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ARTICLES
Comprehensive
Acupuncture
Therapy Without needles
Lowell E. Kobrin,
MD
ABSTRACT
Several non-invasive acupuncture techniques offer different approaches
to clinical therapy. Korean Hand Therapy (KHT) press pellets can be
used in lieu of needles using any number of therapeutic systems. Other
approaches include a polarized ion generator, piezo stimulators, and
other point stimulators. These methods may offer greater convenience,
lower cost, and less discomfort to patients than needling. The author's
clinical observations and a recent patient survey indicate an effectiveness
using KHT press pellets equal to needling; however, larger outcome studies
must be conducted for specific conditions to determine the equivalency
of non-invasive acupuncture compared to traditional techniques.
KEY WORDS
Acupuncture Point Stimulators, Korean Hand Therapy, Non-Invasive Therapy,
Press Pellets
INTRODUCTION
Logic dictates that if physicians can find a simpler and less invasive
way to correct a pathologic process resulting in the same outcome as
a more invasive technique, researchers should evaluate the non-invasive
technique. Some of the current non-invasive methods that may influence
the acupuncture energetic system are presented in this article. The
focus is not on the myriad of non-invasive magnetic and piezo stimulators
that can be used to temporarily relieve headaches and musculoskeletal
pain; rather, it is on methods that elicit the Qi response (De Qi) and
potentially allow for a complete treatment design that addresses both
the energetic root as well as the branches (i.e., physical manifestations)
of the patient's problem.
DISCUSSION
It appears that the most comprehensive and efficient way to influence
the acupuncture system without penetrating the skin is through the Korean
Hand Therapy (KHT) micromeridians. Preliminary observations1 indicated
that the special KHT press pellets appeared equal to using needles within
the KHT micromeridian system; however, they were ineffective if applied
on the corresponding traditional body points. Such has been the case
in the author's clinical practice with the use of press pellets in lieu
of needles for the last 3 years (KHT needles used per patient request).
A January 2000 evaluation of 62 patients in the author's practice indicated
that the majority of patients who have had both invasive (needles) and
non-invasive (no needles) micromeridian point stimulation found no difference
between these modalities in treatment outcomes, and most preferred the
non-invasive approach. In this situation, the patients were their own
control. New patients, usually treated non-invasively from the onset,
reported outcomes that were similar to invasive needling.
These results have been corroborated by the clinical findings of Jodorkovsky,2
who treated 56 children with various illnesses using KHT with only the
press pellets. According to Yoo, discoverer of the KHT microsystem,3
there are a few instances in which needling the point may be better
than press pellets (e.g., acute injuries), but chronic illnesses seem
to respond better with the non-invasive KHT press pellets or with hand
magnets. However, the author has observed equally satisfactory results
in acute as well as chronic problems when press pellets were appropriately
used. This may be explained by the use of techniques such as tendinomuscular
meridian (TM) activation and the NÆN+1 rule when treating acute
traumatic pain problems;4 these advanced energetic techniques are not
included in the traditional KHT syllabus and text.
KHT press pellets can be used in lieu of needles on the KHT points using
any system of treatment design in which the practitioner has been trained.
KHT hand magnets may be substituted for silver (negative) and gold (positive)
press pellets, but they must be oriented correctly: north = negative
and south = positive. The points can be chosen on the basis of Traditional
Chinese Medicine (8 Principles), Five Phase Theory, French Energetics,
etc. A method of patient evaluation unique to KHT is known as 3 Constitutions
Diagnosis. This system allows the practitioner to rapidly determine
the energetic root of the patient's problems with great accuracy, and
then to design treatments based on either Five Phase relationships or
Curious (Extraordinary) Meridian therapy, whichever method would best
treat the patient's symptom complex. These techniques are explained
in detail elsewhere.1,5 Treatment protocols based on 3 Constitutions
Diagnosis and using KHT press pellets appear to be as effective as the
same treatment with needles. Moreover, the 3 Constitutions Diagnosis
is actually made by using press pellets (not needles) over the appropriate
micromeridian points.
Another non-invasive stimulator for KHT points (but not traditional
body points) that can be used as successfully as needles is a polarized
ion generator that is completely pain-free. Both a positive and a negative
lead are placed over the appropriate set of micromeridian points on
the hand, the frequency and intensity of the output is set, and the
device is turned on. For example, if one wished to signal the Curious
Meridian Chong Mai, the negative lead would be placed over the hand
correspondent for SP 4 (F 4), and the positive lead would be placed
over the hand correspondent for PC 6 (K 9). The device would then be turned on for about 10-15 seconds.3
Effective and direct stimulation of the traditional acupuncture points
on the body by non-invasive means to obtain the De Qi has been limited.
Transcutaneous electrical nerve stimulation (TENS) application does
not "call the Qi," which is one reason why neurophysiologist
Bruce Pomerantz created a device called the Codetron in 1987.6 This
device is a non-invasive acupuncture and trigger point stimulator that
does obtain the Qi sensation through the use of a low-frequency (2-4
Hz), high-intensity stimulation. The superiority of this device over
conventional TENS units has been demonstrated in a number of studies
in patients with various musculoskeletal pain problems.7-9
A number of acupuncture point stimulators use tuned, solid state quartz
crystals (piezo stimulators) that require no batteries. When pressure
is applied and released, a single pulse is generated that is characterized
as a high volt/low current monophasic spike waveform.10 Piezo stimulators
are used as a "first aid" device on acupoints, trigger points,
or along muscle groups and meridian pathways. No information has been
found that suggests that piezo stimulation obtains the Qi sensation.
A new type of point stimulator, called the Genesen, was invented by
the Korean engineer Chi Kyung Kim about 4 years ago. That device uses
a combination of a 600-G focused magnet (1 stimulator in the set is
oriented south, while the other is north); a pinpoint far infrared beam
(between 6 and 14 micrometers) that is
continuously emitted at room temperature from a ceramic powder; and
a negative ion emitter to precisely stimulate an acupuncture or trigger
point.11
The hexahedron tube, containing 2 special lenses, acts similarly to
a radio crystal set. Old-fashioned crystal radios resonated with the
frequency range of sound vibrations in the air and amplified them. The
hexahedron tube array, according to the inventor, attracts and amplifies
the frequency range of Qi and strongly focuses this "fresh"
undifferentiated energy through the stimulator tip to the acupoint center.11
This system is self-contained, portable, requires no power source, and
never runs down. These stimulators can be used singly or in pairs, making
them suitable for any type of polarity therapy. A strong Qi sensation
is obtained by applying the stimulators perpendicularly to the skin
over the acupuncture point.
CONCLUSION
The ability to treat pain and emotional or physical illness by needling
points on the body, hand, ear, and scalp has been well established.
It now appears that non-invasive acupuncture techniques can also be
used in a comprehensive manner, allowing practitioners to use the style
of acupuncture in which they have been trained to achieve results equal
to needling. This may allow the physician to greatly simplify certain
treatment methods that are more cumbersome and time-consuming to implement,
using a minimum of equipment that does not need sterilization. Most
of the tools needed to accomplish this can be carried in a medium-sized
pocket, making them portable and convenient.
Physicians, however, tend to become attached to various sophisticated
treatment techniques and are often slow to adopt new systems. Physicians,
as well as patients, tend to believe that the breaking of the skin yields
better results than not doing so (e.g., acupuncture is demonstrably
more effective than TENS). This is not necessarily the case, however,
and researchers need to compare the outcome of treating specific complex
problems such as fibromyalgia by conventional acupuncture vs non-invasive
acutherapy in a large-scale study. Yet we must never forget that in
chronic problems, it is essential to address the energetic root of the
problem in addition to the branches. It is contradictory to comprehensive
medical acupuncture training to use acupuncture (with or without needles)
to solely treat the area(s) of the body where a problem is manifesting,
except when treating acute injuries or inducing acupuncture anesthesia.
Physician acupuncturists must be able to understand the patient from
the energetic paradigm as well as from the structural paradigm. All
of medicine must ultimately evolve to see the patient from this expanded
frame of reference. The author's belief is that if we do not utilize
this knowledge in practice, we become "middle workers" again
and thereby reduce acupuncture to merely an alternative to drugs to
diminish pain.
REFERENCES
-
Kobrin
LE. Three constitutions diagnosis as a first line approach to patients
using Korean hand acupuncture, part II: extraordinary meridian therapy.
Am Acad Med Acupuncture Rev. 1991;3:37-48.
-
Jodorkovsky
R. Hand acupuncture experience in pediatric patients. Medical Acupuncture.
1999;11(1):25-28.
-
Yoo T-W.
Koryo Sooji Chim: Koryo Hand Acupuncture. Vol 1. Seoul, South Korea:
Eum Yang Mek Jin Publishing Co; 1988.
-
Helms
JM. Acupuncture Energetics: A Clinical Approach for Physicians.
Berkeley, CA: Medical Acupuncture Publishers; 1995.
-
Kobrin
LE. Three constitutions diagnosis as a basis for five element therapy:
a first line approach to patients using Korean hand acupuncture.
Am Acad Med Acupuncture Rev. 1990;2:5-16.
-
Pomerantz
B, Niznik G. Codetron, a new electrotherapy device overcomes the
habituation problems of conventional TENS devices. Am J Electromedicine.
1987.
-
Cheng
RSS Pomerantz B. Electrotherapy of chronic musculoskeletal pain:
comparison of electroacupuncture-like transcutaneous electrical
nerve stimulation. Clin J Pain. 1986;2:142
AUTHOR INFORMATION
Dr Lowell E. Kobrin has been practicing Medical Acupuncture since 1985,
and is a Board-certified Gynecologist. He is a Founding Member of the
American Academy of Medical Acupuncture, and frequently lectures on
Korean Hand Therapy. Dr Kobrin has been a member of North Bend Medical
Center in Coos Bay, Oregon since 1978.
Lowell E. Kobrin,
MD, PhD
North Bend Medical Center
1900 Woodland Dr
Coos Bay, OR 97420
Phone: 541-267-5151, Ext. 301
Fax: 541-269-1545
E-mail: lekobrin@earthlink.net
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