Xu Zhengyi, Xue Biru (The International Peace Maternity & Child Health Hospital)
He Shufang, Zheng Zehui (Shanghai Institute of Physiology, Academia Sinica)
In our previous papers, we reported that electro-needling of Jizhong point on the Dumai Channel gave satisfactory results for acupuncture anesthesia in abdominal hysterectomy. Up to Dec. 1977, 674 cases of total hysterectomy were performed with the same acupuncture points and electro-needling method. According to the criteria set before, the success rates for grade I (excellent group) and grade II (good group) were 35.8% (241 cases) and 33.8% (228 cases) respectively. The rate of failure was 16.9% (114 cases). The superiority of acupuncture anesthesia as compared with epidural anesthesia and the probable causes of failure were also discussed.
The location of the acupuncture needle in Jizhong point was identified roentgenographically in 7 patients with organic iodide (Conray) injected into the epidural space as a contrast medium. It was found that the tip of the needle in 6 cases was outside of the dura at the same time the needle and the iodide shadow overlapped one another. Of the 6 cases, 5 showed grade I or grade II anesthetic effect. In the 7th case, the tip of the needle appeared at the outer part of the iodide shadow, and the anesthetic effect of this case was grade III.
The change of impedance along the trajectory of needle was studied with various depths of puncture in 11 cases of tubal sterilization. A close relationship existed in the change of impedance of the tissue, hand feeling of the acupuncturist and subjective sensation of the patient. It was further verified anatomically in dogs that the size of high impedance which gave the dense and tough hand feeling to the acupuncturist was the yellow ligament. Thus, having a dense and tough hand feeling followed by a sudden drop in impedance is an indication that the tip of the needle has pierced into the epidural space. It seemed, therefore, that for successful application of electro-acupuncture in Jizhong point, the needle tip must reach the deep layer of yellow ligament.
The effect of long time stimulation of Jizhong point on spinal nerve tissue was studied histologically in cats. The electrical stimulation (Beihang 57-6 stimulator, biphasic unsymmetrical pulses, 100c./sec.) was applied directly to the epidural space through acupuncture needle for 3 hours. No findings of tissue damage could be observed until the stimulating current reached 23 mA. The first sign of tissue damage was localized degeneration of the connective tissue of the spinal dura as shown by dark staining and condensation of tissue. As the stimulating current exceeded 32 mA, the pathological changes involved not only the spinal dura but also the superficial nerve fibers of the spinal cord. Clinically, the optimum stimulating current for Jizhong stimulation was found to be around 15 mA. Hence, stimulation with high carrents must be avoided.
He Shufang, Zheng Zehui (Shanghai Institute of Physiology, Academia Sinica)
In our previous papers, we reported that electro-needling of Jizhong point on the Dumai Channel gave satisfactory results for acupuncture anesthesia in abdominal hysterectomy. Up to Dec. 1977, 674 cases of total hysterectomy were performed with the same acupuncture points and electro-needling method. According to the criteria set before, the success rates for grade I (excellent group) and grade II (good group) were 35.8% (241 cases) and 33.8% (228 cases) respectively. The rate of failure was 16.9% (114 cases). The superiority of acupuncture anesthesia as compared with epidural anesthesia and the probable causes of failure were also discussed.
The location of the acupuncture needle in Jizhong point was identified roentgenographically in 7 patients with organic iodide (Conray) injected into the epidural space as a contrast medium. It was found that the tip of the needle in 6 cases was outside of the dura at the same time the needle and the iodide shadow overlapped one another. Of the 6 cases, 5 showed grade I or grade II anesthetic effect. In the 7th case, the tip of the needle appeared at the outer part of the iodide shadow, and the anesthetic effect of this case was grade III.
The change of impedance along the trajectory of needle was studied with various depths of puncture in 11 cases of tubal sterilization. A close relationship existed in the change of impedance of the tissue, hand feeling of the acupuncturist and subjective sensation of the patient. It was further verified anatomically in dogs that the size of high impedance which gave the dense and tough hand feeling to the acupuncturist was the yellow ligament. Thus, having a dense and tough hand feeling followed by a sudden drop in impedance is an indication that the tip of the needle has pierced into the epidural space. It seemed, therefore, that for successful application of electro-acupuncture in Jizhong point, the needle tip must reach the deep layer of yellow ligament.
The effect of long time stimulation of Jizhong point on spinal nerve tissue was studied histologically in cats. The electrical stimulation (Beihang 57-6 stimulator, biphasic unsymmetrical pulses, 100c./sec.) was applied directly to the epidural space through acupuncture needle for 3 hours. No findings of tissue damage could be observed until the stimulating current reached 23 mA. The first sign of tissue damage was localized degeneration of the connective tissue of the spinal dura as shown by dark staining and condensation of tissue. As the stimulating current exceeded 32 mA, the pathological changes involved not only the spinal dura but also the superficial nerve fibers of the spinal cord. Clinically, the optimum stimulating current for Jizhong stimulation was found to be around 15 mA. Hence, stimulation with high carrents must be avoided.
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