Emily Mangan Traditional Chinese veterinary medicine (TCVM) has been used for the treatment and prevention of disease in veterinary species for 4,000 years, and has utilized acupuncture in horses for the last 2,000 years [1]. Common TCVM modalities include acupuncture, Chinese herbal medicine, Tui-na, and food therapy [1]. The oldest surviving text describing a complete and organized system of diagnosis and treatment using acupuncture in humans was The Yellow Emperor’s Classic of Internal Medicine, dated around 100 BCE [2]. This text described channels within the body in which Qi, or vital energy, flowed, as well as the current Taoist philosophies of the time. Later, during the Ming Dynasty (1368–1644), The Great Compendium of Acupuncture and Moxibustion was published, which formed the foundation of modern acupuncture [2]. However, there exist records of application of Chinese medicine in horses long before these texts were published. Some of the earliest records of the application of Chinese medicine in veterinary species describe the practitioner, Zao Fu, treating horses with acupuncture during the Zhou-my-gong period (947–928 BCE), and the equine veterinary practitioner Bo Le, who lived from 659–621 BCE, treating horses and selecting good racehorses from unproven stock (Figure 5.1) [1]. Bo Le’s Canon of Veterinary Acupuncture is considered the first true and complete veterinary text and included diagrams of equine acupuncture points (Figure 5.2) [1]. Figure 5.1 Portrait of Sun Yang (Bo Le), an equine veterinary specialist during the Qing-mu-gong period (659–621 BCE) [1] From Xie H, Chrisman C. Equine acupuncture: from ancient art to modern validation. Am J Trad Chin Vet Med 2009;4:1–4; with permission. Figure 5.2 Acupoint chart in Bo Le Zhen Jing in Shi Mu An Ji Ji (published between 618–907 CE) [1] From Xie H, Chrisman C. Equine acupuncture: from ancient art to modern validation. Am J Trad Chin Vet Med 2009;4:1–4; with permission. The number of veterinary texts available continued to grow over the next millennia, with Collection of Effective Prescriptions for Equine Diseases written by Wang Yu during the Song dynasty (960–1279 CE), Treatment of Sick Horses written by Bian Guan-gou during the Yuan dynasty (1279–1368 CE), and Yuan-Heng’s Therapeutic Treatise of Horses written by Yu Benyuan and Yu Benheng in 1608 CE [1]. In the 1950s and 1960s, acupuncture had made its way to the West and European veterinarians began investigating its use in horses [1]. However, it wasn’t until the 1970s that veterinary acupuncture was introduced to the United States [1]. Despite the long history of use, the scientific method has only been applied to acupuncture within the last 50 years. Acupuncture does not exist in a vacuum, but rather, is a unique treatment modality in an intricate medical system that has come to be known as traditional Chinese veterinary medicine. The Taoism that formed the foundation of Chinese medicine was based on observation of the natural cycle of the world, including the passing of the seasons, the phases of the moon, and the birth and death of organisms. The medical philosophy of TCVM relies on several basic theoretical principles derived from these observations, including Yin/Yang Theory, the Five Treasures, the Five Element Theory, and the Meridian Theory [3]. These principles are paramount to understanding the philosophy of diagnosis and treatment of disease in TCVM, and from which the practitioner may formulate a Bian Zheng (Pattern Diagnosis) which is the basis for selection of TCVM therapy, including acupuncture. The concept of Yin and Yang can be described as the law of opposing forces (Figure 5.3). It is a Taoism principle based on the observation of the dualistic nature of the universe that was first described in the text Yi Jing (Book of Changes) around 700 BCE, and applied to medicine sometime between the Spring and Autumn period (722–481 BCE) and the Warring States period (403–221 BCE) [3]. The concept of Yin and Yang is complex. Yin and Yang are universal opposites, and everything in the universe can be categorized into Yin and Yang components [3]. Yin refers to the quiet, the dark, and the substantial, and Yang refers to the loud, the light, and the insubstantial [4]. Some opposites are intuitive, such as cold (Yin) and hot (Yang) but others are less intuitive, like fish (Yin) and bird (Yang),where the fish is more Yin than the bird because it is in the cool water and close to the earth, whereas the bird is more Yang because it is active and close to the sky [4]. Yin or Yang designation is dependent on the relative nature of the compared pairs and must always be in balance [4]. Figure 5.3 The Tai-ji, symbolic of Yin (black, right) and Yang (white, left). Just as Yin and Yang must remain in balance in the world, so must they remain in balance in the body. The Yin governs the structure of the body, the physical nature, tissues, fluids, and cooling, and Yang governs the function of the body, the enzymes and nerve impulses, energy, and warming. This balance of the two is homeostasis, and imbalance results in disease. Within TCVM, the concept of Yin/Yang is further applied to the internal organs, where they are classified as Fu (Yang) Organs and Zang (Yin) Organs [4]. Yang organs include Large Intestine, Bladder, Gallbladder, Stomach, Small Intestine, and Triple Heater (Triple Heater is considered an organ in Chinese medicine, and is more spiritual in nature as it does not have an anatomical counterpart) [4]. Yin organs include Lung, Kidney, Liver, Spleen, Heart, and Pericardium [4]. In the body, Yin provides moisture and cooling, and Yang provides warmth and energy. Animals with Yin deficiency are not able to adequately cool themselves, and animals with Yang deficiency cannot keep warm. Animals with Yin Excess have too much cold, and they present with similar temperature preference as those with Yang Deficiency, as both conditions result in the feeling of cold. Likewise, Yang Excess presents with similar clinical signs to Yin Deficiency, in that there is excess Heat in the body, and patients are hot and dry. Yin/Yang balance must be restored for patient homeostasis. Understanding of these principles is vital for a complete understanding of how imbalances in the body results in disease, and inversely, how these principles may be utilized for therapy. Within TCVM, there exists Five Treasures, also known as Vital Substances, consisting of Jing (Essence), Qi (Energy), Shen (Mind), Xue (Blood), and Jin Ye (Body Fluid) [3, 4]. These substances are necessary for life, and account for the physical properties of TCVM within the body [3, 4]. They impel the function of the body, nourish the body and the mind, and support the function of organs [4]. When the Treasures are depleted or obstructed, disease results [3, 4]. Jing is the essence of an organism. There are two types of Jing: prenatal Jing and postnatal Jing. Prenatal Jing, also known as Congenital Jing, is the seed of life and is stored in the Kidney. Jing is responsible for development of the fetus, for all growth and reproduction, as well as maintaining the life force throughout the organism’s life. Jing is inherited from one’s parents, and Jing deficiencies typically result in congenital disorders or sickness in early life. Jing is slowly depleted over an individual’s lifetime and cannot be replenished. Once Jing is exhausted, the animal dies. The conservation of Jing is therefore vital to maintain life. Prenatal Jing may be supplemented by postnatal Jing, which is also known as acquired Jing, and is created from food. Creating good-quality postnatal Jing supplements the continuous depletion of prenatal Jing [3, 4]. Qi (energy) is the life force of the world, and where there is Qi, there must be life [4]. In TCVM, there are more than 32 types of Qi identified, with 8 types being most commonly discussed, each with its own actions, and creation and depletion cycle [3, 4]. The various types of Qi each play a specific role in the body: impelling, warming, defending, holding, nourishing, and activity. This chapter will discuss all forms of Qi together as a singular concept of life energy [4]. Qi may be brought into the body by breathing and by eating, which is then transformed and transported throughout the body in channels, also known as meridians. It is on these channels that acupuncture points are found [3, 4]. Manipulation of acupuncture points has its TCVM physiologic effect on the body by influencing the Qi that is flowing within the network of channels within the body [3]. Stagnation of Qi within these channels causes stiffness and pain, and deficiency in Qi in the body results in weakness and lack of vital functions [3]. Shen is loosely translated as the “mind” or the “spirit” [4]. Shen is the outward appearance of all the activities of the body, taking into account personality, mental activity, memory, sleep, and behavior [4]. Shen is what allows clear thought, a focused mind, and inner peace [4]. Shen is stored in the Heart, nourished by Yin and Blood, and disturbances in the Heart or in the Shen may result in in behavioral abnormalities including anxiety, mania, insomnia, restlessness, hyperactivity, fear, inability to focus, pica, and stereotypies [4]. The TCVM concept of Blood is similar to the Western concept in that Blood contains nutrient Qi that circulates throughout the vessels of the body [4]. Blood is formed from food, Qi, Jing, and Body Fluids, and functions to nourish, moisten, to move Qi [4]. Deficiency of Blood may result in anemia, as in Western medicine, but there are other forms of Blood Deficiency in TCVM that do not necessarily result in changes in the hematological profile [4]. Because Blood nourishes tissues and brings moisture, Blood Deficient animals suffer from degeneration of soft tissues and are more prone to soft tissue, tendon, and ligament injury [4]. Blood Stagnation, where the Blood is stagnant within a channel, may result in hematomas, neoplasia, and pain [4]. Jin Ye applies to all the fluids of the body, including intravascular, intraarticular, intraocular, as well as excretions, such as tears, nasal discharge, sweat, urine, gastric and intestinal fluids [4]. Jin Ye moistens and nourishes the tissues of the body, and is intimately associated with Blood such that imbalance in one will eventually result in imbalance of the other [4]. The TCVM physiology of water formation, distribution, and excretion is complex and relies on the functions of the Stomach, Spleen, Lung, Small Intestine, Kidney, and Bladder [4
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Traditional Chinese Medical Foundation of Veterinary Acupuncture
Brief History of Acupuncture
Yin and Yang Theory
The Five Treasures (Vital Substances)
Jing (Essence)
Qi (Energy)
Shen (Mind)
Xue (Blood)
Jin Ye (Body Fluid)
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