Although it would be quite unacceptable to attempt most forms of treatment without defining the dose, acupuncture has so far remained without any means of quantification.
Electrical and deep manual needling probably rely for their main effect on direct nerve and muscle stimulation. It is suggested that superficial needling acts by producing a cone of tissue damage, with release of inflammatory mediators which increase the sensitivity of local nerve endings so that trivial, incidental stimulation continues to induce CNS inhibitory effects for a prolonged period. The degree of local inflammatory effect can easily be recorded by measuring the area of skin flare.
A simple formula is offered to determine the dose of acupuncture, based on skin flare recordings after experimental needling and theoretical considerations of tissue damage. Needles of varying shaft radius were inserted to a number of depths in the abdominal dermis and subjected to specific degrees of stimulation. The experimental data correlate well with the theoretical model. Needle response increases with depth of insertion, and with needle thickness although this is outweighed by the effects of manipulation if carried out.
The formula derived for determining the dose of acupuncture which correlates with inflammatory response, as measured by skin flare, is (r + 0.1 l)K, where r is the radius of the needle shaft, l is the depth of insertion and K is 10 for unmanipulated insertions or 12.4 if the needle is manipulated.
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