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This technique involves the use of electricity to stimulate acupuncture points. Most commonly, the source of electricity is connected to needles in the acupuncture point.
An alternative, used by some, is the application of electricity to the skin surface. Electroacupuncture is especially useful where one might want to stimulate several
needles continuously for a long time, such as during the technique of acupuncture analgesia. Many types of electric energy can be applied, and many types of
equipment are available in the United States, Canada, China, Japan, and other countries.
Electricity is the flow of electrons through a material. This system can be quantified in several ways. The rate of flow of electrons per unit time is called the current and
is measured in amperes (A); the force controlling this flow is called the voltage and is measured in volts (E or V); and the resistance of the material to the flow of
electrons is called the resistance and is measured in ohms (R or ). The primary law relating these factors is called Ohm's Law and has three forms: E = IR, I = E/R,
and R = E/I. Given any of the two factors, it is a simple matter to calculate the third. These basic parameters can be modified by the appropriate scientific notations to
make them more convenient to write—for example, microamperes instead of 0.000001 A (Table 2-7). For the range of these parameters found in
TABLE 2-7. Electrical Conversions
1 Ampere = 1000 milliamperes (ma)
1 Ampere = 1,000,000 microamperes (µa)
0.001 ampere = 1 milliampere
0.000001 ampere = 1 microampere
1 ohm = 0.001 kilohm (k )
1 ohm = 0.000001 megohm (m )
1000 ohms = 1 kilohm
1,000,000 ohms = 1 megohm
acupuncture equipment, it is most convenient to use milli- or microamperes, volts, and kilo- or megohms—that is, in the Ohm's law calculations, use volts,
milliamperes, and kilohms or volts, microamperes and megohms.
There are two types of current flow: direct current (dc) and alternating current (ac). Direct current is one in which the electrons flow through a circuit continuously in
one direction, the type of current produced by a battery. The amplitude of the current may be positive or negative, and the flow is usually continuous.
Alternating current is one in which the electron flow through a circuit periodically changes direction. Two reversals of direction constitute a cycle, and the number of
cycles, in hertz (Hz), occurring in one second is called the frequency. The shape of a plot of current versus time is called the waveform—for example, sine wave,
The two basic pieces of acupuncture electrical equipment are point finders and stimulators.
It is reported that the skin above acupuncture points has a much lower resistance to the flow of current than the rest of the skin. If a large indifferent electrode is
attached to the body and a source of current at constant voltage is applied to a searching electrode, the resistance can be measured by the change in current flow. This
change can be read from an ammeter or may be indicated by the lighting of a lamp or an increase in frequency of an audible sound (Figs. 2-24, 2-25). These finders
may seem to be a very simple way to find acupuncture points, but they are not. There are many problems associated with their use, especially in animals.
The pressure at which the searching electrode is applied to the skin can markedly affect the resistance, and a point can be indicated at any site merely by pressing the
electrode firmly on the skin. The rate at which the electrode is moved over the surface of the skin will markedly affect the resistance and, if the searching electrode is
left at one place on the surface of the skin for a few seconds, the resistance will fall dramatically, resulting in the creation of a pseudoacupuncture point that may remain
for several hours.
If the applied voltage is too high, there may be many false points. If the voltage is too low, many points will not be indicated. If the voltage is too high,
Acupuncture point finder and meridian balance meter.
(Courtesy of BX&L Industries, Inc.,
The Acuprobe I-a small, hand-held, unit for point
location by skin conductance measurement, capable of
sensing with very low currents in the region of 0.5-1.0
microamperes. Indication is by means of an audible
sound plus a visual red light output. Probe-sensing
is adjustable by means of two sensitivity controls,
coarse and fine, for a full range of skin resistances. The
power source is a standard 9-volt transistory battery.
(Courtesy of Intertronic Systems, Ltd., Ontario, Canada.)
Drawing of the voltage waveform from the Chinese
626-1 stimulator. The negative portion of the wave
has a duration of 400 msec and the positive portion
has a duration of 40 msec at 50% of the peak amplitude.
(From Babich. 1974. The American Journal of Chinese
Medicine, 1:341-50. By permission of The American
Journal of Chinese Medicine.)
the skin will be burned, and a blister may appear. If the animal is sweating, there will be many more points than when the skin is cold and dry. If the hair coat of an
animal is very dense, there will be no response—these instruments do not work on unshaved cats but do on dogs. If the skin is irritated due to diseases or hair
clipping, there will be points all over the area.
It appears that the low-resistance points are in the skin. If a point is found and the skin is then moved several inches, the point moves with the skin. If the skin is
removed from the animal, the point remains in the skin—that is, the area of low electrical resistance can often be located in a piece of skin lying on a table.
The mobility of the skin of animals in relation to the underlying tissue, and the fact that the point to be stimulated is often in the deeper tissues, provide further
complication in the use of point finders in animals. A system of diagnosis and treatment based on the actual values of current flow for certain points is called ryodoraku
(see p. 22). This method, which originated in Japan for the treatment of humans, is being examined there and in other countries for possible application to animals.
These devices have many basic features in common; some models are very simple while others are very elaborate. Their basic function is to produce a current to
stimulate acupuncture points.
SOURCE OF POWER
Most of the stimulators used are battery-powered, usually with several 1.5-volt D batteries, several 9-volt transistor radio batteries, or with rechargeable batteries.
There are two basic groups of stimulators—those whose output is dc and those whose output is ac.
The ac stimulators may have one waveform or a choice of several waveforms. The most common waveform used is some variation of a spike (Figs. 2-26 to 2-28).
Other possible waveforms are square wave, sine wave, and so on.
Most machines have some method of controlling the frequency of stimulation. One common system is a continuously variable frequency control, from about 0.5-2 Hz
to 100 Hz. Some devices have only preset frequencies that can be dialed.
MODE AND MODULATION
Many devices have controls that can vary the time between burts of stimuli—for example, the frequency of stimulation may be 10 Hz, but these stimuli may occur for
only 3 sec and then no stimuli occur for a 3-sec period. During the periods of stimulation, the frequency of stimulation is 10 Hz. On many machines, another control
varies the amplitude of the signal in a continuing consistent manner—for example, a signal may occur with a frequency of 10 Hz. The amplitude of this signal may be 20
volts. Normally, all the signals have the same amplitude; however, with this control, this may be varied. For example, a train of impulses can be generated with
increasing amplitude, decreasing amplitude, or both.
Drawing of a photograph of an oscilloscope screen display
of the voltage waveform from an Acuflex CZ-110 Dual
(Courtesy of Professional Medical
Distributors, Wixom, Michigan.)
The manner in which these amplitude changes can occur can be varied in some machines.
There is always a control that varies the voltage applied and therefore the current flow, because the resistance remains constant. In many devices, the voltage controls
are connected to each other so that as the voltage to one pair of needles is increased, the voltage at another pair of needles decreases. The opposite also occurs, so
that when the voltage between one pair of needles is decreased, the voltage at another previously connected pair of needles increases. Therefore, great care must be
taken to decrease the voltage control in small steps and to decrease the voltage to all the pairs of needles sequentially instead of just turning each control completely off
before changing the next control.
Use of Electric Stimulators
Great care must be exercised when using electric stimulators. Before the connectors from the device are attached to implanted needles, the voltage controls must be
checked to determine that they are in the off position or lowest possible setting. The voltage is then slowly increased to a maximum that the patient will comfortably
tolerate. When needles are placed in or near muscle or appropriate nerves, the muscle will contract. When the stimulus is such that the muscles are gently contracting,
the animal will usually tolerate the procedure; however, some animals are very sensitive and become agitated even with a stimulus that only causes barely perceptible
When the stimuli are applied at sites that do not cause muscle contraction, it is more difficult to determine if the stimuli are reaching the site, if the animal feels the
stimulus, and if the stimuli are as strong as the animal will comfortably tolerate. If the applied votage is slowly increased while the animal is carefully observed, it is
usually possible to determine if, when, and to what extent the animal is feeling the stimuli. The person restraining the animal should be aware of what is going on and the
possibility that the animal may react vigorously if the applied stimulus is too great.
In the horse, needles placed in some muscular sites, especially when electrically stimulated, may be expelled by the voluntary local twitching of the area by the animal,
which often occurs—that is, the horse responds as if an insect were bothering it. Taping the needles in place usually overcomes this problem.
Drawing of a photograph of an oscilloscope screen
display of the voltage from an Akupunctuer 71-6.
(Courtesy of Ack Laboratories, New York, N.Y.)
Care should be taken to make sure the stimulator is in a relatively safe place, protected from the animal jumping on it or pulling it off a table because the leads are too
short to accommodate movement of the animal.
It is generally thought that a pair of needles should not be connected across the chest because of the possibility of causing cardiac arrhythmias. The negative electrode
is usually connected to a more important point. When decreasing the voltage or disconnecting leads, care must be exercised as described under "Amplitude" (above).
The discussion of the use of the stimulator so far has applied only to alternating-current stimulators. Direct-current stimulators are commonly used in the Japanese
system of ryodoraku and must be used differently. The application of direct current may be painful and will be tolerated only for a short period so generally the
stimulus is applied to one needle at a time and for 7 sec. (see p. 38).
When using high-frequency ac stimulation, the feeling is more uncomfortable at a particular voltage setting than that same voltage would be applied at a lower
frequency. Therefore, if an animal is being stimulated at a low frequency and the frequency is going to be increased, the applied voltage should be reduced first. After
the frequency has been increased to its new higher rate, then the voltage can be increased to a comfortable level.
Commercial Acupuncture Stimulators
There are many electric stimulators sold. Some are precision instruments and well constructed; others are very poorly designed and constructed. The original and the
most well-known equipment worldwide comes from China and Japan (Figs. 2-29 to 2-32). Many devices are now manufactured in the United
Chinese model 626-1 multipurpose electrotherapeutic
apparatus. This equipment is manufactured by the
People's Republic of China; sole distributor, East
Wind Medical Instruments Company, Ltd., 589 Nathan
Road, Kowloon, Hong Kong.
(Courtesy of East Wind
Medical Instruments Co., Ltd.)
States (Figs. 2-33 to 2-38). Importation of acupuncture equipment is strictly controlled by the Food and Drug Administration (see also "Importation of Equipment", p.
To exemplify the operation and uses of electric acupuncture equipment, the instructions for use of several devices are reproduced in the appendix to this chapter. The
inclusion of these specific models should not be construed as an indication of superiority or inferiority but merely examples of available equipment. The multiple
Chinese examples are to provide an insight into the methods of operation and the equipment used by the Chinese.
Panel diagram for Chinese model 71-1. This equipment
is manufactured by the People's Republic of China; sole
distributor, East Wind Medical Instruments Company, Ltd.,
589 Nathan Road, Kowloon, Hong Kong.
(Courtesy of East Wind Medical Instruments Co., Ltd.)
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