Dkaraba Introhowacu LN TCMWT

TCM Wisdom TubeTM
Intro to How Acupuncture Works:

Simplify How You Educate
Patients and Colleagues
by
David Karaba, OMD, LAc
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Items Covered in this Webinar

Intro to How Acupuncture Works:
Simplify How you Educate
Patients & Colleagues
Tel: (626) 780-7182 Fax: (626) 609-2929

Web: www.elotus.org Email: info@elotus.org
Tissue Response
Simplified Explanation
Technical Neuro-endocrine-immune response
Basic Neurological Activation and Response
8 hour course
Detailed Neuro pathways and responses
Effects on Autonomics
Understanding the physiology of Master Tungs
method of distal pts and how to explain how they
work.
And More (Reviewed and expanded at conclusion)
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Shall not be copied, duplicated, or distributed in any format or be used for teaching without prior written consent from Lotus Institute of Integrative Medicine
Patient Question:
So
How Does Acupuncture Work?
Usually after:
Does It Hurt?
Puncture Wound
Acupuncture is a Puncture Wound.
A puncture wound is a serious threat to the Body.
It is a breach of the skin barrier system
The body mounts a major response to neutralize any potential
pathogens
What I tell my patients
Puncture Wound
The Body responds to investigate and
neutralize any Pathogens or Toxins
Vasodilation / Inflammation (initial part of healing)
Allow WBCs to migrate out of vessels to find any bacteria,
venom, or poison.
Mast cells, basophils
Histamine
Heparin
Leukotrienes
Arachidonic Acid
Prostaglandins
Immune compliment
Chemotaxis (i.e. tells WBCs where to go)
Venom
Snake bite
Insect bite
Bacteria
Abrasion
Nail
Poison
Plant thorn, Animal, etc.
Puncture Wound
The Body doesnt find any pathogens or toxins
Only a Stainless Steel Sterilized - One-Time Use Needle
Investigation takes some time (~15 min)

When the body realizes that its a false alarm
it turns off the inflammation.
It does by creating anti-inflammatory substances
This is natural part of homeostasis
Otherwise we would be inflamed all the time.

Tel: 626-780-7182 Fax: 626-609-2929 Website: www.eLotus.org Email: info@eLotus.org
Shall not be copied, duplicated, or distributed in any format or be used for teaching without prior written consent from Lotus Institute of Integrative Medicine.
Puncture Wound
These anti-inflammatory substances circulate in local
tissue and reduce inflammation that may be present
Muscle Injuries
Arthritis
Tendonitis
Etc.
Puncture Wound
Further still, the body creates natural pain
killers (opioids, endorphins, enkephalins, etc.)
to turn off the False Alarm signal as well.
Further, sometimes the body forgets or doesnt

remember to turn off inflammation (i.e. chronic
inflammation)
Chronic pain that is filtered (i.e. ignored)
Acupuncture (needling) evokes a high enough threshold to
re-investigate
Puncture Wound
Note:
Alternatively Occasionally there are pathogens in the body as is
the case when someone is sick with a cold or flu.
(Provided the Root is Strong)
We want to stimulate aggressively and remove

needle quickly so the body goes out and seeks
pathogens and puts out the fire
Needle Manipulation
Characteristics of treatment controlled by
strength of needling, insertion depth, and
retention time
Stronger stimulation produces more needle
induced tissue damage products
Longer needle retention time favors restorative
anti-inflammatory response
Leaving needles in situ may calm body to much and allow

pathogens to enter further into the body.
Muscle Spasms
Muscle Spasms
Injured muscles or joints can result in

spasmodic muscles that tighten to reduce
movement as one heals (guarding
phenomenon).
Chronic tightness in muscles (and m. spindle
fibers) can hinder rehabilitation.
Needling (puncture wound) is higher priority

than guarding phenomenon.
Allowing blood flow necessitates relaxation of
the muscles
As WBCs looks for any venom, bacteria, or poison.
Blood flow allows metabolitic build up (i.e.

lactic acid, etc.) to be released from m. cells
And allows re-supply of oxygen and nutrients
to nourish m. cells

Muscle Spindles
and Golgi Tendon
Organs
Muscle Spasms
Resetting of muscle spindle cells allows
stretch and consequent progress towards
restoration of full range of motion
Effects can be immediate

Known as quick needle technique
Oblique Acupuncture
Also called trigger point therapy
Trigger response or muscle twitch is to resetting of
muscle spindle and tendon spindle fibers.
It has been calculated that

only 1/3 of the fibers of a
muscle nerve consists of
motor axons connected to the
muscle fibers,
While more than an half
consists of fibers conveying
signals from the
neuromuscular spindle to the
spinal marrow and vice
versa.
Known as Gamma Loop Reflex
HDNJ: Jing Jin treatment: 3 or 2 needles
Muscle Spindle Fibers

Spinal Reflexes
1. Myotatic (stretch) reflex
Monosynaptic
Muscle spindle afferents (1A)
Principles of Anatomy & Physiology, 10th E., Tortora, Grabowski
Spinal Reflexes
Spinal Reflexes
2. Inverse myotatic (tendon organ)
3. Gamma-loop reflex
Golgi tendon organ receptors

Inhibitory input to same muscle
Protects tendon and muscle from
injury due to excessive tension
33% of ventral root axons are from

gamma motor neurons
Gamma motor neurons innervate
intrafusal muscle fibers
Maintain sensitivity of spindle during
contraction of muscle
Increase muscle tone by triggering
myotatic reflex contraction of muscles
(postural)

Muscle Spindle Afferents

Static load spindle serves as feed back control
sensor essential to motor function
Disorders in this system can result in paralysis,
stiffness, pain and tenderness
Static load fibers needed to provoke PS
Spindle affected by local temperature and
pressure which can influence PS
Puncture Wound
Muscle spindles
It has been calculated that only 1/3 of the
fibers of a muscle nerve consists of motory
axons conducing to the muscle fibers, while
more than an half consists of fibers conveying
signals from the neuromuscular spindle to the
spinal marrow and vice versa.
The neuromuscular spindle is richly supplied
with nerve fibers and blood vessels.
Organ Referred Pain Patterns
How it works to treat organs

Anti-inflammatory substances may also go to other areas
at the same segmental level (region of the spinal chord)
(Enhanced by propagated sensation, PS)
Organ referred pain concept (viscero-somato effect)

Originating from the same segmental level of the spine
Somato-Visceral effect:
Because a puncture wound is serious (high enough threshold),
the brain isnt sure where signal is coming from and sends
resources (&/or has specified CNS neurological responses) that
effect both regions to produce the desired effect.
Desired effect is at the discretion of Doctor
(i.e. Technique employed and used)
Neuroendocrine Mechanisms of Acupuncture in the Treatment of Hypertension
Wei Zhou, John C. Longhurst. Evid Based Complement Alternat Med. 2012; 2012: 878673.
Published online 2011 December 18.
Visceral
Relationships
|
Recognized in terms of
organ referred pain
reflecting in certain body
regions
Also produce organ traction

as noted during surgery
Viscerovisceral
relationships occur as well
where function or treatment
stimulation of one organ
produces autonomic
reflexes in another organ
Puncture Wound
Basically, Acupuncture is an ingenious way to
trick the body into healing itself by bringing
blood flow to the region and related areas
Providing Oxygen, nutrients, defensive substances,
and endocrine substances to these regions
Its all about the blood flow

How to Explain it to Kids
Fine Vessels-Sunmai
Arterioles, Venules
and Capillaries
Critical Nodes-Jie
Propagated Sensation Pathway
Fire Alarm analogy
Fire Alarm
Fire Drill at school (or accidental)
Everybody moves to designated spaces
Fire fighters come to investigate
Fire fighters dont find a fire
May find other areas of concern and remedy
Fire alarm turns off

Fire fighters go back to station
Kids and teachers go back to class
Superficial
Lymphatics
Skin
Muscle
Tissue
Veins
Arteries
Longitudinal Distribution
Vessels-Jingmai
Collateral Vessels-Luomai
at each Node
Connecting-Luomai
Between Paired Zangfu
Vessels in the Extermeties
and Other Regions of Body
Basic Concept of Jingluo Theory
Tendency to remember such special (or unusual) days

Dao of Chinese Medicine. Donald Kendall, Oxford University Press, 2002
Defensive Role of Skin

Chinese noted skin has primary defensive role
Body evolved efficient defense against pricking
injuries, pathogenic assault, insect bites, and
animal bites
Involves many factors of blood coagulation
system which then triggers immune complement
system
Needling Therapy
Needling therapy
effects the body first
at the capillary /
cellular level
Sun Mai
Second sensory
nerves that affect the
CNS
Defensive Role of Skin

Has complex neurovasculoimmune network of
cutaneous tissues, fine vessels, immune cells,
somatic afferents, and SNS fibers
Important mediators include substance P (NK 1),
bradykinin (B1 & B2), and cytokines
How Does Acupuncture Work?

Needle
Insertion
Causes the production of Bradykinin via the

Blood Coagulation tissue reaction and
Immune Compliment system activation
Stimulation of Substance P containing afferent

nocioceptive pain fibers activating local, spinal and
brainstem restorative processes.
Activates Descending Control from Brain Stem to the
spinal cord and finally to trauma site.
Inhibition of nocioceptive Pain signals
Restoration of blood flow and vascular tone
Relaxation of residual muscular tension (antispasmodic)
Promotes tissue repair

Hageman Factor XII

Dependent Reactants
Needling Mechanisms
Kinin Generating
Protease
Kallikrien
Complement Anaphylatoxin
C3a, C5a, or C4a
C5a
CA++
IGE
NA+
Heparin
+
Histamine
IGE
Receptors
Granules
Mast Cells
& Basophils
Dao of Chinese Medicine. Kendall,

Oxford University Press, 2002
Selected
Phospholipids
Mast Cells
and Baosophils
Other Cell
Types
Arachidonic
Acid
Cyclooxygenase (3)
5-HPETE
Leukotriene A4
PGG2
5-HETE
SRS-A
Pathway
LTB4
Cleaved by
Aryl
Arly Sulfatase B
LTC4
LTD4
Modulates motility and

possibly glucose transport
Potent
chemotactic
agent
comparable
to C5A
100X
1000X
More potent than histamine

in producing bronchospasm
100X
100X
More potent than histamine

on vascular permeability
LTE4
Prostaglandin H2
Causes dissagregation
of platelets
PGI2
Potent broncho and

vasodilators that regulate
tissue microenviornment
PGE2
Powerful bronchial
constrictor
PGF2
Potent vasodilator
preferently in human
lung
PGD2
Potent regulators
of blood coagulation
and homeostasis
1. Blocked by steroidal antiinflamatory drugs
2. Blocked by 5-LOX inhibiters
3. Blocked by selective and non-selective non-steriodal antiinflamatory
drugs (NSAIDs) as COX-1 and COX-2 inhibiters
Selected Phosopholipids
Leukotrine (LT A, B)
SRS-A (LT C, D, E)
Prostaglandins
PGE1
GGE2
PGF2a
PGD2
PGI2 - PGF1a
Thromboxane A2
Thromboxane B2
Platelet Activating Factor
Leukotrienes
Phospholipase A2 or
Phospholipase C + Diglyceride Lipase (1)
5 - Lipoxygenase (2)
Histamine
Heparin
ECF-A
NCF-A
Arylsulfatase A&B
Thromboxane A2
LTB4: potent chemotactic agent comparable to

C5a
LTC4 and LTD4: 100 to 1000 times more
potent than histamine in producing
bronchospasm
LTD4 and LTE4: 100 times more potent than
histamine on vascular permeability
LTC4, LTD4, and LTE4 cleaved by arly
sulfatase B from eosinophils
Thromboxane B2
Dao of Chinese Medicine. Kendall, Oxford University Press, 2002
Prostaglandins
PGI2: causes disaggregation of platelets
PGE2: potent broncho and vaso dilators that
regulate tissue microenvironment
PGF2: potent bronchial constrictor
PGD2: potent vasodilator in human lung
Mast Cell
Are heavily granulated wandering cell found
in connective tissue beneath epithelial
surfaces
Granules contain histamine, heparin, and
many proteases
Have IgE receptors and like basophils they
degranulate when IgE coated antigens bind
to their surfaces

Mast Cell
Also participate in non-specific natural immunity
activated by Complement
Marked mast cell degranulation produces
allergic reactions and can produce anaphylaxis
Eosinophil
Have a short half life in circulation and
attracted to surface of endothelial cells
Like neutrophils, they release proteins,
cytokines, and chemokines producing
inflammation
Capable of killing off invading organisms
Basophil
Also enters tissue and release cytokines and
proteins
Resemble but are not identical to mast cells,
but do contain histamine and heparin
Participate in immediate-type hypersensitivity
Ranges from mild urticaria, rhinitis, and to
severe anaphylactic shock
Eosinophil
Abundant in mucosa of gastrointestinal tract to
defend against parasites
Circulating eosinophils increased in allergic
reactions
Includes asthma, other respiratory diseases,
and gastrointestinal diseases
Platelets
Platelets
Smallest corpuscular components of human

blood (diameter 2-4m)
Have a half life of about 4 days
About 300,000/mm circulating in blood, and
25% more sequestered in spleen
Have primary role in clot formation
Membrane have receptors for collagen, ADP,
fibrinogen, and vessel von Willebrand factor
Cytoplasm contain actin, myosin, glycogen,

lysosomes, and two types of granules
including serotonin
Aggregation fostered by platelet activating
factor (PAF) secreted by neutrophils,
monocytes, and platelets

Nociceptive Activation
Bradykinin B2 from blood coagulation triggers

nociceptive fibers
This activates three difference key events that
mediate needling response:
1. Activates axon reflex to sustain inflammation
2. Sends nociceptive signals to spinal cord and
ascending tracts in spinal cord
3. Provokes muscle spindle mediated reflexes
activating propriospinal system
Blood Coagulation System

Needle damage products activate Hageman
Factor XII
XIIA simultaneously activates the kinin,
fibrinolytic, and coagulation features of blood
coagulation system
Principal effect is a localized immune defense to
needle involving vasodilatation, immune cell
egress, nociceptive excitation
Needle Insertion
Slide Title
Damage to Endothelium of Small

Blood Vessels and Capillaries
Collagen, Microfibrils
and Basement Membrane
Text
XIIa
Hageman Factor XII
Text
Kinin Protease
from Mast Cells
& Basophils
(Plasma & Tissue Zymogen)
Text
Plasmin
Plasmingen
Text
Text
Inhibited by Heparin
XIIa
Prothrombin
Thrombin
XIIa
Blood Coagulation
System Provokes
Needling Response
Kallikrien
Chemotaxis
Plasma Kininogen
Bradykinin
Potent Vasodilation and
Smooth Muscle Contraction
Nociceptive
Excitation
Immune Complement System

Basic defense mechanism that uses at least 30
proteins in circulating blood
Named "complement" because system helps
antibody kill invaders
Marks any cell that does not have certain
protective protein coatings
However, has an alternative pathway that is
activated by minute tissue trauma
Immune
Compliment System
Classical Pathway
involves attack by C1 when
antibody bound to antigen in
an antigen-antibody complex
is encountered

Immune Compliment System

Immune Complement System
Alternative Pathway
C3
Plasmin
C3b
Factor B
C3b,B
Fractor D
Thrombin
Amplification
C3b,Bb
C3
Activated by Plasmin
to Provoke Immune
Response to Needling
Anaphylatoxin
C3bn,Bb
Alternate pathway is activated by the blood

coagulation system response to tissue damage
Does not require antibody to function
Interacts with blood coagulation system to
amplify inflammatory response
Properdin
C3bn,P,Bb
C5
C6
C7
C8
C9
Anaphylatoxin
Chemotaxis
Lysis, Cytotoxicity
Dao of Chinese Medicine. Kendall

Oxford University Press, 2002
Immune Compliment System:

Alternative Pathway
Plasmin
Complement Alternative
Pathway
+ =
C3 activated by Plasmin
immediately forms C3b
binding with Factor B
which then activates more C3
in a feed-forward amplification
Combined Action
Blood coagulation system and alternative
pathway immune complement system interact
to amplify response
C3 causes mast cell and basophils
degranulation and release of kinin protease
This preferentially causes more production of
bradykinin to stimulate nociceptive fibers
Complement Alternative
Pathway
Plasmin activates C3 provoking the immune
complement system
Complement proteins C3 and C5 cause potent
vasodilatation by degranulating mast cells and
plasma basophils
Released heparin inhibits thrombin
Needling Mechanisms
Needle
Insertion
Hageman
Factor XII
Microfibrils and
Basement Membrane
Damage Products
Factor XIIa
Plasminogen
Kininogen
Plasmin
Activates C3
Prothrombin
(Inhibited by
Heparin from
Mast Cells)
C3
Immune
Complement System
Alternative Pathway
Blood Coagulation
System
Kinin
Protease
Bradykinin
C3
C5
Amplification
Loop
C3b,Bb
Mast Cell and

Arachidonic Acid
By-products
Histamine
Heparin
Nociceptive Excitation
Via B2 Receptors
ECF-A
NCF-A
LT C, D & E
PGE2
Potent Local
Vasodilation
Immune Cell
Attraction
Dao of Chinese Medicine, Figure 14.1,

Oxford University Press 2002

Sensory Neuron Fiber Types
Spinal Chord
Dorsal Horn
I, II, III, IV, V, VI
Intermediate Zone
VII
Ventral Horn
VIII, IX
Grey Matter
(surrounding
central canal)
X
Neuroanatomy through Clinical Cases. Blumenfeld, 2002
Nocioceptive Fibers Subgroups

A-Delta
Nociceptive Fibers
C-Fiber
Myelinated, Large
Non-Myelinated, small
Respond to mechanical stimuli

and some to thermal also
Responds to any noxious stimuli.
Receptive fields consist of

cluster of small spots
Receptive field is a single area

rather than clusters
May be sensitized
May be sensitized.
Resistant to local anesthetics

but susceptible to pressure
Susceptible to local anesthetics
Inactivated with higher temp
Inactivated at temp 55C
Responsible for 1st pain (early,

sharp, brief pain)
2nd pain (dull, prolonged pain)
Acupuncture studies have consistently shown

both A and C fiber participation
Typically more A fibers then C fibers
C fibers clearly participate in axon reflexes
Both A fibers and C fibers can activate
propriospinal afferents
Nociceptive Fibers
Neurogenic Inflammation
A fibers have a broader area of coverage and

wider distribution in spinal cord laminae
A fibers provide quick proprioceptive
response, especially to pricking injuries
These features may favor A fibers in
mediating propagated sensation and directing
descending control responses
C fibers are interconnected with process of

inflammation
Action potentials in certain branches cause
axon reflexes
Releases Substance P on capillary bed and
mast cell to cause degranulation
Sympathetic activate axon reflex to constrict
deeper veins to enhance cell egress

10
Somatosensory Pathways
Posterior Column
Medial Lemnisical
Pathway
Sensory
Vibration
Joint Position
Proprioceptive
Muscle Spindle
Golgi Tendon
Fine Touch
A-alpha, I
A-beta, II
Ascending Pathways
ALT comprised of spinothalamic (STT),
spinorecticular (SRT), and spinomesencephalic
(SMT) tracts
Somatic and visceral nociceptive signals
synapse on ALT crossed fibers
Major portion of SRT and SMT fibers project to
the pons, midbrain, and medulla
A small portion of STT fibers projects to the
thalamus, which sends fibers to sensory cortex
Proprioception
Sherrington: defined proprioceptors as
sensory receptors for stimuli that "are
traceable to actions of the organism itself, and
since the stimuli to the receptors are delivered
by the organism itself, the deep receptors may
be termed proprioceptors...
(1906) Brain 29:467-482
Proprioception Receptors
Joint receptors: sensory endings in joint
Cutaneous receptors: movements and
postures cause deformations of skin
(mechanoreceptors)
Specialized muscles receptors:
Muscle spindles respond to stretch
Golgi tendon organs sensitive to changes in tension
Essential Properties
Proprioception
Amount of muscle activity mobilized by
proprioceptive inputs is small
Adequate stimuli for proprioceptors arise from
actions of organism itself
System can be stimulated by needling
superficial body
Slide Title
Anterior Lateral
Pathways
Sensory
Pain
Temperature
Crude Touch
Pressure
A-delta, III
C, IV

11
The Yin and Yang of the Spinal Chord
Corticospinal
Tract
Descending
Motor
Pathway
Text
Text
Text
Text
Text
Descending Tracts from

Primary Motor Cortex
Somatotopic Organization of
Spinal Chord
Motor:
85%
Descending
Corticospinal
Cross over
pyramidal
decussation to
form:
Lateral
Corticospinal
Tract.
Remaining
Make Anterior
Corticospinal
Tract.
Blue:
Ant. Cortico Red:
Rubrio Note:
Assoc.
Neurons
Crossing to
opposing sides
Acupuncture and Internal Medicine

Descending control from
the brain returns to the
specific level where
activation occurred
Restorative processes
are activated for both
muscles [motor] and
internal organs (along
with related vessels)
[autonomic motor]
Somatic Afferents
Nociceptive (1)
Needle
Insertion
Skin and
Superficial
Tissue
Gamma
Loop
Ascending
(4)
Pathways (3)
Motor (5)
Muscle
Autonomic
Motor (6)
Blood
Vessels
Inhibition (9)
Spinal Cord
Dorsal Horn
Proprioceptive
(2)
Spinal Cord
Ventral Horn
Brain
Response (8)
Autonomic
Motor (7)
Visceral
Afferent (10)
Dao of Chinese Medicine, figure 14.4,

Internal Organs

12
Acupuncture and Internal Medicine

Needle insertion along
vessel pathway relative
to location of problem
Proximal
Nodes
Descending
Inhibition
Detailed schematic
shows specific neural
pathways along with
specific
neurotransmitters
Brain
Stem
Segemental
Level
Area Proximal
to Problem
Afferent
Signals
Local and
Adjacent
Nodes
Region of
Problem
Segemental
Level
Distal
Nodes
Area Distal
to Problem
Segemental
Level
CNS Descending
control is shown as
separate from stress
analgesia which
utilizes
norepinephrine rather
than natural opiates
Propagated
Sensation
Sensations of energy
moving up or down the
arm (or leg) are properly
known as propagated
sensation
SENSORY CORTEX

Norepinephrine
Neurons
Dorsal Root Ganglia
A- and C Nociceptive Neurons
& Group II Static Load Neurons
Node 3
PS
Automatic reflexes
occurring in the spinal
cord levels reverse the
flow of sensory nerves
and activate adjacent
areas of skin along the
longitudinal pathway of
related vessels and
nerves
Node 2
Antidromic
Pathway
THALAMUS
PERIAQUEDUCTAL GRAY
DORSAL RAPHE
PS as Neural Reflex
Serotonergic
Neurons
Enkephalin
Interneuron
Anterior
Lateral
Tract
Propriospinal
Pathways
DRR
Tract of Lissauer
and DLF
Antidromic
Pathway
DRR
Dorsal
Columns
PS
Node 1
Needling Sensation &
Proprioceptive Signals
Ventral
Funiculi
Result of stimulating high threshold SP

nociceptive fibers to activate muscle spindle
afferents to produce DRRs the DLF
Afferent neural signals enter spinal cord over
several segmental levels
This overlap allows higher and lower levels to be
activated if threshold conditions permit
Progressive activation of overlapping segments
produces PS along nodal pathways
Spinal Cord
Segment
Skin, Muscle, Connective

Tissue, Fine Vessels, Afferent
Nerve Endings, & Intrafusal
Muscle Spindle Fibers
Acupuncture evidence for

Restorative Effects in CTS
Saturday Lecture
CNS / Brain pathways
Acu Mechanisms and pathways
Significance to Tx
HDNJ
(LAPD)
Balance Method / Master Tungs Points

Acupuncture may benefit CTS patients via both peripheral (e.g.
increased blood flow to median n. via vasodilatative peptide
release) and central mechanisms (e.g. the cholinergic antiinflammatory pathway 5 via hypothalamic activity).
Proprioception
Embryology
Cerebellar coordination patterns

Association neurons on midbrain tracts
Central Processing of Acupuncture Stimuli in Carpal Tunnel Syndrome

Vitaly Napadow, et al

13
Saturday Lecture (cont.)
Questions /Comments
Propagated Sensation (PS)

ANS
Sedation and Tonification
Sympathetic activation
Pathogenic response
Predation nerve block
Parasympathetic
Relaxation Restoration
Chronic conditions
Inflammation

Pacific Center for Optimum Health
250 E. 17th St., #220
Costa Mesa, CA 92627
pacificacupuncture@gmail.com
PENS Perspectives
This webinar is sponsored by:
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Email: sales@evherbs.com

14
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Our goal is to support you in improving your clinical skills, and
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To learn more about Evergreen Herbs and our products, please

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TCM Wisdom TubeTM

Intro to How Acupuncture Works:

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Items Covered in this Webinar

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How Does Acupuncture Work?

What I tell my patients

Investigation takes some time (~15 min)

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Further, sometimes the body forgets or doesnt

We want to stimulate aggressively and remove

Leaving needles in situ may calm body to much and allow

Injured muscles or joints can result in

Needling (puncture wound) is higher priority

Blood flow allows metabolitic build up (i.e.

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Effects can be immediate

It has been calculated that

Known as Gamma Loop Reflex

HDNJ: Jing Jin treatment: 3 or 2 needles

Muscle Spindle Fibers

Principles of Anatomy & Physiology, 10th E., Tortora, Grabowski

2. Inverse myotatic (tendon organ)

Golgi tendon organ receptors

33% of ventral root axons are from

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Muscle Spindle Afferents

Organ Referred Pain Patterns

How it works to treat organs

Organ referred pain concept (viscero-somato effect)

Also produce organ traction

Its all about the blood flow

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How to Explain it to Kids

Fire Alarm analogy

Fire alarm turns off

Basic Concept of Jingluo Theory

Tendency to remember such special (or unusual) days

Defensive Role of Skin