Therapeutic by injection into acupuncture points
Injection of liquid drug into the Acupuncture Points _ APs or Mesopuncture is part of the acupuncture session objective which is the research and treatment of cause and symptoms, apparent or not, of the health deterioration.
Questioning, inspection etc., application of eight rules (BA GANG) pulse taking, examination of the tongue etc., allow retaining three kinds of APs: General, regional and local points. Injection of liquid drug, into APs, essentially concerns local points including, in addition to the ASHI points, points of positive reaction as one can read it in the article below, translated in extenso from french, published in 1977 by Academy of traditional Chinese medicine in 'Précis d’Acupuncture Chinoise’, Edition in foreign languages (French), page 292, Beijing :
Therapeutic by injection into acupuncture points is a method of treatment developed on the basis of acupuncture, combining traditional Chinese medicine and Western medicine. It involves injecting drugs into the points or areas of positive reaction. By injecting a solute of drugs into the acupuncture point it will produce sensations due to the physical and chemical stimulation caused by acupuncture and drugs which allows to regulate the body's resistance and thereby achieve the healing of ailments.
(1) Palpation of the Points
Palpation points aims to detect abnormal change of meridians points, i.e. their expressions of positive feedback, using the touch sense of fingers, which is the basis for the diagnosis and treatment.
To practice palpation, we first leave the patient take a comfortable and natural position according to the regions to be palpate and asked him to relax the muscles. And then we palpate carefully and with patience the regions selected using the thumb and forefinger.
We can leave the finger slide on the skin, massaging it, pressing it point-by-point, or depressing it to determine if there are abnormalities (manifestations of positive reaction) in the connective tissue of the dermis and subcutaneous and deep tissue.
For example there are perhaps at the level of the meridians points, cords and nodules, large or small, soft or firm of different shapes (round, spindle-shaped or flattened). Hypersensitive or painful points by pressure can be found and the same for impastos, musculo-cutaneous depressions and modification of muscle tone, the change of the skin color can be also observed.
The scope of palpation includes, paravertebral points (Huatuojiaji), Shu points of the back located on the dorsal lumbar region, Mu points in the thoraco-abdominal region, points of the four members meeting the condition to be treated as well as Ashi points (painful points by digital pressure)
(2) Treatment technique
1- Choice of points.
a. By palpation of the fingers, are chosen the points having the most remarkable reaction as key points for treatment. We should know to avoid choosing too many points in a single session. It is important to accurately locate the selected points. It is important to accurately locate the selected points… If the positive reaction is not very clear, we can choose the corresponding meridian points.
b. We choose the points as is done in regular acupuncture. But the points of the hand and foot as well as areas where there are not many soft parts are less-used.
2- Operative technique.
Prior to treatment should be explained to the patient characteristics of the therapeutic process and reactions that may occur when processing such as feelings of swelling, heaviness or weariness. Some patients may feel a sensation of heat.
After usual disinfection of the determined point, we take a charged syringe and inserted its needle into the acupuncture point to a desired depth or until the appearance of a certain acupuncture sensation. Then, if by pulling slightly the piston, no trace of blood appears in the syringe, then we will be able to inject the drug into the AP.
Manipulations vary according conditions to be treated. In most cases the injection is made at an average speed. For debilitated patients with chronic disease injection should be slow and more diluted medicinal solution, while that for patients of strong constitution, injection should be fast with more concentrated solution.
3- Choice of medication
The drugs used must be easily absorbable and without side effects. In addition to pharmacological effects, they must still present some irritant properties to extend the effect of acupuncture.
The usual drugs are:
a. Placental extract: it is stated in common diseases. Often prescribed in the treatment of chronic hepatitis, nephritis, gastric ulcer, allergy reactions, neurosis and certain gynecological disorders reactions.
b. The solutes of Vit.B1, Vit.B12 and Vit. C are indicated in chronic diseases and elderly and debilitated people. The sensation produced by the Vit.B12 is less pronounced than that determined by the Vit. B1. The Vit.C is indicated in hembleeding tendency and cardiovascular diseases...
c. Drugs responding to disorders such as penicillin, Streptomycin and sulphate of magnesia.
d. Some medicines of traditional Chinese medicine such as injectable aqueous extracts of Radix angelicae and Flos Carthami can also be used.
e. the intradermal injection of distilled water alone is painful and can provide a physical stimulation without side effects. It is suitable in certain diseases. Injection should be fast because the duration of produced acupuncture sensation is fleeting.
a. Account must be taken of incompatibilities, of allergic reactions and side effects of drugs used. Skin Allergy tests should be performed prior to use drugs of antigenic properties. The injection will be made only when the test is recognized negative.
b. Carefully follow the dosage and concentration of injectable solutions. They vary depending on the disease state and regions to treat. In general for the region cephalo-facial (rarely chosen region), we would use medicated fluids at low concentration, less irritating, the dosage should be reduced with a slow injection. For regions of the trunk, drug solute must be more concentrated, stimulation may be stronger, the highest dose and rapid injection.
For Points of the four members we should not use drug solutes very concentrated or very irritating. But it is permissible to combine drug injection to acupuncture treatment..
c. In principle we retain to introduce solutes into articular cavities or blood vessels.
d. A large aseptic care will be taken to prevent any infections. For elderly and debilitated patients, are taken fewer points and for the first meeting, a smaller dose of solute will be injected.
e. Avoid the puncture of the viscera during injection into back points and more, precautions will be taken to avoid the needles discomfort, needles breaking and other potential accidents.
f. A session a day or every two days. A cure includes 7-10 sessions. The interval time between two cures is 4-7 days.