Acupuncture is based on theories thought to originate some 3500 years ago in China. Because of this ancient origin TCM is based in a thought process extremely different to our own. Western based medicine starts by looking at the symptoms and seeks to locate a specific cause, then isolate, alter or destroy the infectious agent or correct a physiological abnormality. Finding a specific cause for a specific disease, the western doctor uses western analytical deduction to sift through different possible causes (differential diagnoses), ruling out causes that don't fit the clinical picture. TCM is radically different.

The physician using TCM doesn't try to identify a specific disease or cause and effect of a disease. In TCM the patient is seen as a whole integrated with its external and internal environment. This includes "metabolic" processes, emotions, and other sources thought capable of affecting the individual. This idea is not so foreign as it may seem: it is common knowledge that something as intangible as worry and grief can result in actual physical damage, for example, stomach ulcers. Both body and mind are essential aspects in the functioning of these external and internal environments. Only recently has the power of the mind been recognized in western medicine and its effects on health are now being extensively studied. This concept, that the individual is interacting with the environment, is conveyed in many aspects of TCM, for example, when taking the history of a case questions such as "does the animal seek heat or cold? Does it like to be rubbed or is it irritated or annoyed by pressure? Does the animal sleep through the entire night or is it restless? Are the symptoms worse during the day or night, or damp versus dry conditions? To the casual observer some of the questions seem completely unrelated to the presenting complaint, but in TCM they help to form a diagnostic picture or weave a "pattern of disharmony" of where the "imbalance" within the body exists. The goal of TCM is to bring the body back into balance, this is very different from the traditional western approach of "fighting" or defeating a disease.

Most people have little or no idea how acupuncture works nor on what it is capable of achieving. It is regarded by many as a primitive belief based system which if indeed it ever results in success, does so by psychosomatic or placebo effect. Others express an interest in TCM but place baseless arbitrary limits in what conditions they believe it would be effective. Still others having lost faith in conventional medicine and surgery have unrealistic expectations of TCM.

Acupuncture should not be thought of as a substitute for western medicine but rather as a valid complement for an incredibly wide variety of ailments. When confronted with serious infections I would always reach for antibiotics first, likewise when a horse requires colic surgery (from a twisted bowel for example) acupuncture will have no benefit. Acupuncture can however help in the recovery of both these types of problems.

The theory and practice of Acupuncture is based on the concept that there are electrical currents throughout the body. These currents, or "meridians" as they are translated from Chinese, circulate energy or Qi (pronounced chee). Today this energy is thought to be micro electrical currents and western science has corroborated many of the body's electrical currents. Two very well known ones are the electrical currents that completely regulate heart function and another is the electrical control of muscle contraction and relaxation. The meridians are divided into two basic characteristics Yin and Yang, or positive and negative (it is interesting to note that this ancient system correctly deduced the bipolar nature of electricity thousands of years before the discovery of electricity). Everything we observe has a Yin and Yang nature to it. Yin and Yang are always in a state of flux and cannot be quantified by themselves but only in relation to each other. Light has no meaning unless you compare it to dark. A similar relationship exists with wet and dry, exterior and interior, masculine and feminine, hot and cold. This positive-negative circulation and balance is at the core of understanding Acupuncture. The ancient Chinese deduced that all balance in the universe is circular and flowing rather than classical Newtonian mechanics of linear progression or getting from "point A" to "point B." For example when a piece of wood is burned it doesn't change to ash, but rather the energy put into it by sunlight, water, and nutrients is released as heat, smoke, and light. Einstein clarified this concept to the modern world by proving that energy cannot be created or destroyed rather just converted from one form to another.

Proper distribution and circulation of Qi is needed for the harmony and balance necessary for healthy bodily functions. Practitioners of acupuncture believe that all dysfunction in the body is caused when there is an imbalance of Qi and it becomes stagnant or moves too rapidly. These imbalances lead to excesses and deficiencies of Qi in the meridians. Acupuncture is used to either stimulate deficient Qi or sedate excess Qi, and disperse stagnation in the meridians.

In practice, acupuncture is used to treat a multitude of problems ranging from diseases as diverse as skin disease, to intestinal upset and back pain. In fact the range of what may be treated with acupuncture may only limited by ones desire to investigate its potential. Today in China hospitals are divided into western medicine and TCM wings. Just as with any medical treatment it is very effective on some problems, less so in others, and completely ineffective on some. In many areas TCM cannot come close to the therapeutic success seen with tradition western medicine. For example, TCM can never give us the information of an X-ray nor repair a lacerated liver or broken bone. However, after such an accident, TCM would be very helpful during recuperation by stimulating healing as well as relieving the mental stress and depression often accompanying disease and trauma. Also when TCM helps in relieving pain it has none of the side effects of our powerful narcotic painkillers. Until this point this article has discussed history, theory, and other generalities of TCM, now I'd like to I'll illustrate one example of how an acupuncture diagnosis may be made and treatment accomplished. Some conditions in which acupuncture has been successful and unsuccessful will also be reviewed.

If you are interested in additional information, The Oregonian, Portland's daily newspaper, had two full pages devoted to human acupuncture in its Living Section of August 26 1998. This should be readily available at most public libraries with microfiche or possibly online.

As previously discussed Qi moves throughout the body via paths known as meridians. Twelve major meridians course over much of the surface of the body and connect inward to internal "organs" (See illustration for a few). Acupuncture points are located at specific positions on the meridians. In TCM the functions attributed to the internal organs is markedly different from the way western medicine understands them today. Despite these different perspectives of function, acupuncture is effective in treating many problems.

In the horse acupuncture treatment is accomplished by dry needling also called acupuncture (inserting special acupuncture needles or standard hypodermic needles), aquapuncture (injection of vitamin B12 or saline), electroacupuncture (low levels of electricity), and acupressure (pressing on the points). Stimulation of these points produces differing effects on the meridians and the "organs" they regulate. For example, needling some points stimulates stagnant Qi while other points have a sedative effect on the "organs" or meridian. If one was to use an electrical circuit as an analogy, acupuncture points can be thought of as circuit breakers, regulators, or resistors in the system.

Other acupuncture points are primarily used for diagnosis. These "Diagnostic Points," some distant to, others local to the trouble site are uncomfortable when pressure is applied. Diagnostic points are very valuable during treatment because they lose their sensitivity after successful treatment. Their use will be further described below with hock problems.

Acupuncture treatment doesn't always entail working over the area where a problem is known to occur but by treating points elsewhere on the meridian in question or on a completely different meridian. In the electrical analogy fixing a headlight in your car doesn't always involve replacing the bulb. Sometimes it involves changing a fuse or cleaning a connection or finding a short circuit; all these repairs far removed from the bulb itself. It is in such a manner that inserting needles in the back treats a hock problem. (See meridian pathways in the illustration.)

Before describing in broad generalities where acupuncture can be successful or not I would like to pass along some thoughts. When asked to treat conditions that are usually unresponsive I will always give a more guarded prognosis for success. Some cases are more difficult to treat (often-longstanding problems) and require a minimum of 3-4 treatments. Similarly if improvement is not seen after this time I usually recommend stopping. Finally, it would be a disservice to persuade someone against the use of acupuncture because of "usual" results. There are exceptions to all rules, both of success and failure.

Acupuncture can be helpful with recent (acute) soft tissue musculoskeletal injuries while long term (chronic) arthritic or bony abnormalities are often more difficult to treat. However in many instances acupuncture can be helpful at alleviating pain with chronic severe arthritis. These animals invariably have soft tissue aches and pains that are secondary to the original lameness and do respond to acupuncture. Musculoskeletal conditions can show up in the horse as a wide variety of lameness, back soreness, performance problems, and changes in attitude or disposition.

One of the most successful areas of acupuncture treatment is in soft tissue injury and hock lameness. Acupuncture has been effective in treating early hock problems as well as the frequently present backache and sometimes-sore front feet (often in heel or navicular region). If the problem has advanced to severe degenerative arthritis with cartilage erosion and bone remodeling, no treatment may be successful at making the horse sound although some pain relief may be possible.

Many acupuncturists use both western and TCM methods to diagnose hock lameness. Western diagnosis often involves observation, palpation (pressure with the fingers), limb flexion, nerve and joint blocks, and x-rays. An experienced examiner can detect minor alterations in gait, length of stride and shoe wear. Careful palpation and flexion of the limbs yields subtle but often-diagnostic painful responses. In TCM palpation of Diagnostic Points is added to the exam. Horses with hock soreness often show sensitivity at certain diagnostic points throughout the meridian body e.g. adjacent to the base of the tail, at the top of the pelvic bone, and behind the top of the 15th and 16th rib.

The two most painful and sensitive diagnostic points for the hock are located locally several inches above the outside of the hock. These two local points are very helpful; they are checked for soreness at specific intervals during treatment. If they become pain free, further treatment is not necessary. On the other hand if they remain painful after acupuncture x-rays are frequently indicated and joint injections are often the treatment of choice.

As was mentioned before, in addition to hock problems, acupuncture can help many other types of musculoskeletal conditions of the stifle, back, ankle, foot, etc., if they have not progressed to cartilage and bone destruction. Navicular syndrome if it has a primarily soft tissue involvement can be helped. Acute episodes of laminitis can also be benefited. With some severely painful problems, pain relief is seen but return to soundness is more difficult to achieve. Sometimes significant benefit is seen with chronic lameness if the original problem has caused chronic muscle contraction, tension, and shortening especially over joints. The benefit seen in these types of problems is from muscle relaxation.

A wide variety of non-musculoskeletal conditions can be also treated. Following are a few examples. Neurological problems, if caught in the early stages, can be helped somewhat, (not 100%) e.g. early facial paralysis and some head shakers. Acute flare-ups of "moon blindness" (anterior uveitis) have been treated successfully. Mild colics of spasmodic (intestinal cramps) or early obstruction nature can be benefited by acupuncture. Because of the potential life and death nature of any colic I never treat these solely with acupuncture. Acupuncture can strengthen and assist the healing process of many conditions; it can reinforce immunity and stimulate a lethargic animal. Other successes have been reported in conditions as dissimilar as skin rashes and attitude or disposition problems (e.g. depression commonly seen with complete stall rest from injury). Favorable results have been reported in appetite stimulation and increasing uterine tone.

The prognosis for some conditions is much more guarded. Chronic lameness of bony origin, as mentioned before, is usually not responsive. These conditions include ringbone, (a form of arthritis of the foot with significant bone remodeling and pain) and chronic laminitis (founder). Chronic navicular disease with bony changes evident on x-rays is usually unresponsive.

Acupuncture is not recommended on pregnant mares and should be used with caution on the very young or old. Acupuncture of tumors or warts usually fails. Acupuncture for cancer is often not recommended and is thought by many to possibly stimulate the growth of cancerous cells.