Clinical experiences with Acupuncture: failures and successes

Philip A.M. Rogers MRCVS
e-mail :  Αυτή η διεύθυνση ηλεκτρονικού ταχυδρομείου προστατεύεται από τους αυτοματισμούς αποστολέων ανεπιθύμητων μηνυμάτων. Χρειάζεται να ενεργοποιήσετε τη JavaScript για να μπορέσετε να τη δείτε.  
IVAS Congress, The Netherlands 1990

SUMMARY

1. Winter follows spring. All creatures die. In life, many suffer dis-ease through failure/inability to adapt to external or internal challenges or stressors.

 

2. Accurate diagnosis is needed for optimum results to any form of therapy. The cause, nature, location and extent/severity of the dis-ease/lesion/disorder should be known. First-degree therapy aims to remove/alleviate the cause, to enhance the adaptive response and to provide supportive/symptomatic relief during recovery.

 

3. The adaptive response is the key to all healing. Acupuncture (AP) activates the adaptive responses, which depend mainly on functional neuro-endocrine transmission. Physical or chemical interruption of transmission or functional inability of the target-organs to respond abolish or reduce the AP effect.

 

4. Clinical failures may be due to professional error (faulty diagnosis, incorrect choice of points, inadequate stimulation, failure to use other supportive therapies, premature withdrawal of therapy); patient/owner error (non-compliance with advice given); coincidental disordersand inability of target organs to respond. Some patients may be "non-responders".

 

5. Clinical success may be due to spontaneous remission or toactivation of adaptive responses (even in cases wrongly diagnosed, or in cases assessed initially as "difficult" or "unlikely to respond"). Some patients may be powerful "responders".

 

6. Examples of the author's failures and successes in cases of muscular lameness or paresis, cervical ataxia, chronic pain, are given. Some failures and successes are difficult to explain.

 

 

INTRODUCTION

Definition of therapeutic success: This is complex, as illustrated by the old joke: ... the operation was successful but the patient died...

Many definitions are possible. Three are given here, the one chosen for discussion in this paper being definition (c):

Definition (a), in humans, is the complete and permanent elimination of all present and past symptoms and signs, with full return of integrated functions of the spirit/mind/body.

By definition (a), most attempts at therapy must be classed as partial or complete failures (non-attainment of success). Permanent restoration of health is not possible: at best, death knocks and enters uninvited at some future time.

Definition (b) substitutes "medium-term" (months or years) for "permanent" in definition (a).

Acupuncture (AP), electro-AP (EA) or transcutaneous electrostimulation (TES), at points such as Earpoint Lung or the mastoid process, can give complete and dramatic success within 10 days in the elimination of withdrawal signs and symptoms in the detoxification of alcohol- or heroin- dependent patients. If combined with naloxone therapy, EA can induce symptom-free detoxification within 4-6 days.

However, by definition (b), that detoxification success would be classed as ultimate failure in most cases if therapy did not include adequate rehabil-itation. This entails rebuilding the self-respect of the patient and providing the possibility of change of internal and external environment to allow his/her growth as a full human being. Without rehabilitation, most detoxified patients who are returned to the environment which spawned the dependence, return to the habit within weeks.

Definition (b) is too severe to be applied to individual clinicians, who may have little control over internal or external environments, (their own or their patients').

Definition (c) is less severe than (b). It also can be applied to animals.

It is the medium-term elimination of most of the severe signs and symptoms, with restoration of body-mind functions to the extent possible under prevailing circumstances.

The "prevailing circumstances" include the possibility or otherwise to activate the body/mind adaptive responses, the physiological/pathological circumstances of the patient (wear-and-tear on organs/joints, senile changes, adjustment of human "purposes" for the animal patient etc).

Definition (c) allows for relapses (due to irreparable damage or weakness of organs/joints etc or due to inability to rectify adverse internal or external environmental factors). It also allows for coincidental disorders, for future unrelated disorders and for re-evaluation of the goals and purposes of the patient in the context of the realistic possibilities.

In limb paralysis due to vaso-spastic or oedematous hypoxia of the motor centres post-Cerebro-vascular accident, AP may give marked (yet incomplete) functional and physical improvement. For some affected patients, partial success may seem "miraculous" but would be unsatisfactory if the patient's goal was to be a professional pianist or Olympic athlete.

In cervical ataxia in a pet dog, AP may restore limb function sufficiently to be most acceptable to the owner but the same degree of success in a racing greyhound could be unacceptable and could lead to a request for euthanasia.

In human arthritis, even with marked radiological signs and crepitation, AP can give marked clinical improvement (pain relief and partial or complete restoration of joint function), even though no change may be evident on radiological re-assessment. Sceptical surgeons and radiologists may attribute the improvement to psycho-somatic temporary remission. However, similar improvements following AP in canine hip dysplasia or animal arthritis can hardly be explained as due to patient suggestibility.