- Welcome, everyone, to Wednesday Nite @ the Lab.
I'm Tom Zinnen.
I work at the University of Wisconsin-Madison
Biotechnology Center.
I also work for the Division of Extension Wisconsin 4-H.
And on behalf of those folks and our other co-organizers,
PBS Wisconsin, the Wisconsin Alumni Association,
and the UW-Madison Science Alliance,
thanks again for coming to Wednesday Nite @ the Lab.
We do this every Wednesday night, 50 times a year.
Tonight it's my pleasure to introduce to you Lindsey Snyder.
She's a veterinary anesthesiologist here
with the School of Veterinary Medicine.
She was born and raised on the Kansas side of Kansas City,
and then she went to Kansas State University
for her undergraduate degree
and stayed there to get her doctor in veterinary medicine.
Then she went to Los Angeles for a year-long internship,
and then went to Ohio State University
to do her residency in veterinary anesthesia
and analgesia.
While she was at Ohio State,
she also earned her master's degree.
Here at UW-Madison, she teaches, practices,
and does research at the Department of Surgical Sciences
in the School of Veterinary Medicine.
Tonight, she's gonna speak with us
about acupuncture in animals.
Would you please join me in welcoming Lindsey Snyder
to Wednesday Nite @ the Lab?
- Thank you so much, Tom.
I'm happy to be with you tonight
to talk about acupuncture in animals.
And I should first tell you how I came
to study acupuncture and animals.
And I am a veterinary anesthesiologist,
and I did my residency at Ohio State University.
And when I arrived, we also did master's projects.
So I got my master's at the same time
that I was doing my residency,
and I showed up, and they had a project ready
and waiting for me.
And that project was looking at acupuncture,
electroacupuncture,
and a transcutaneous electrical current,
which just means a current going across the brain,
external to the skull,
so this current going through the brain.
So looking at these three methods
and looking at the requirements
of inhalation anesthetics in dogs.
So what we are looking at
is would acupuncture, electroacupuncture,
and this electrical current,
would they decrease the gas anesthetic requirements of dogs?
And this is kind of a universal method
for determining if something causes analgesia in a patient.
And I went into it thinking,
"I don't really wanna do this project
because I don't really believe in acupuncture."
And what I did
was I proved that all three of these methods
did, in fact, decrease the need of general anesthesia in dogs,
but I also proved to myself
that acupuncture does have significant effects
in animals and humans.
This paper based on my research was published in 2005,
and at the time, it was one of the first papers
that really had an objective method
for evaluating acupuncture's effects in an animal
that had no placebo effect.
And so it was sort of revolutionary at the time,
and again, the academic community really liked it,
and it made a believer of me,
who went into it very much skeptical.
So I've learned quite a bit about acupuncture
throughout my time as being a veterinarian,
not only through my master's,
but then I went on and got further training.
So what is acupuncture?
Acupuncture itself is, by definition,
it is the stimulating of specific anatomic points
in the body to produce therapeutic
or analgesic effects.
So what does that mean?
We can not only produce pain management
so that analgesia, where we can decrease pain in a patient,
but we can also get therapeutic effects
like regulating how the GI system is working.
So something like that.
Traditionally speaking,
when someone talks about acupuncture,
they typically think of the traditional method
of acupuncture, which is using fine gauge needles
to puncture the skin in these specific anatomic points.
Interestingly, we can use many different methods
to actually produce these effects.
So we can use heat, pressure, aqua, or a liquid of some sort,
even electroacupuncture,
using a low-level electrical current.
So if we look at some of these, we can use heat.
So if we start sort of clockwise in the top left corner,
that's actually using an herb called mugwort.
Mugwort burns very, very hot.
And so just even placing this herb over an acupoint
can produce an effect in this acupuncture point,
this specific anatomic point.
We can also use pressure.
So you can see someone is pushing on their hand
in a very sort of traditional spot
that a lot of people see when they have a headache,
they're pushing on their hand in this spot,
and that's using pressure to get an effect
in this acupoint.
What they're doing here
is actually stimulating a master point
for the head and face.
You can see, as we move along clockwise,
there's actually a needle with liquid.
And we can use liquid and inject that
into an acupoint to get an effect.
So we can use saline, we can use vitamin B12.
We can even use the patient's own blood, called hemopuncture.
We can even use really small amounts of a drug
and do what's called pharmacopuncture
and deliver very small amounts of a drug into an acupoint.
In the bottom right corner, you can see
that we've actually, in this, this was part
of my study dogs,
and we actually attach very small clips
onto acupuncture needles,
and we're able to deliver a very low electrical current
between two needles to develop
or enhance the effect of the acupuncture alone.
So this is just another method of stimulating those needles.
You can see in the bottom middle picture,
they're using pressure with,
those are actually motion sickness bands
that are being used to put pressure
and use acupressure on points
that are really beneficial for decreasing nausea.
And in the bottom right, you can see
that they've actually used that same herb, mugwort,
and actually put it in a cup
attached to the acupuncture needle itself,
and that warms the needle down into the acupoint.
So that is going to intensify the effects
of the acupuncture.
I personally don't use this method.
As you can see in the picture, it is a burning substance,
and if anyone's ever been in a barn,
there's usually a lot of hay and a lot of straw,
and it makes me a little bit nervous to do that.
So each practitioner develops their methods
for stimulating those acupuncture points.
So something that's been interesting
in more recent years,
even more than, not even 20 years ago,
you would not have found that places like Johns Hopkins
were advertising acupuncture and its benefits
on their websites.
But now, not only the scientific community,
but the medical community have really caught on
to the beneficial aspects of acupuncture
and what it can do.
So you can see that Johns Hopkins
is even touting acupuncture's beneficial effects
right on its website.
Additionally, you can see that something like the NIH
is advertising acupuncture's beneficial effects as well.
And the NIH recognizes that acupuncture is beneficial,
and acupuncture in all of its variations,
electroacupuncture, et cetera.
It's beneficial for things like dental pain after surgery,
headaches, myofascial pain.
So those are those real deep aches and pains
of your connective tissue, and even things like asthma.
The NIH is promoting acupuncture
for these various conditions within the body.
In a traditional sense,
acupuncture is based on patterns of energy flow
throughout the body.
And these were thought to be meridians in the body,
and it's disruptions of this energy flow
throughout the body
that was thought to be the basis of disease in the body.
So disruptions in these patterns of flow
were what caused ailments in the body.
Acupuncture has been described in writing
as early as 1,000 BC.
So it has been in practice
that we have a written history of
for at least 3,000 years.
That being said, there are artifacts
that indicate that acupuncture has actually been practiced
for thousands of years even before that.
Very sharp bones that were sharpened to a point
and even stones that were sharpened to a point
have been found that were most likely used
as acupressure modalities.
So acupuncture or acupressure tools
that go back to even 5,000 years ago.
So why would someone recommend acupuncture
or seek it out as a treatment for either themselves
or their animal?
Well, first and foremost,
acupuncture has virtually no side effects.
So it really is something that we can go into
with the hopes that it will help
and realistically know that it will not harm one,
either themselves or an animal.
Like most things that we try
to alleviate pain or have a therapeutic effect,
it might not be universally effective.
So when I get a headache, I take ibuprofen.
Ibuprofen works for my headaches,
whereas another individual,
ibuprofen is not what works for their headaches.
And in reality, something like Tylenol
might be beneficial for them.
Acupuncture is the same way.
It might really work well with one person,
but might not be the method of choice
for another person.
For some things, it might be the only thing
that we need to use.
And again, I'll use the headache example.
If I have a headache, ibuprofen is usually enough
for my headache to go away.
However, it might not be the only thing that works.
So if I have a really excruciating headache,
I might need ibuprofen and something else with it.
And acupuncture is the same.
When I talk to clients about their animal,
I'm never looking at just acupuncture.
I'm looking at everything that goes together
for that patient.
So both the Western approach and the traditional approach,
and I use them as adjuncts for one another.
When we use acupuncture needles
or pressure or something, whatever method we choose,
we are gonna be activating that acupuncture point.
So what are acupuncture points?
Well, we know that they're cutaneous areas
with high concentrations of specialized nerve endings.
There are specialized nerve endings that are responsible
for picking up pain impulses,
and those are both A delta and C fibers.
And acupuncture points have really high concentrations
of both A delta and C fibers compared to surrounding tissues.
We also know that acupuncture points
have a high concentration of mast cells.
Now, mast cells release histamine,
and so if I really get a point
that's really dead-on on that point,
I might get a little reddend area,
and that is a really, really small,
localized release of histamine from that acupuncture point.
There are also high concentrations
of capillaries and venules, so it's not entirely uncommon
to have a little bit of blood when you take the needle out.
We also know that acupuncture points
are areas of decreased electrical resistance.
So there's actually increased electrical conduction
within the acupoint itself.
So I find this so fascinating
because thousands of years ago, these points were discovered
and now science has said, "Wait a minute,
"there is something to these points.
They are anatomically different from surrounding tissue."
Things that we know about acupuncture
is that acupuncture can decrease muscle spasms.
So just by placing a needle within a spasming muscle
or an area of muscle that has a tight knot,
it can relax that muscle in and of itself
just by placing a needle.
So this picture that you're looking at
is actually, that's actually me with straight hair for the day,
but I am actually going
and having what's called trigger point therapy.
So other areas of medicine have caught on
to this effect of decreasing muscle spasms.
When I go in, I have someone who is in physical medicine
and rehab, so a specialist, who takes a needle
and actually pistons that needle within my muscle knots.
And every time those muscles fire,
it starts to relax those muscles.
Physical therapists also do what's called dry needling,
and they will use acupuncture needles
targeting the musculature.
So they're not actually targeting acupoints,
so they can't call it acupuncture,
but they're using acupuncture needles
to decrease the muscle spasms.
So this is starting to translate into other areas of medicine.
We also know that acupuncture can induce the release
of neurotransmitters.
So neurotransmitters will be released,
and that will affect how the body responds to pain.
So we can release neurotransmitters
and decrease the pain experience overall.
Some of the big ones that we would talk about
would be endorphins and dynorphins.
So that's working on the body's endogenous opioid system.
And when we talk about that, one of the things that often
is brought up is with endorphins,
we talk about a runner's high.
So that release of endorphins causing a runner's high.
Well, I can get a runner's high without having to run,
which is a delightful way for me to get a runner's high.
All I have to do is place acupuncture needles
and get that release of endogenous endorphins.
I also know that acupuncture then can be reversed
with the opioid antagonist naloxone.
So something that we can use to get rid of opioids
within the body, and we can reverse the effect of opioids
in the cases of overdoses or something like that.
That drug can actually be used
to reverse the effects of acupuncture.
So we can actually reverse acupuncture's effects
through pharmacology.
So to understand acupuncture and its mechanism of action,
we really need to understand the pain pathway.
So pain starts at the area of a noxious stimulus.
So that's just something that causes pain.
That could be mechanical, chemical, thermal,
placing your hand on a hot pot,
or in our case, we'll say that this dog
has its foot stepped on.
So we take that impulse, that mechanical impulse
of having the dog's foot stepped on,
and it will be transduced into an electrical signal.
It then will be transmitted through transmission
to the level of the dorsal horn of the spinal cord.
That transmission will occur
by those two specialized nociceptive fibers.
So those two nerve fibers that are responsible
for delivering pain.
The first are the A delta.
Those are large, myelinated fibers
that are responsible for fast, pinprick pain.
And the second are C fibers.
Those are small, unmyelinated fibers that are responsible
for slow, burning pain.
So again, we have our impulse,
it gets transduced into an electrical stimulus
that then is transmitted to the level
of the dorsal horn of the spinal cord.
At that point, we can modulate the pain impulse.
So we can have excitatory neurotransmitters
that will intensify the pain experience,
or we can have the release of inhibitory neurotransmitters
like the endorphins
that will decrease the pain experience.
Then that impulse is projected to higher levels
of conscious perception.
So with that in mind,
we can look at one of the theories
for how acupuncture creates its analgesic effects,
and that is called the gate control theory.
The gate control theory states
that when we place these needles into the skin,
we stimulate those large, myelinated fibers
responsible for fast, pinprick pain.
That gets carried to the level of the spinal cord,
and the release of inhibitory neurotransmitters occurs,
so we release things like endorphins,
which will close the gate and decrease the pain experience
from those slow, burning, more pathologic pain nociceptors,
the C fibers.
The small, unmyelinated fibers responsible
for slow, burning pain.
The points themselves are based on the meridian system
of human acupuncture.
So it's the same names and the same codes
that we use in human acupuncture,
and everything has a very specific anatomic location
associated with it.
For example, if I were to read spleen 6
is three cun directly above the tip of the medial malleolus
on the posterior border of the tibia.
Now, when I look at these different anatomic locations,
I can look and say that the interior of the tibia
is 13 cun,
whereas the external portion of the tibia is 16 cun.
But keeping that in mind that it's 13 cun,
then I know that this point, spleen 6,
is approximately 25% more proximal
up the level of the tibia.
So working our way up the tibia,
it's gonna be approximately 25% up the level of the tibia.
And so we find most of our points
based on these anatomic descriptions.
You can also use something like a point finder.
A point finder is, it's a small machine
that actually looks for electrical resistance
within the skin.
This is beneficial in people.
It's not as beneficial in our veterinary patients
that are covered with hair or fur.
When looking at something like chronic pain,
we look at it like we would any other method of analgesia,
in that I don't look at an animal
that has been suffering pain for weeks or months
and expect that one pill of a pain medication
is going to treat all of its pain.
I know that I'm going to have to give continued treatment
to see improvement, and that's the same with acupuncture.
So we really need to approach chronic pain
with several treatments
and know that these treatments will build upon each other
and the effect will be additive,
and that we should give it a number of treatments
before we really assess whether the acupuncture
is working or not for that particular patient.
Electroacupuncture is simply, I pointed out earlier,
is simply adding small clips to the needles themselves
and adding a very low electrical current
between those needles.
The stimulation of needles
creates a more profound analgesic effect.
So I say that electroacupuncture
is simply taking a highlighter to that effect,
and we're just highlighting that effect.
Now, we can stimulate the needles
a couple of different ways.
So you can rotate needles.
They used to have women that would sit in a room,
and they'd actually spin the needles
up to 200 times a minute.
I jokingly say that their carpal tunnel then kicked in
and they could no longer spin the needles for them
and needed acupuncture themselves.
Other methods, if anybody has ever had acupuncture,
sometimes, practitioners will come in
and spin the needles periodically,
or they're actually, some individuals will come in
and actually flick needles.
But the most consistent method for stimulating a needle
is adding that electrical stimulation.
It is very repeatable in every patient.
And that electrical stimulation is more intense
than any of the manual manipulation could be.
I point out this study, and you can see just as a fun aside,
this is actually doing electroacupuncture on a giraffe
that was anesthetized.
They tend to have muscle contraction
while they're anesthetized.
And so we were using electroacupuncture
to keep the muscles soft and supple
so that the giraffe could stand up
without any complications there.
And I point out this study
because it's really looking at the neurotransmitters
that are released in the presence of electroacupuncture
and acupuncture.
And the point is not to read off all of these neurotransmitters,
but you can see that there are different types of pain
that was looked at,
and looking at the periphery versus the spinal
versus the central nervous system,
and looking at all the different neurotransmitters
that can be affected by using acupuncture
and electroacupuncture,
and how all of these neurotransmitters
can affect the pain impulse and decrease the pain experience
for both humans and animals.
So science has a lot to say about acupuncture.
We know that neurotransmitters are heavily involved
in the pain reduction that acupuncture can produce.
We know that it decreases muscle spasms
and improves comfort in patients.
I've not really even discussed the therapeutic benefits,
but the science community is aware
that all of these things are happening.
What I think is really fun then
is to pay homage to the history of acupuncture
and to really talk about some
of the traditional Chinese medicine as well.
This is often, when we talk about acupuncture,
this is where we start to lose people a little bit
is when we start to talk about traditional Chinese medicine
and the aspects of traditional Chinese medicine.
People tend to go towards the science side
and the traditional Chinese medicine loses them
a little bit, which is one of the reasons
that I love talking about it with all of the clients
while I'm treating their patients
and to really incorporate the history with the science.
So traditional Chinese medicine has five components,
with acupuncture just being one component.
So you can see that, obviously, acupuncture
is one of the components of traditional Chinese medicine.
But the other components include herbal medicine.
And herbal medicine, again, this is something
where some people sort of glaze over
and they don't quite, you know, treating things
with herbs seems very difficult
for certain individuals to wrap their head around.
But really, I could go back and say
that morphine is actually a derivative of the poppy plant.
And so morphine in and of itself is a type of herbal remedy.
So we can develop synthetic opioids following that,
but really, the gold standard opioid morphine
is an herbal remedy.
And so herbal medicine really targets what's happening
within the body, and individuals
would describe it as daily acupuncture,
very specific daily acupuncture.
So really getting targeted therapy
to what is happening within the body.
Another component of traditional Chinese medicine
is massage, and this is called tui na.
And tui na is not a lovely, relaxing massage.
It is actually a very intense massage,
where most people will describe it
as the end justifies the means.
It can be quite uncomfortable during the process,
but produces very beneficial effects
in targeting meridians and targeting pressure points
within the body.
Another component is exercise, which is qigong,
which is an exercise that is very similar to Tai chi
and really incorporates the mind-body connection.
So it is slow movements
that promote health in the joints,
as well as having that mind-body connection.
I jokingly say that I have yet
to get my dog to do Tai chi with me in the morning,
but what I can do
is have a relaxing walk with my dog
to incorporate that exercise.
So it's not about running and getting his heart rate up
and moving as quickly as possible,
but it is about more relaxation and movement of the body.
And then the last component is food therapy.
Food therapy is a really interesting topic.
It is much more than just eat the right thing
and you'll feel better.
Food therapy really targets cooling food and warming food,
and looking at individuals.
It's using food as medicine.
And when I talk to people about this,
I usually have, if I'm in a group,
I'll have people raise their hand if they're always cold.
And inevitably, there will be people in the group
that raise their hand,
and I can say, "One of the things you can try
is to incorporate cinnamon into your diet."
Cinnamon is a warming herb,
and it can actually warm the body from the inside.
Then you can ask the same question in opposite
and say, "How many people are hot all the time?"
And inevitably, there are people that raise their hand.
Try incorporating mint into your diet.
Mint is a cooling herb.
Well, beyond herbs,
there are proteins that are cooling and warming,
and spice and spice level plays a component in this.
And so it's really looking at food as medicine
to treat what is ailing someone in the body.
On a traditional basis, as I mentioned,
acupuncture has been utilized
in writing, at least, for 3,000 years,
and realistically, it's probably been practiced
for longer than that.
It's thought that traditionally speaking,
a decrease or increase in energy flow or qi
along hypothesized lines or channels within the body
are the basis for disease within the body.
And these hypothesized channels are called meridians.
In reality, the meridians
have never been demonstrated to exist.
That being said,
there are studies out there that say
that there's something to them.
So we have found, scientifically, we've found
that the meridian systems themselves,
there are multiple meridians in the body,
but those meridians follow nerve pathways
or they follow connective tissue in the body.
So they're actually following anatomic structures
within the body.
And they actually have found
that some of the points themselves
are right over major connections
of connective tissue within the body,
and even over areas where there is connective tissue
that dives deep in between musculature
and incorporates a lot of the nerve fibers.
So these points follow these fascial planes in the body.
These meridians follow them.
We also have found that the meridians tend to be
right over big neuronal bundles within the body.
So these two studies are looking at those
and saying that there's actually something
to these meridians.
Although we can't prove that they anatomically really exist,
we know that they follow structures that exist.
On a traditional basis,
pain is a result of excess conditions
leading to obstruction of circulation
within that meridian.
So we can have exterior pathogenic factors.
Scientifically speaking, we could say that
that's a heavy flu season
or a high level of ragweed in the air.
Those would be those exterior factors.
It could be interior cold or heat,
stagnation of qi or blood.
And all of this is a little hard to understand
at first, of course,
because it's really just learning a new language
associated with acupuncture,
and it's this language of internal medicine
before there was internal medicine.
So although it sounds, talking about something
like qi might be a little bit hard
to wrap your head around, it's really describing things
before Western medicine described it in a different way.
It's really just using a different language
to describe very similar things.
And so again, I think it's important
that we learn some of this language
so we can translate between the two.
On a traditional basis,
pain can also be a result of deficiency conditions.
So deficiency of qi, blood, consumption of bodily fluids.
You can also have a situation
where you just have stagnation of qi,
which causes a distending pain
with no real pinpoint location to that pain.
And the best description I could give of that is depression.
People with depression often describe pain
without a real fixed location
for where that pain is occurring.
So the idea is that we wanna restore balance
within the body.
We wanna take the body to homeostasis.
And what is homeostasis?
I got into this discussion not long ago with an individual.
What is homeostasis?
Homeostasis is not a universal term for every individual,
but it's for that specific individual.
So we wanna take that individual,
that individual animal, that individual person,
we wanna take them back to their baseline
at which their body performs in the best way possible.
So we are trying to take it to their baseline
that allows them to have optimum health.
So needles placed in appropriate locations will help
to alleviate any of these underlying causes of pain,
or obstruction, or decreased circulation
within the meridians.
And, therefore, we can alleviate pain,
and we can create therapeutic effects.
So how do we get there?
How do we know where to place our needles?
Well, we do that
by developing what's called a pattern diagnosis.
A pattern diagnosis
is simply a traditional Chinese medicine diagnosis.
We do that using some terminology
that's a little bit different.
The first is yin and yang.
Yin and yang are in opposition of one another.
And I think of yin as cool and dark.
So it is nighttime, it is the moon,
associated with nighttime.
It is cold, and so it is winter as far as a season.
Things slow down in the winter.
As compared to yang,
which is bright, and sunny, and warm,
and things are moving fast, and it's summer.
And so we look at these different things.
And how does this come into play?
Well, I might...
Well, I can use the example, I should say,
of something that creates yang excess.
So an animal that is hot,
that can be yang excess, meaning a fever,
or we can have an individual that is hot
because of yin deficiency.
So a woman going through menopause,
she does not actually have a fever, she is not excess yang.
Instead, her cooling system is broken,
causing her to be warm from time to time.
So she has yin deficiency.
So it's just looking at it in two different ways.
So we can apply yin and yang when looking at a patient.
We can apply it to the body.
So parts that see the sun on one of our patients,
a veterinary patient, that's gonna be the back,
that's gonna be the outside of the limbs.
Those are yang meridians that pass through those areas.
We also have yin meridians.
The yin meridians are gonna be on the abdomen,
they're gonna be on the inside of the legs,
the areas that are dark; they don't see the sun.
And if I'm looking at a situation
where a patient has a yin deficiency,
I'm probably gonna wanna stimulate yin points
to build up the yin system.
And it's gonna help us in determining
our pattern diagnosis or our diagnosis.
We can also use the five element theory.
And the five element theory is really fun to talk about
because I'll discuss the five elements,
and then sort of get to some of the fun parts as well.
But the five elements go in this order.
Wood, fire, earth, metal, and water.
And each of those elements has a color associated with it,
it has a taste associated with it, and it has organs.
So the zang-fu organs associated with each.
Each of those has a yin and a yang organ.
So I can choose the organ system
that would be yin or yang for that particular animal.
There are also sense organs and body parts,
and we can go through all of these,
and you can see that there are, as I said,
specific organs associated with the different elements.
But that doesn't mean much yet.
But we can actually apply these
to conditions within the body and personality,
and that's where it gets fun.
When I teach this in the vet school,
I actually add links to quizzes that you can take online
that tell you which element you are, your personality.
So I'll go through.
The wood personality is a very take-charge personality.
They are the cruise director.
They're gonna tell everyone where we're going,
and what we're doing, and this is when we're gonna go,
and please be on time.
For animals, I think of a police horse needing to be a wood.
They need to be take-charge and they need to not back down
when people are coming at them.
So that's kind of your wood personality in a nutshell.
When they are out of balance, when woods are out of balance,
they're prone to tendon and ligament issues.
The fires, those are the social butterflies.
And they are the poodle that comes up
and greets everyone at the dog park.
Dog park, every dog at the dog park,
every person at the dog park,
and they're friends with everyone.
They wanna come up and lick your face.
That's your fire.
We all know social butterflies as well, and oftentimes,
they are prone to having arrhythmias.
They also can be prone to anxiety.
The earths, they're the laid-back individuals.
So the earths are the very mellow Lab
who is extremely friendly
but doesn't feel the need to be in your face.
They're going to greet you eventually
when you come to the door,
but again, they're not gonna charge you down
and try and lick your face.
So very mellow.
Older Lab is a classic example.
And they are prone to worry, and they're prone to overeating.
So they're actually prone to weight gain
when they are out of balance.
I myself am mostly an earth,
and do consider myself to be pretty laid-back.
And sure, I like to eat as well.
The metals are best described in animals as aloof.
In humans, we would describe them as individuals
that are a little antisocial or introverted,
individuals that like to be by themselves,
and they are extremely meticulous.
So individuals that will unpack the dishwasher
to put it in the right way.
Those are your metals.
In animals, how that manifests
is that they're the animals that wake up
at the same time every day,
they eat from the same food bowl every day.
If you incorporate a new food bowl, they won't eat.
And so they're very routined animals.
When they are out of balance, they're prone to skin issues
and allergies and asthma.
And then the last are the waters.
They're extremely loyal to a small group of people.
So they're very loyal family animals,
but not the most social.
They are extremely loyal in people
to a small group of friends
and don't feel the need to be friends with everyone,
but profoundly loyal to their group.
In animals, we describe them a little bit as fear biters.
And then when they are out of balance,
they are prone to osteoarthritis,
and they can be prone to some kidney concerns.
So there are personalities associated with all of these.
Additionally, they are phases of life.
So wood being the first phase of life,
going through the phases of life,
lastly, the water phase of life.
So if you look at water as the last phase
of an individual's life,
a geriatric animal, or a geriatric individual,
a geriatric human, you'll see osteoarthritis is there
'cause bones are the body part.
The sense organ is the ears.
It's very common for individuals to lose their hearing.
Kidney and bladder;
we see urinary incontinence occur much more
in our older populations.
So we use these to help us develop that pattern diagnosis.
So I ask a lot of questions about an animal's personality.
So to see what they're predisposed to.
It also helps in determining how we can balance
that individual.
Because the ideal situation
is that someone is such a perfect combination
of all five of these personalities
that nobody can tell what they are
because they are so well-balanced
between all of the elements.
Oftentimes when people take the quiz,
they'll find that is not the case.
So we also talk about qi,
and qi is one of those things, as I said,
that gets really hard for people to wrap their head around.
Well, qi is best if we really just break it down
into the words like energy or health.
I'd really like to use the word health
in place of qi.
So when I talk about improving qi in a limb,
what I might really be saying
is I want to improve the health of that limb
because in reality,
qi is an overarching, all-encompassing term
for many smaller components of qi.
For example, there's something called gu qi.
And on my diagram, you can see it's sort of in the top left.
Gu qi, and that is food qi.
That is the energy or the health that you get from food.
So we all know that if you eat healthy food,
you will be in better health
than if you eat food that is not as healthy for you.
That is something that's been proven time and time again,
and we know it from elementary school on.
There's also qi associated with environmental factors.
So when the pollen is really high,
I am not gonna be in as good of health
because I have seasonal allergies.
There's also the immune system qi.
So all of these different components that make up qi.
So when I am saying qi,
I'm actually describing something
that has multiple smaller components to it.
And when we start to break that down and really look at it,
we can understand how qi can be the,
it's all-encompassing word,
and it makes it a little bit more digestible for people
that have a hard time talking about qi
or energy within a body.
So we use things like yin and yang,
and our organ systems, and our five element,
and we make a pattern diagnosis.
And when we do that,
we might also incorporate a few other things
in addition to their personality and things like that.
We can include pulses.
So practitioners that are really adept
at traditional Chinese medicine
can actually feel pulses differently in three locations.
Along the wrist and the wrist here.
In animals, we might use their femoral pulses,
so just on the inside of the back legs.
But you can actually feel the pulse differently
in each location,
and you can actually start to interpret what is happening
within the body based on the strength of the pulses
in these different locations.
I've been doing acupuncture
for many, many years, 15 years-ish,
and I am not adept at doing this.
There are practitioners that will feel pulses
for 10 to 15 minutes,
and they'll be able to list off all the things
that are wrong with you with a high degree of accuracy.
So there are people that are extremely skilled
at feeling pulses.
I do look at tongue.
So we don't think of the tongue
as having changes in color necessarily,
but there are actually locations of the tongue
that are associated with different elements,
or we can say the organs
that are associated with those elements.
So you can see spleen and stomach in the center.
And so we can look at that,
and we can look at the color changes of the tongue
in these different locations
to see what is happening within the body.
So a really good example
is a pale tongue being qi deficient.
So when I look at the color of the tongue,
when veterinary students are going through finals,
they almost all have qi stagnation,
which is the lower left corner.
That is a pale tongue in the middle,
so that's that qi deficiency in the middle,
but where the heart is,
and I said anxiety is associated with heart,
with that fire element, they get a bright red tongue.
And so during finals time,
almost all the students have a pale tongue
with a bright red tip.
And so we see these changes,
and it can help us determine what is happening
within the body.
And you say,
"Well, how can the tongue actually look that different?"
Well, it can look quite different.
So you can see our friend in the top left corner
has a little bit more of a pale center
with a brighter red tip.
The ideal color is called peach petal.
And the dog on the bottom has that color more
around the edge of the tongue,
with it being a little bit more pale in the spleen center.
The dog in the top right
has more of that red, dark red color,
which if it starts going a little bit towards a purple
is an indication of stagnation,
which is usually stress or pain in the body.
So I'm definitely gonna be looking for pain
within that patient.
So I take all of these factors into account
when I am looking at a particular patient,
and I develop a pattern diagnoses or a diagnosis,
so that I can treat the patient as an individual.
So if I'm looking at acupuncture
for something like osteoarthritis,
I'm gonna look at each case individually.
Western medicine might treat patients very similarly,
whereas the acupuncture in the traditional Chinese medicine
is gonna parse it out a little bit more.
So I might look at two patients
that actually are very similar in their presentation.
So they both have a history of osteoarthritis.
NSAID's help, but lately, it hasn't been helping.
I then gather more information about each of these patients.
I ask questions about their personality.
So it looks like Max is pretty mellow and easygoing,
more likely an earth,
whereas Hank is that fear biter; he's a water.
And I start to see that Max is seeking out warm locations.
So he's cold a lot, whereas Hank is the opposite.
And I look at their tongue and I make a pattern diagnosis.
And these two cases that come in looking very similar
actually have two different pattern diagnoses.
Max has kidney yang deficiency,
whereas Hank has kidney yin deficiency.
So they sound very similar,
but they can be treated individually.
So I can pick points that are very similar for both of them
that are just going to be points
that are gonna work on the areas of the body that hurt,
but I also can work on points
that treat that underlying pattern diagnosis.
So, for one, increasing the yin within the body.
The other is really toning down the yang within the body.
And so we start to balance it that way,
and we treat them as individuals with the points that we choose.
And there are nice flow charts
that help us with this in the beginning
because it is a lot to learn, and a lot to understand,
and a whole different language, as I said,
from the Western medicine perspective,
and the Western medicine approach,
and the traditional Chinese medicine approach.
So I wanted to share this with you
because I'm passionate about acupuncture,
and I want people to understand
that we can talk about the history
and we can talk about these things like yin and yang
without alienating the Western medicine
and the science that comes and goes hand in hand
with acupuncture.
So it's really marrying
the traditional Chinese medicine approach
and the scientific approach,
and using them both in combination
to do what is best for the patient.
So I thank you for sticking with me throughout this talk.
And I hope that you learned something
and are open to talking about acupuncture in the future.
Thank you so much.