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The problem of acupoint contraindications in pregnancy Stephen Birch PhD, LicAc (USA), MBAcC (UK), lid NVA (Holland) Stichting (Fondation) !or the Std" o! #raditional $a%t A%ian Medicine &'' Plein * +*- S A.%terda. #he Netherland% Introduction
#oda" /e !ind .an" .odern te0t1oo2% reco..ending the %e% o! acpoint% !or certain condition% and contraindicating their %e% in other condition% 34i +556' 7ne o! the 1e%t 2no/n e0a.ple% o! the contraindication% contraind ication% i% the prohi1ition again%t needling L89- and SP9: drin pregnanc" 34i +556' #here are ho/e;er <e%tion% a1ot the ;alidit" the%e %tate.ent% 3Birch, Felt +5556' #hi% paper /ill di%c%% the point% that are %all" %aid to 1e contraindicated contraindicated !or treat.ent dring pregna and trace the hi%tor" o! the%e idea% and contradiction% in the literatre a1ot the.' &hat re.ain% are %erio% <e%tion% concerning the ;alidit o! the clai.%'
#o do thi% 8 %hall !ir%t li%t the point% that are contraindicated dring pregnanc", 1" e0a.ining thirt" !i;e hi%torical and .odern te0t% and all the point contraindication% dring pregnanc" each .a2e%' #hi% allo/% contra%t o! %tate.ent% a1ot point contraindication% dring pregnanc" 1et/een .odern and hi%torical Chine%e %orce%, .odern and hi%torical =apane%e %orce% and .odern /e%tern %orce%' #o nder%tand the%e ;ariation% and their contradiction% 8 %hall then e0a.ine change% in the Sign up to vote on this title indication% o! needling depth !or acpnctre point%, co.paring !i;e Useful Not useful hi%torical te0t% /ith !or .odern Chine%e te0t%' 8t /ill 1eco.e apparen that idea% a1ot the %e% o! acpnctre point% ha;e e;ol;ed o;er ti.e
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ha;e 1een ;ariation% at all le;el% in acpnctre practice, !ro. te0tal ;ariation in the %e% o! acpnctre point% to .ethod% o! %ti.lation o the point%'
M" h"pothe%i% i% that the %e o! acpnctre point% ha% changed %igni!icantl" !ro. hi%torical to .odern ti.e%' #hi% %hold not 1e %rpri% gi;en hi%torical de;elop.ent% in and ot%ide o! $a%t A%ia /here;er acpnctre ha% 1een practiced, 1t it doe% rai%e di!!iclt <e%tion% a1o ho/ practitioner% atte.pt to athenticate or %ti!" /hat the" do' Mo% traditional !or.% o! acpnctre atte.pt to athenticate /hat the" do clai.ing an hi%torical lineage, !or e0a.ple 1" citing certain hi%torical te andEor 1" %tating that /hat the" do i% traditional or cla%%ical' #he e0pected ;ariation% in acpnctre point %e% do not eli.inate hi%torica lineage% per %e, 1t the" do rai%e i.portant <e%tion% a1ot thi% rote %ti!ication' #hi% paper !oc%e% pri.aril" on the di%continit" o! idea%, highlighting .aor di!!erence% 1et/een hi%torical and .odern te0t%, an di!!erence% 1et/een tradition%' 8! the citing o! %!!icient hi%torical doc.ent% i% in%!!icient a% a .ean% !or %ti!"ing one% .odern idea%, then one %hold cite other rele;ant %orce% e%peciall" .odern e;idence !or tho%e idea%' 8n the a1%ence o! dependa1le .odern %orce% the idea <e%tion 1eco.e% di!!iclt to %1%tantiate' Acupoint contraindications inReading pregnancy You're a Preview #o e0a.ine point contraindication% in general and in pregnanc" in Unlock full access with a free trial. particlar 8 co.piled all the acpnctre point contraindication% or prohi1ition% in thirt" !i;e hi%torical Downloadand With.odern Free Trial %orce% (%ee ta1le +)'
7! the !ollo/ing %orce% that /ere co.piled in thi% %td" (%ee #a1le +9> /ere !ir%t co.piled 1" Sorei Ganagi"a in hi% te0t, Shin2" 8t% n Mon 3Ganagi"a, +5-6. +9>> are cla%%ical te0t% in Chine%e, =apane%e or Korean, >9> are .odern =apane%e athor% in =apane%e' #e0t% >59 o! /ere co.piled !ro. %e;en .odern $ngli%h langage %orce%, three Sign up to vote on this title /hich are direct tran%lation% o! Chine%e te0t%, (>5, *, ,) one o! /hic Useful Not useful i% a direct tran%lation o! a =apane%e te0t, ()' #e0t% +, >, and - are co.piled !ro. Chine%e %orce%' 8n the !ollo/ing li%t C9 indicate% a
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? - Yi Xue Ru Men; (C - 1575) - Xi ang Zi Ming Tang Jiu Jing; (C - +++) 5 9 Zhen Jiu Zi Sheng Jing; (C 9 +>>*) +* - !ei !e"#u $ !ai; (J - +*?) ++ - %akan San#ai Zue; (= 9 +?+>) +> - &ei Jing; (C 9 +:>-) + - %ai Tai 'i Yao ang; (C 9 ?>) +- - To $ Ho !a"i; (K 9 +:+) 15 - ian Jin ang; (C - 5*) +: - Su %en hI (C 9 +5-) +? - Shinkyu Se"#uyaku; (J - 1+1*) + - Ryoi no ai ai#hu; (J - 1++/) +5 9 Zhen Jiu Yi Xue a ang; (C - ing 0yna#"y) >* - Shinkyu Yoho Shinan; (J - 17*/) You're Reading a Preview
>+ - oui Shinkyu 2a#ui; (J - nine"een"h 3en"uy) Unlock full access with a free trial.
>> - Ni3hiyo !yuho; (J - nine"een"h 3en"uy)
Download With Free Trial > 9 Mr' Ga.o.oto (= 9 t/entieth centr")
>- 9 Mr' Mat%.oto (= 9 t/entieth centr") > 9 Mr' #at%i (= 9 t/entieth centr") >: 9 Mr' #a.a.ori (= 9 t/entieth centr") >? 9 Mr' Sa%aga/a (= 9 t/entieth centr") > 9 Mr' #o.inaga (= 9 t/entieth centr")
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TABLE 2 - oints contraindicated in pregnancy by 1 or more of t !" texts L89- 9 > hi%torical Chine%e (+*, +5) J .odern Chine%e (>59)
SP9: 9 - hi%torical Chine%eE=apane%e (, +>, +, +5) J .odern Chine (>5, *, ) CV9 9 hi%torical Chine%eE=apane%e (++, +, +5) J .odern =apane%eEChine%e (>, >, ) B9>+ 9 > hi%torical Chine%e (+>, +5) J > .odern Chine%e (>, ) CV9: 9 + hi%torical =apane%e (++) J + .odern Chine%e (+) CV9 9 > hi%torical Chine%eE=apane%e (5,++) CV9- 9 > .odern Chine%e (>, ) CV9? 9 > hi%torical =apane%e (+*,++) SP9+ 9 + hi%torical Chine%e () S#9+> 9 + hi%torical Chine%e (+5) S#9> 9 + .odern Chine%e () You're Reading a Preview BL9:* 9 + .odern Chine%e () Unlock full access with a free trial. BL9:? 9 + .odern Chine%e ()
K89>+ 9 + hi%torical =apane%e (++) With Free Trial Download CV9+* 9 + .odern Chine%e (>) CV9++ 9 + .odern Chine%e () #a1le > %ho/% % that there are no ni;er%all" accepted acpoint contraindication% dring pregnanc"' Not onl"Sign i% up there to votegeneral on this title incon%i%tenc" in the hi%torical literatre (+9>>), incon%i%tenc" Useful Not useful in the .odern literatre (>9) 1t there i% al%o con%idera1le incon%i%tenc" 1et/een the hi%torical and .odern literatre' So.e .odern Chine%e
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&hat di!!erence% e0i%t 1et/een hi%torical, .odern Chine%e and .odern =apane%e tradition% that .a" accont !or %ch ;ariation &h" do none the %e;en .odern =apane%e and .an" o! the %i0 .odern Chine%e te0t% contraindicate needling o! the%e !or point% in pregnanc" A% 8 ha;e di%c%%ed el%e/here, there are .aor di!!erence% in the needling techni<e% 1et/een =apan and China 3Birch, Felt +5556, perhap% thi% i% the rea%on' #o e0plore thi% <e%tion 8 e0a.ine the reco..ended needl depth% !or acpoint% in the hi%torical and .odern period% and then %peci!icall" !or the%e !or acpoint%' #ecommended needling depths
A% the .odern %"%te. o! acpnctre %tarted to 1eco.e a;aila1le in th &e%t, certain .odern Chine%e te0t% /ere tran%lated' #he $ngli%h lang 1oo2 Acpnctre a Co.prehen%i;e #e0t 37Connor, Ben%2", +5+6 /a% one o! the earl" in!lential te0t% in the &e%t' 8t /a% al%o i.portant in China' 8t i% a tran%lation o! te0t% /ritten in +5:> and +5?- 1" the Shanghai College o! #CM 37p'cit p' 0;6' 8t re!lect% %o.e o! the pioneeri /or2 o! the Shanghai College !ro. the +5*% and +5:*%' 7ne o! the . %tri2ing change% in acpnctre de%cri1ed in thi% te0t i% the rather larg increa%e in the reco..ended depth o! needling !or the acpnctre point%' #o e0plore thi% change %"%te.aticall" 8 e0a.ined the reco..ended depth% o! in%ertion in cn !or all the .aor acpnctr You're Reading a Preview point% in the !ollo/ing i.portant hi%torical acpnctre te0t% hen =i full en access with trial.hen =i # =ing 3&ang Gi =ing 3Hang F9.i, >>6,Unlock #ong Sha free e &ei9"i, +*>?6, hen =i =i Sheng =ing 3&ang hi9@hong, +>>*6, hen =i Download With=i FreeDa Trial = Ging 3ao &, +>56, and the hen Cheng 3Gang =i9@ho, +:*+6' Ba%ed pon the n.1er o! point% reco..ended !or each needle depth, it /a% then po%%i1le to calclate the o;erall .ean depth o! in%ertion and .edian depth o! in%ertion a% indicator% o! the relati;e depth% o! in%ertion !or each te0t' #a1le li%t% the n.1er% o! point% in each te0t reco..ended in the depth range% gi;en, the o;erall .ean Sign up to vote on this title depth o! in%ertion, and .edian depth o! in%ertion !or the%e !i;e hi%toric Useful Not useful %orce% (!or point% that /ere gi;en a range o! depth o! in%ertion, the . point o! that range i% %ed in thi% ta1le)'
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#ABL$ mean$
numbe r %'& recom mende d at ()1-()! cun
numbe r %'& recom mende d at ()!"()* cun
numbe r %'& recom mende d at ()*"1)( cun
numbe r %'& recom mende d at 1)1-1)" cun
numbe r %'&
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()+1 %()!&
+5+ 5: - (?O)Download (>5O) (+-O) With Free Trial
+ (*O)
+ (*O)
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*'>O (*O)
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recom mende d at 1)*-!)( cun
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(+:*+) ()+! Mean (.edian) %()!&
>5'-O (>5O)
+-':O (+O)
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#ABL$ mean$
numbe
numbe
Useful
numbe
Not useful numbe
numbe
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(+5+)
%()."&
Fnda.e ()"+ %()+"& ntal% (+5) Mean
()*,
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(O)
(++O)
(O)
(-O)
(++O)
?(>+O)
+: (--O)
++? (O)
(>O)
+ (*O)
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7ne can %ee that all the .odern Chine%e te0t% generall" reco..end deeper needle in%ertion% than the hi%torical te0t%' 7ne can clearl" %ee a %hi!t a/a" !ro. %e o! point% /ith %hallo/er needling to deeper needlin /ith a .ore than *O increa%e in reco..ended needling depth o;eral &hile the actal .ea%re o! the cn can 1e ;aria1le a% it i% a relati;e .ea%re !or di!!erent people and on di!!erent area% o! the 1od", it ha% pro1a1l" not changed that %igni!icantl" o;er ti.e' 7ne .odern Chine%e re%earcher ha% e%ti.ated that the cn i% appro0i.atel" >'> c. 3Che et al, +5?56, /hile cla%%ical %cholar% ha;e e%ti.ated that the cn /a% a1ot >'+c. 3Harper, +5>6' Acupoint comparisons
8! /e loo2 at the .o%t co..onl" contraindicated acpoint% in pregnanc Reading L89-, SP9:, CV9 and B9>+You're /e !ind thata Preview the" are all needled di!!erentl" .odern China co.pared to Unlock hi%torical te0t%' #a1le %ho/% the%e full access with a free trial. ;ariation%' Download With Free #ABL$ Trial
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#ong en Sh e
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*' cn
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B-21
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no needle
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(+5*) AC# (+5+)
*'9+'* cn
+'9>'* cn
+'*9+' cn
*'9+'* cn
CAM (+5?)
*'9+'* cn
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*'9*' cn
*'9+'* cn
*' 9*' cn *'9*' cn
enerall" L89- and SP9: are needled a1ot t/ice a% deep in the .odern Chine%e te0t% co.pared to the hi%torical Chine%e te0t%' CV9 and B9>+ appear to 1e needled arond the %a.e depth% co.paring hi%torical and .odern te0t%, 1t the" 1oth appear to 1e needled di!!erentl", pro1a1l" re!lecting greater anato.ical 2no/ledge in the .odern period' For e0a.ple CV9 doe% not ca%e pro1le.% /ith !ertilit" th% the contraindication o! needling it i% dropped in the .odern te0t%' 8.pro;e anato.ical 2no/ledge o! the lng% indicate% the need !or a generall" %hallo/er approach to needling B9>+' /ummary
#he !act that there i% ;er" poor agree.ent 1et/een .odern and hi%tor %orce% on the contraindication% o! SP9:a and L89- in pregnanc" and tha You're Reading Preview there ha;e 1een change% in the /a" that the%e point% are needled in th Unlock full access with a free trial. .odern Chine%e te0t% co.pared to the hi%torical te0t% %pport% the interpretation that it i% not the acpoint% per %e that are contraindicate Withon Free Trial point% that .ight 1e 1t rather the %e o! tho%e Download techni<e% tho%e contraindicated' Bt e;en thi% interpretation .a" 1e %tretching the !act #here i% con%idera1le incon%i%tenc" 1et/een hi%torical %orce%, 1et/een hi%torical and .odern %orce% and 1et/een di!!erent .odern tradition%
Frther, there i% no e;idence !ro. the .edical literatre o! actal Sign up to vote on this co.plication% dring pregnanc" !ro. doing acpnctre a%title no ad;er%e Useful Not useful 3Birch et e!!ect% /ere !ond in an" o! the %r;e"% or literatre re;ie/% >**-6' Man" patient% recei;e acpnctre !ro. % /hile pregnant and 1e!ore the" reali@e that the" are pregnant' #here are no report% o!
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#ecommendations:
M" !eeling i% that it i% perhap% 1etter not to tr" to .a2e !ir. polic" %tate.ent% a1ot contraindication% o! acpnctre dring pregnanc", e%peciall" a% the" pertain to the %e o! %peci!ic acpnctre point%' #he i%%e% in;ol;ed are co.ple0 and, .ore i.portantl", there are no report ad;er%e e!!ect% a%%ociated /ith acpnctre in relation to pregnanc"'
#eferences 9 Anon (+5*)' $%%ential% o! Chine%e Acpnctre' BeiingI Foreign Langage% Pre%%'
9 Birch S' (+55>)' Na.ing the nna.ea1le A hi%torical %td" o! radial pl%e %i0 po%ition diagno%i%' #raditional Acpnctre Societ" =ornalI + >9+' Al%o in =ornal o! the Acpnctre Societ" o! Ne/ Gor2I +55-, + 9- +59>'
9 Birch S, Felt ' (+555)' Under%tanding Acpnctre. London, Chrchi Li;ing%tone'
9 Birch S, Keppel He%%elin2 =, =on2.an FAM, He22er #AM, Bo% A' (>**Clinical re%earch o! acpnctre Part one 9 /hat ha;e re;ie/% o! the You're Reading a Preview e!!icac" and %a!et" o! acpnctre told % %o !ar = Alt Co.ple. Med' Unlock full access with a free trial.
9 Chen &C, et al' (+5?5)' #he deter.ination o! the depth o! pnctre ! the de;elop.ent o! needling %en%ation' National S".po%ia o! Acpnct Download With Free Trial and Mo0i1%tion and Acpnctre Ane%the%ia' Beiing, =ne +9, +5?5, page% ++9++-' 9 Cheng N' (+5?)' Chine%e Acpnctre and Mo0i1%tion' BeiingI Foreign Langage% Pre%%' 9 $lli% A, &i%e.an N, Bo%% K' (+5)' Fnda.ental% o!onChine%e Sign up to vote this title AcpnctreI Broo2line, Ma%%ach%ett%, Paradig. Useful P1lication%' Not useful
9 ao &' (+>5)' hen =i = Ging, #aipei, Hong Ge Boo2%hop P1li%hin Co.pan", +5'
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*-9' 9 7Connor =, Ben%2" D' (+5+)' Acpnctre a Co.prehen%i;e #e0tI Seattle, $a%tland Pre%%'
9 Po.eran@ B' (+55)' Scienti!ic 1a%i% o! acpnctre' 8n St0, B Po.eran@' Ba%ic% o! Acpnctre' Berlin, Springer9Verlag, !orth editio pp' :9?>' 9 4i ML' (+55)' Chine%e Acpnctre and Mo0i1%tion, $din1rgh, Chrchill Li;ing%tone' 9 #ana2a #H' (+55:)' Pro!e%%or Ni%hio% re%earch9acpnctre and the atono.ic ner;o% %"%te.' N A.er = 7rien Med' , :9+*' 9 &ang &ei9"i' (+*>?)' #ong en Sh e hen =i # =ing' #aipei, & ho P1li%hing Co.pan", +5?:'
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