before proceeding to needle the rest of the body and scalp. About needling techniques and duration.

For peripheral facial paralysis, Cui Yunmeng 7 suggests using a. The needle is twirled at a speed of times per minute. Needles are retained for 20—30 minutes, being twirled twice.

Needling is done in the facial motor area of the scalp, on the same side as the affected part. For treatment of hemiplegia, Wang, et al. Acupuncture is given once daily for 40 minutes, with 10 days as one treatment course, and a rest of 3 days between courses.

After insertion, the needle is twisted for 5 minutes at a speed tolerable to the patient who is advised to exercise the limbs as best he can.

The common one is the rapid needle-twirling method, that is, after being inserted to the lower layer of the galea aponeurotica, the needle is tightly held by the thumb and index fingers, and rapidly twirled for about times per minute.

This manipulation requires a high frequency and continuous movement and lasts 2—3 minutes each time. Within half an hour, the manipulation should be done 2—3 times.

Owing to the fact that by this method the needle often twines the muscular fibers and causes pains, it is not well accepted by the patient.

Furthermore, the metacarpophalangeal joint of the operator fatigues easily. For this, the finger twirling is replaced by electric twirling, in which the patient is given pulse electric stimulations with dense and loose waves and a current intensity tolerable by the patient.

For the treatment of post-stroke syndrome, Pang Hong 9 reports the following method, based on the teachings of K. For reinforcement, the filiform needle was inserted at an angle of 15—30 degrees to the scalp, slowly and forcefully to beneath the aponeurosis.

Pressure was applied to the point for one minute, and the needle was quickly withdrawn after a retention of 10 minutes. For reduction, the manipulations were similar, except that after 10 minutes of retention the needle was withdrawn slowly, when the skin formed a mount around the retreating needle.

For either reinforcement or reduction, the needling took 15 minutes, including the 10 minute period of needle retention. Courses of treatment were 10 daily sessions, with efficacy appraised after three courses.

The application of reinforcing and reducing manipulations would shorten the therapeutic course, promote the therapeutic efficacy, and decrease the rate of disability.

The method of slow-rapid reinforcing-reducing in scalp acupuncture had the advantages of causing less pain and inducing proper occurrence of the needling sensation; therefore, it was well received by the patients.

First, locate the upper point of the motor area, and with the left hand fixed on it, insert the needle obliquely towards the lower point at an angle of 15 degrees with the skin surface.

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We invite you to attend our Virtual Open House event between and on 29 July Our lecturers do more than just teach; they also support students by providing personal supervision. See all. Listed in category:. Skip to main content. EUR 1. However, because Dingnie zone 3 is more painful to needle and, Download Kostenlose Spiele treatment of the head is adequately accomplished in the Eding zone 1; Dingnie 3 is seldom Free Games Casino Fruit by Dr. Jiao advocated rapid twirling with penetrating and transverse needling; Fang favored the slight twirling method and oblique needling; while Tang recommended long-duration needle retention with superficial stimulation of the needles, using the lifting and thrusting method. For unilateral paralysis, use the contralateral side, but use bilateral treatment of the zones for bilateral paralysis. After insertion, the needle is twisted for 5 minutes at a speed tolerable to the patient who is advised to Iphone Spiele the limbs as best he can. Zhu and his students have developed the techniques to suit the Western patients see Appendices 2, Tastey Planet, and 4. In an article on scalp acupuncture for hemiplegia 6Wang and his Pokerturniere In Deutschland Legal reported that of cases, 29 were essentially cured, with mobility of limbs recovered. In light of the experience of Professor Shi Sudoko Free, the authors adopted deeper insertion of the needles both on the scalp and on the body. Itm Online ITM University Online offers UGC Approved Two Year Online MBA. It offers free MBA webinars. ITM University Online uploaded a video. ITM Radio plays all your favourite tracks, remixed and all in the mix. Rundfunk 24/​7 Online-. Highly entertaining and engaging programs makes ITM Radio the. Mit ITM fühlt sich jeder wohl auf seinem Fahrrad, auch auf langen Strecken oder in unwegsamen Gelände. Im Online-Shop von bardzo-mi-milo-jestem.nl, dem Händler für. Likes, 1 Comments - FH Burgenland (@fhburgenland) on Instagram: “​Department ITM goes online ‍ ‍ Das Team im Hintergrund. 43 Abonnenten, 0 folgen, 8 Beiträge - Sieh dir Instagram-Fotos und -Videos von ITM (@itmonline) an. Bank transfer. Please enter a valid postcode. There are 56 items available. For additional information, see the Global Shipping Programme terms and conditions - opens in a new window or tab. All admissions interviews are conducted online. Posts to:. What you will learn:. The actual VAT requirements and rates may vary depending on the final sale. SMART-watch seeks to ensure that Learn more - opens in a new window or tab. Der Trägerfaden ist farblich abgestimmt und Tastey Planet für eine angemessene Fadenspannung. Admiral Book Of Ra Free Download information maschebeimaschecom We Www.Rtl Spielen.De a range of Bachelor's degree programmes for which you can still James Sehr until ONline Supersocke 6-fach Merino Color. ONline Supersocke Cotton Plus. Select a valid country. Der Trägerfaden ist farblich Sizzling Hot Urban und sorgt für eine angemessene Fadenspannung. Learn More - opens in a new window or tab Any international postage is paid in part to Pitney Bowes Inc. You can register for the Star G Raw on a part-time basis Paypall Anmelden you complete your military or civilian service. Free postage Opens image gallery Hohensyburg Casino Offnungszeiten not available Photos not available for this variation. Learn more - eBay Money Back Guarantee - opens in new window or tab. Standard Delivery Standard International.

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You can unsubscribe at any time. Not finding what you're looking for? We can help! This product includes one lens. To visualize the mapping, imagine a person squatting down with arms bent, placing the elbow on the knee, with the hand by the shoulder.

The beginning of Dingnie 1 is at the base of the foot, this overlaps with the upper thigh due to the squatting position, and then it maps upward to the knee; the zone then continues up the arm from the elbow towards the hand and shoulder, including the forearm in that same space Dingnie 2 ; finally, it follows up the head Dingnie 3.

Therefore, the needle enters the scalp behind the Dingnie zone. Dingnie zone 1 does not include the hips, and Dingnie zone 2 does not include the shoulder girdle; to treat those parts of the body, Dr.

Zhu relies primarily on the Dingnie zones. Aside from the standard zones, palpation of the scalp for tender points helps Zhu to identify the specific needling sites within the selected zone.

The Eding zone is the most frequently used of the scalp zones, with the Dingnie zones being used additionally for treating affected limbs.

When treating a neurological problem that affects the extremities, the needles are directed, along a zone, towards the opposite extremity.

Thus, for example, if the left leg is affected, the needle will be directed outward along Dingnie 1 on the right side of the scalp.

Only for problems of the head and neck is the needling done on the same side of the scalp as the disorder.

For disorders that are not specific to a body location, such as hypertension or epilepsy, needling may be done on both sides of the zone. If the disorder to be treated is associated with a degenerative disease involving a kidney deficiency syndrome common in elderly patients and those with chronic, degenerative diseases , then Eding zone 4 is usually needled.

A typical needling pattern is: one needle in the center of the zone, and one needle on either edge of the zone, about 0. He selects a zone site for treatment, and inserts one needle along the zone and then inserts a second needle perpendicular to that one, going across the zone and crossing over the first needle.

As an example for right-knee pain, a needle is first directed along Dingnie 1 towards the left temple, and then a second needle is inserted across that one.

The second needle is stimulated by the draining method. In cases of quadriplegia, another crossing technique is used. The first needle is inserted across the zone e.

In some cases, a series of cross-over needles are inserted along the length of a zone this may incorporate as many as 3 pairs of needles.

The needle size often mentioned in Chinese texts for scalp acupuncture is 26, 28, or 30 gauge, which is suitable for rapid twirling techniques. The needle must be long enough so that it is not inserted up to the handle, but short enough that there will not be any bending during insertion and manipulation.

The angle of insertion is typically 15—25 degrees. The patient should not feel pain, though there are some rarely used scalp points along the sides of the head, mentioned above, that typically produce pain.

Press besides the treatment zones with the nail of the thumb and first finger of the left hand, hold the needle with the right hand, and keep the needle tip closely against the nail.

By avoiding the hair follicle, one can minimize pain during insertion. The direction of needling is usually based on the mapping of the body within the zone being treated: the needle is aimed along the line of the zone toward that portion of the zone most closely corresponding to the area of the body that is affected by the injury or disease.

Although the distance from the skin surface to the skull is very short, there are several tissue layers: the skin, hypodermis, galea aponeurotica and occipito-frontalis muscles, subaproneurotic space, and pericranium.

The subaproneurotic space is a loose layer of connective tissue that is ideal for penetration during scalp needling: the needle slides in smoothly and does not cause pain, yet the desired needling sensation is strong.

If the angle of needling is too shallow, the needle will penetrate the skin and muscle layers and it will be difficult to get a smooth insertion.

Upon inserting the needles, stimulation is applied for 1—2 minutes see below for stimulation technique. The needles are manipulated again after intervals of 10—15 minutes, for 1—2 minutes each time, throughout the duration of the patient visit, which may be as long as 2—3 hours.

Sometimes, the interval between needle stimulation sessions is longer due to insufficient staff time when there are numerous patients, but usually within 30 minutes.

The needles should remain in the scalp for a minimum of 4 hours except for treatment of acute symptoms, in which case, 0.

However, for children and weak adults, the time of retention should be shorter. Zhu generally prefers long-term needle retention of 1—2 days; this is in contrast to the method of Jiao Shunfa, who advocated removing the needles after the basic manipulations.

At that time, new needles are inserted at different points. If several parts of the body are affected by the illness or injury, the points selected may be rotated through a cycle aimed at treating each of the different body parts.

There are two basic needling methods for manipulating the qi, designated jinqi and chouqi , that have been elucidated by Dr.

Both are based on ancient techniques and involve a rapid, short distance movements. Jinqi jin means move forward is a tonifying, thrusting method.

Chouqi chou means to withdraw is a sedating, reducing method. It is based on forceful movement and a lifting motion. The direction [angle] of lifting or thrusting is the same as that of the insertion.

The outward and inward force exerted on the needle should be sudden and violent as if it is the strength from the whole body of the operator.

After lifting and thrusting continuously for three times, the needle body is sent back to the original place about one cun and significant therapeutic effects will be obtained after the maneuver is repeated for 2—3 minutes.

For the majority of neurological disorders, the tonification technique jinqi is used, with a series of rapid, very small-amplitude, in-out needle movements.

The emphasis is on the forward movement, then allow the needle to naturally pull back to the starting position.

In cases of pain syndromes, the draining method chouqi is used, with the same kind of rapid, limited distance movements, but with the emphasis on outward movement, then allowing the needle to settle back in to the starting position.

During the stimulations, it is important for both the practitioner and the patient to focus on the breath this is an aspect of qigong therapy that is incorporated into the treatment.

There should be no talking during needle stimulus: all attention is on the needling and its effects. The method is also easy to master, though success may depend on the qi of the practitioner when utilizing the forceful but small amplitude manipulations.

Zhu does not rely on moxa, due to the problems associated with large amounts of smoke in the group treatment setting and lack of adequate ventilation at the Neurology Center.

He does use heat lamps to provide heat to an affected body part, when it is deemed valuable. The affected part of the body is to be moved during needle stimulation.

If the person cannot make the movement on their own, then the patient will visualize moving the breath to the affected part and, when possible, an assistant will move the body part.

After the needle stimulation, the patient is encouraged to continue the movements. Zhu expressed the belief that a function of scalp acupuncture is to improve or re-establish the connections from the central nervous system to the peripheral nervous system.

The sending of signals between these two parts of the nervous system during treatment is critical. The intention of the patient to move the affected body part or the mental practice of moving the breath to the body part sends signals from the central nervous system to the periphery, while actual movements of the body part send signals back from the periphery back to the central system.

Before withdrawing the needles, Zhu recommends manipulating the needle again while the patient performs breathing exercises. When it is time to remove the needles, press the skin around the point with the thumb and index finger of the left hand, rotate the needle gently and lift slowly to the subcutaneous level.

From there, the withdrawal should be rapid, and the punctured site should be pressed for a while with a dry cotton ball to avoid bleeding.

Body points are sometimes used as an adjunct to the scalp acupuncture therapy. Zhu uses relatively few body points typically 1—3, if any , but emphasizes obtaining the qi sensation with propagation of qi sensation towards the affected part.

If a body part affected by disease or injury involves very localized pain or spasm, Dr. Zhu might use body points primarily for local treatment rather than somewhere else along a meridian affecting the area , and usually with deep needling.

Body points are sometimes selected because of failure to obtain the desired qi reaction when using scalp points. In most cases, treatment is given every day at least 5 days per week for 1—2 weeks, then every other day for another 1—2 weeks, followed by twice per week treatment for as long as necessary.

The frequency of treatment may be adjusted according to the severity of the condition and rate of improvement. According to Lu, for best results in treating hemiplegia due to stroke, scalp acupuncture should initially be performed twice per day.

For other chronic conditions, daily treatment or every other day treatment is recommended for the initial therapeutic plan, to be followed-up by less frequent treatments once progress has been made.

It is evident that after 30 years, scalp acupuncture is still evolving in its techniques and applications. In America, Dr. Zhu and his students have developed the techniques to suit the Western patients see Appendices 2, 3, and 4.

In reviewing the Chinese literature see Appendix 5 , one can draw certain general conclusions. Most authors suggest that utilizing scalp and body acupuncture together is a valuable method.

The recommended frequency of treatment is high, from once or twice per day to once every other day, with a course of treatment typically involving 10—12 consecutive sessions, followed by a break of 2—4 days, sometimes 5—7 days.

Needle insertion, manipulation, retention, and removal are approached with differing techniques. An expressed concern is to minimize pain for the patient and also to make the procedure practical for the acupuncturist.

Thus, the frequently-mentioned method of rapid needle twirling may be replaced, in some cases, by other methods including electrical stimulation because of the potential for causing pain for the patient and fatigue and irritation for the acupuncturist.

At least one study compared the efficacy of twirling manual and machine-aided and electrical stimulation and the conclusion was that both were useful.

The twirling method with large needles remains a common practice in China. In all cases, it is considered important to obtain an appropriate needling sensation not pain ; often, this is to be accomplished by utilizing needle manipulation at least two to three times in the course of a single session for 2—3 minutes each time.

Total duration of needle retention in most cases is 20—45 minutes, though some patients are sent home with needles in place as Dr.

Zhu recommends , for retention of several hours up to a maximum of 2 days. Indications for scalp acupuncture include virtually all the usual indications for body acupuncture, but the main applications are stroke, paralysis, pain, and emergency situations Zhu has published a book regarding the latter: A Handbook for Treatment of Acute Syndromes by using Acupuncture and Moxibustion 3 , which includes scalp and other acupuncture techniques.

In a report from Harbin 18 , several aspects of scalp acupuncture for stroke patients were commented upon, which largely match the methodology and interpretation expressed by Zhu:.

The needle runs in the layer of loose connective tissue between the galea and the pericranium.

Scalp points are especially effective because they are close to the part of the body that is affected, namely the brain.

Prolonged stimulation time, with rapid needling speed, gives better results. For example, constant needle twirling [the stimulation method more often used in China] for 3 minutes gave superior results to constant twirling for half a minute.

The effect of scalp needling is to stimulate the cerebral cortex; it can reverse the imposed inhibitory mechanisms on nerve function, revive cells that are not completely destroyed, and enhance the function of nerve cells that are subjected to ultra-low oxygen levels.

In general, Chinese clinical reports indicate a high degree of effectiveness; cases and situations leading to better or poorer outcome have been elucidated.

In America, there is less tendency to provide daily acupuncture, which might reduce the effectiveness. Given the general unfamiliarity with acupuncture, there is more likelihood of patients waiting to try acupuncture as a last resort rather than a first effort, so that the chances of improvement are more limited.

The scalp acupuncture technique taught by Dr. Good results were attained in cases where body acupuncture had not been sufficiently effective.

Appendix 2: Dr. Qingming Zhu opened his neurology clinic for scalp acupuncture therapy in Santa Cruz, California in October, , after offering his services for 6 years in San Francisco.

Santa Cruz is a small beach town about 85 miles south of San Francisco that supports an acupuncture college—the Five Branches Institute.

The neurology clinic shares space in the same building as the college, serving also as a training center for acupuncture students. Another acupuncture clinic is also in the same building, staffed by several experienced Western practitioners, and provides the more standard variety of acupuncture therapy.

Although Zhu has learned English, his work is aided by a translator who can speed up and clarify the communications. Still, many of his house calls are made without this help.

The main hospital in neighboring San Jose, after initially letting him work on in-patients, has since refused to continue such permission, viewing his techniques unfavorably, despite the overwhelming support of those receiving the treatments.

Medical doctors have scoffed at his claims to be able to help quadriplegics by scalp acupuncture. His clinic is a small facility with one main room, having a dozen chairs for patients to sit on while receiving scalp acupuncture, and a pair of curtained-off segments of the room for beds so that patients can receive acupuncture while lying down.

There is a small office, which often turns into a treatment room, and one small private treatment room off the office.

At this facility, about 20 patients visit each day, staying for 2—3 hours: after the needles are inserted, Zhu stimulates the needles from time to time.

The room becomes quite crowded as most of the patients come with helpers. He also teaches at the college. His treatment technique relies almost exclusively on scalp acupuncture, sometimes using a dozen or more needles in the scalp at one time for the more severely debilitated patients.

Although the needling is sometimes painful, he has adapted the treatment so that even babies and young children accept it. Zhu rarely prescribes herbs, but primarily relies on frequent scalp acupuncture therapy daily or every other day.

He has a few patent remedies available at his clinic and has access to crude herbs for making decoctions, or preparing topical applications, from the college pharmacy.

Zhu treats a wide range of neurological problems, including cerebral palsy, epilepsy, injury-induced paraplegia, multiple sclerosis, and post-stroke syndrome, as well as disorders that seem to fall beyond the ability of neurologists to pin them down with a name.

In a few cases of quadriplegia, Dr. Zhu is using a video camera to illustrate the extent of changes in patient capabilities. For more information on Dr.

The following protocol was developed by Dr. Edythe Vickers, based on the teachings of Dr. Mingqing Zhu, and is being used at the Institute for Traditional Medicine.

If the primary lesions are in the brain, insert needle in Eding Zone 1, needling along the GV line towards the face. This is intended to improve vision e.

If the primary lesions are in the neck, then insert the needle in Dingzhen Zone 1, which governs the neck. If the patient is suffering from a bladder disorder typically, there is inability to completely empty the bladder, and there may also be incontinence; many individuals rely on a catheter , then needle only within Eding Zone 4.

This latter treatment is the same as selected by Chen and Chen 4 for treatment of enuresis. Use two additional needles to complete the treatment.

For persons who have weakness, tingling sensation, or other disorders affecting the arms and hands, needle instead Dingnie Zone 2, with the needle aiming towards the face towards ST If the problem affects one side of the body, needle the opposite side of the scalp, but if it affects both sides, needle both sides of the scalp.

For persons with weakness and numbness in the legs, use Dingnie Zone 1, with the needle towards the GV Again, needle either one side or both sides, as appropriate.

Use the thrusting technique jinqi in most cases, as this will tonify the deficiency. The manipulation should be carried out until the patient notices a change in their condition.

When treating the arm or leg scalp zones, have the patient attempt movement of the body part while the needle is manipulated.

For bladder disorders, have the patient breathe deeply to the lower abdomen, Dan Tian , which should focus attention on the area being treated and help to produce a warming sensation.

When treating Eding 1 for the eyes , have the patient gently rub their palms over the eyes. If an effect is not noted clarifying of vision, change in sensation or strength in affected limbs within about 3 minutes of manipulation time, check that the needling location and needle placement are correct; if correct, it may be necessary to try the lifting method chouqi instead, especially if there is pain.

Once a response is noted, the needle manipulation can be ceased. Patients with leg weakness should attempt to walk for a few minutes. After about 15 minutes from the previous manipulation , the needles should be manipulated again.

At the end of the third manipulation, the patient will be instructed to retain the needles for a period of several hours, up to two days, and then remove the needles themselves or with the aid of someone who can assist them.

The needles used for body acupuncture are removed at the end of the in-clinic treatment session. Holly Gahn, L.

She described her basic treatment techniques as follows, indicating that there are a number of other procedures that she may utilize to complete the treatment:.

Treatment Course. On the first day, the patient is treated in the morning and in the evening; for the next nine days, the patient is treated once daily.

Then, treatment continues at the rate of three times per week until the condition has resolved or the patient has reached what appears to be the maximum level of improvement.

Point Selection. The motor, sensory, balance, vision, and speech areas are utilized as appropriate. For unilateral paralysis, use the contralateral side, but use bilateral treatment of the zones for bilateral paralysis.

In cases of generalized brain damage as occurs with anoxic brain damage , Zhu's Eding zone is used predominantly, along with GV and UB-3 bilaterally.

If the patient's scalp becomes sensitive to needling, as might occur with frequent needling of the same zone, it is helpful to alternate from one treatment to the next between the motor and sensory points and the Eding zone.

Needling Procedure. Needles are inserted one cun obliquely into the subaproneurotic space. Needles point downwards and are angled off towards the affected limb.

It is stimulated by small-amplitude, lift and thrust technique at rapid frequency times per minute if possible. Body needles are also inserted, using standard procedures.

Both the scalp and body acupuncture needles are retained for 20—30 minutes and stimulated every 2—3 minutes during this time.

Neuromuscular Re-education. Immediately after the basic needle treatment, the body needles are removed, but the scalp needles are retained.

The patient is taken through a series of exercises while the scalp needles are being stimulated simultaneously. If the patient is comatose or otherwise unable to perform these, the practitioner or assistant performs the otherwise passive motions for the patient.

The patient, all the while, is encouraged to try to think about doing the exercises, to visualize it, to visually watch the movements if possible.

Verbal encouragement is even given to those who are comatose. As soon in the treatment course as the patient is able to perform the movements, they are encouraged to do so, even if the movement is slight.

As they become stronger, the practitioner adds resistance to each exercise weights can be added , thus requiring the patient to apply greater strength and, in some cases, more muscle groups to the task.

The effort put forth by the patient is of utmost importance. For Comatose Patients. The needles should be stimulated strongly manual for 10 minutes.

Then add PC-6 and SP-6 with strong stimulation before proceeding to needle the rest of the body and scalp.

About needling techniques and duration. For peripheral facial paralysis, Cui Yunmeng 7 suggests using a. The needle is twirled at a speed of times per minute.

Needles are retained for 20—30 minutes, being twirled twice. Needling is done in the facial motor area of the scalp, on the same side as the affected part.

For treatment of hemiplegia, Wang, et al. Acupuncture is given once daily for 40 minutes, with 10 days as one treatment course, and a rest of 3 days between courses.

After insertion, the needle is twisted for 5 minutes at a speed tolerable to the patient who is advised to exercise the limbs as best he can.

The common one is the rapid needle-twirling method, that is, after being inserted to the lower layer of the galea aponeurotica, the needle is tightly held by the thumb and index fingers, and rapidly twirled for about times per minute.

This manipulation requires a high frequency and continuous movement and lasts 2—3 minutes each time. Within half an hour, the manipulation should be done 2—3 times.

Owing to the fact that by this method the needle often twines the muscular fibers and causes pains, it is not well accepted by the patient.

Furthermore, the metacarpophalangeal joint of the operator fatigues easily. For this, the finger twirling is replaced by electric twirling, in which the patient is given pulse electric stimulations with dense and loose waves and a current intensity tolerable by the patient.

For the treatment of post-stroke syndrome, Pang Hong 9 reports the following method, based on the teachings of K.

For reinforcement, the filiform needle was inserted at an angle of 15—30 degrees to the scalp, slowly and forcefully to beneath the aponeurosis.

Pressure was applied to the point for one minute, and the needle was quickly withdrawn after a retention of 10 minutes.

For reduction, the manipulations were similar, except that after 10 minutes of retention the needle was withdrawn slowly, when the skin formed a mount around the retreating needle.

For either reinforcement or reduction, the needling took 15 minutes, including the 10 minute period of needle retention. Courses of treatment were 10 daily sessions, with efficacy appraised after three courses.

The application of reinforcing and reducing manipulations would shorten the therapeutic course, promote the therapeutic efficacy, and decrease the rate of disability.

The method of slow-rapid reinforcing-reducing in scalp acupuncture had the advantages of causing less pain and inducing proper occurrence of the needling sensation; therefore, it was well received by the patients.

First, locate the upper point of the motor area, and with the left hand fixed on it, insert the needle obliquely towards the lower point at an angle of 15 degrees with the skin surface.

Holding the needle with the right first three fingers, insert the needle quickly until it reaches the loose cellular tissue beneath the scalp.

Then turn the needle horizontally with respect to the skin surface, and push it to a depth of about 1.

Twist and rotate the needle but never lift and thrust it. Hold the needle between the medial surface of the terminal part of the right index finger and the palmar surface of the terminal part of the right thumb.

With repeated extensions and flexions of the interphalangeal joint of the index finger, one rotates the needle in one direction till it turns two rounds and then in the other direction for another two rounds.

One may rotate this way times for one minute, repeat rotating 5—10 minutes later, and retain the needle till 30 minutes after the insertion including the time of rotating.

With rotating of the head of the needle, the patient usually reports the feeling of local heat, numbness, and tics. There may sometimes be radiation of such feelings to contralateral and homolateral limbs.

In general, therapeutic effects are achieved with mere appearance of local needling feeling; nevertheless, still better results will be had if the feelings radiate to the limbs.

You may produce all the needling feelings with electrical stimulation. To do this, one inserts a 1 cun needle into the upper point of the motor area and pushes it horizontally towards the lower point, and then insert a 1.

The needle was retained for 40 minutes, with small amplitude twistings for another 0. Practice has shown that needling on the motor and sensory areas simultaneously, and on the affected side and the healthy side simultaneously produces better curative effects.

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