One Medicine, One Acupuncture

Abstract

"One Acupuncture", like "One Medicine", has the potential to improve research quality and clinical outcomes. However, while human acupuncture point locations have remained largely consistent over time, the veterinary versions remain imprecise and variable. Establishing anatomical criteria for veterinary acupuncture atlases in keeping with the human template will create congruence across species, benefiting both research and practice. Anatomic criteria for points based on objectively verifiable structures will facilitate translational research. Functionally comparative innervation, in particular, should be similar between species, as the nerves initiate and mediate physiologic changes that result from point stimulation. If researchers choose points that activate different nerves in one species than in another, unpredictable outcomes may occur. Variability in point placement will impede progress and hamper the ability of researchers and clinicians to make meaningful comparisons across species. This paper reveals incongruities that remain between human and veterinary acupuncture points, illustrating the need to analyze anatomical characteristics of each point to assure accuracy in selecting transpositional acupuncture locations.

Keywords: One Acupuncture; One Medicine; acupuncture; anatomy; comparative anatomy; neuromodulation; translational research; veterinary acupuncture.

Figure 1

(a) This image illustrates the complete bony orbit of the human. Note the relationship of periocular acupuncture points to the orbit, showing how a needle inserted into TH 23 would reach bone and deliver feedback through the needle and to the acupuncturist that a hard surface was reached. In addition, this rendition reveals the complex interplay of trigeminal and facial nerve branches that mediate the ophthalmic benefits of needling TH 23. (Image courtesy of Narda G. Robinson, DO, DVM, MS and Teton NewMedia. From [17]); (b) This overlay image of the dog reveals the relationship of the skull to a dog’s external features. Note the hiatus of the orbit between GB 1 and the site just ventral to TH 23. (Image courtesy of Narda G. Robinson, DO, DVM, MS and Colorado State University).

Figure 2

This cross section demonstrates the relationship of acupuncture point TH 23 to the zygomatic process of the frontal bone and the overlying thin layer of orbicularis oculi muscle. The clinical significance of this anatomy pertains to translational safety issues in acupuncture. That is, a human acupuncturist expects to reach bone shortly after penetrating the soft tissues. In contrast, the bony orbit in the dog ends at this site. A needle entering the soft tissue could therefore enter the orbit. (Image courtesy of Narda G. Robinson, DO, DVM, MS and Teton NewMedia. From [17]).

Figure 3

GV 20, known as Bai Hui or “Hundred Convergences” is located at near the vertex of the skull. The term “Hundred Convergences” connotes the meeting place of trigeminal and upper cervical nerves at this site. (Image courtesy of Narda G. Robinson, DO, DVM, MS and Teton NewMedia. From [17]).

Figure 4

Translational acupuncture research studies citing Bai Hui as one of the points stimulated may be referring to GV 20a, GV 20b, or GV5. The resultant confusion imposes hurdles for researchers who attempt to replicate the study in the same or other species, clinicians who try to achieve the outcomes claimed in the research trial, and physiologists who strive to interpret the mechanisms of action of Bai Hui stimulation. (Image courtesy of Narda G. Robinson, DO, DVM, MS and Colorado State University).

Figure 5

This lateral, layered view of the human illustrates the relationship between the temporalis muscle and a short segment of the Gallbladder channel. Although in humans and ruminants the temporalis muscle is confined to the lateral cranium, in carnivores it may extend up over the head to reach the midline. This would change the configuration of the Gallbladder (GB) channel and the layout of points along it. (Image courtesy of Narda G. Robinson, DO, DVM, MS and Teton NewMedia. From [17]).

Figure 6

Comparative anatomy calls into question the transposition of many points from the human hand and foot to the equine digit. This image highlights distal points on the Large Intestine (LI) and Lung (LU) channels, all of which should likely be omitted in the horse. Specifically, this entails LI 1 through LI 4, LU 10, and LU 11. (Image courtesy of Narda G. Robinson, DO, DVM, MS and Teton NewMedia. From [17]).