WEBVTT 00:02.500 --> 00:04.300 align:left position:25% line:5% size:65% - Welcome, everyone, to Wednesday Nite @ the Lab. 00:04.300 --> 00:05.466 align:left position:32.5% line:5% size:57.5% I'm Tom Zinnen. 00:05.466 --> 00:07.600 align:left position:20% line:5% size:70% I work at the University of Wisconsin-Madison 00:07.600 --> 00:09.133 align:left position:25% line:5% size:65% Biotechnology Center. 00:09.133 --> 00:12.566 align:left position:15% line:5% size:75% I also work for the Division of Extension Wisconsin 4-H. 00:12.566 --> 00:15.566 align:left position:15% line:5% size:75% And on behalf of those folks and our other co-organizers, 00:15.566 --> 00:19.200 align:left position:15% line:5% size:75% PBS Wisconsin, the Wisconsin Alumni Association, 00:19.200 --> 00:22.033 align:left position:27.5% line:5% size:62.5% and the UW-Madison Science Alliance, 00:22.033 --> 00:24.733 align:left position:22.5% line:5% size:67.5% thanks again for coming to Wednesday Nite @ the Lab. 00:24.733 --> 00:28.600 align:left position:17.5% line:5% size:72.5% We do this every Wednesday night, 50 times a year. 00:28.600 --> 00:32.166 align:left position:17.5% line:5% size:72.5% Tonight it's my pleasure to introduce to you Lindsey Snyder. 00:32.166 --> 00:34.866 align:left position:27.5% line:5% size:62.5% She's a veterinary anesthesiologist here 00:34.866 --> 00:37.400 align:left position:32.5% line:5% size:57.5% with the School of Veterinary Medicine. 00:37.400 --> 00:41.833 align:left position:12.5% line:5% size:77.5% She was born and raised on the Kansas side of Kansas City, 00:41.833 --> 00:43.766 align:left position:30% line:5% size:60% and then she went to Kansas State University 00:43.766 --> 00:45.633 align:left position:15% line:5% size:75% for her undergraduate degree 00:45.633 --> 00:49.433 align:left position:17.5% line:5% size:72.5% and stayed there to get her doctor in veterinary medicine. 00:49.433 --> 00:53.800 align:left position:15% line:5% size:75% Then she went to Los Angeles for a year-long internship, 00:53.800 --> 00:56.566 align:left position:35% line:5% size:55% and then went to Ohio State University 00:56.566 --> 00:59.900 align:left position:27.5% line:5% size:62.5% to do her residency in veterinary anesthesia 00:59.900 --> 01:01.566 align:left position:32.5% line:5% size:57.5% and analgesia. 01:01.566 --> 01:03.166 align:left position:15% line:5% size:75% While she was at Ohio State, 01:03.166 --> 01:06.166 align:left position:32.5% line:5% size:57.5% she also earned her master's degree. 01:06.166 --> 01:10.966 align:left position:27.5% line:5% size:62.5% Here at UW-Madison, she teaches, practices, 01:10.966 --> 01:14.766 align:left position:20% line:5% size:70% and does research at the Department of Surgical Sciences 01:14.766 --> 01:16.900 align:left position:35% line:5% size:55% in the School of Veterinary Medicine. 01:16.900 --> 01:18.533 align:left position:32.5% line:5% size:57.5% Tonight, she's gonna speak with us 01:18.533 --> 01:21.366 align:left position:15% line:5% size:75% about acupuncture in animals. 01:21.366 --> 01:24.333 align:left position:20% line:5% size:70% Would you please join me in welcoming Lindsey Snyder 01:24.333 --> 01:26.266 align:left position:15% line:5% size:75% to Wednesday Nite @ the Lab? 01:27.933 --> 01:30.000 align:left position:20% line:71% size:70% - Thank you so much, Tom. 01:30.000 --> 01:31.466 align:left position:10% line:71% size:80% I'm happy to be with you tonight 01:31.466 --> 01:34.933 align:left position:35% line:71% size:55% to talk about acupuncture in animals. 01:34.933 --> 01:38.533 align:left position:27.5% line:71% size:62.5% And I should first tell you how I came 01:38.533 --> 01:41.433 align:left position:25% line:71% size:65% to study acupuncture and animals. 01:41.433 --> 01:45.033 align:left position:25% line:71% size:65% And I am a veterinary anesthesiologist, 01:45.033 --> 01:49.566 align:left position:22.5% line:71% size:67.5% and I did my residency at Ohio State University. 01:49.566 --> 01:54.066 align:left position:27.5% line:71% size:62.5% And when I arrived, we also did master's projects. 01:54.066 --> 01:56.033 align:left position:25% line:71% size:65% So I got my master's at the same time 01:56.033 --> 01:57.866 align:left position:12.5% line:71% size:77.5% that I was doing my residency, 01:57.866 --> 02:01.600 align:left position:30% line:71% size:60% and I showed up, and they had a project ready 02:01.600 --> 02:03.033 align:left position:27.5% line:71% size:62.5% and waiting for me. 02:03.033 --> 02:06.133 align:left position:25% line:71% size:65% And that project was looking at acupuncture, 02:06.133 --> 02:08.133 align:left position:27.5% line:71% size:62.5% electroacupuncture, 02:08.133 --> 02:11.766 align:left position:25% line:71% size:65% and a transcutaneous electrical current, 02:11.766 --> 02:15.566 align:left position:17.5% line:71% size:72.5% which just means a current going across the brain, 02:15.566 --> 02:19.766 align:left position:22.5% line:71% size:67.5% external to the skull, 02:19.766 --> 02:22.766 align:left position:25% line:71% size:65% so this current going through the brain. 02:22.766 --> 02:25.800 align:left position:27.5% line:71% size:62.5% So looking at these three methods 02:25.800 --> 02:29.733 align:left position:12.5% line:71% size:77.5% and looking at the requirements 02:29.733 --> 02:32.766 align:left position:20% line:71% size:70% of inhalation anesthetics in dogs. 02:32.766 --> 02:34.900 align:left position:20% line:71% size:70% So what we are looking at 02:34.900 --> 02:38.400 align:left position:25% line:71% size:65% is would acupuncture, electroacupuncture, 02:38.400 --> 02:41.900 align:left position:15% line:71% size:75% and this electrical current, 02:41.900 --> 02:47.633 align:left position:17.5% line:71% size:72.5% would they decrease the gas anesthetic requirements of dogs? 02:47.633 --> 02:49.866 align:left position:27.5% line:71% size:62.5% And this is kind of a universal method 02:49.866 --> 02:55.200 align:left position:15% line:71% size:75% for determining if something causes analgesia in a patient. 02:55.200 --> 02:57.266 align:left position:15% line:71% size:75% And I went into it thinking, 02:57.266 --> 02:59.466 align:left position:32.5% line:71% size:57.5% "I don't really wanna do this project 02:59.466 --> 03:02.266 align:left position:22.5% line:71% size:67.5% because I don't really believe in acupuncture." 03:02.266 --> 03:04.400 align:left position:32.5% line:71% size:57.5% And what I did 03:04.400 --> 03:08.966 align:left position:17.5% line:71% size:72.5% was I proved that all three of these methods 03:08.966 --> 03:14.800 align:left position:12.5% line:71% size:77.5% did, in fact, decrease the need of general anesthesia in dogs, 03:14.800 --> 03:18.866 align:left position:17.5% line:71% size:72.5% but I also proved to myself 03:18.866 --> 03:22.433 align:left position:25% line:71% size:65% that acupuncture does have significant effects 03:22.433 --> 03:24.433 align:left position:22.5% line:71% size:67.5% in animals and humans. 03:26.366 --> 03:31.033 align:left position:12.5% line:83% size:77.5% This paper based on my research was published in 2005, 03:31.033 --> 03:34.766 align:left position:30% line:83% size:60% and at the time, it was one of the first papers 03:34.766 --> 03:38.733 align:left position:32.5% line:83% size:57.5% that really had an objective method 03:38.733 --> 03:44.133 align:left position:15% line:83% size:75% for evaluating acupuncture's effects in an animal 03:44.133 --> 03:46.300 align:left position:17.5% line:89% size:72.5% that had no placebo effect. 03:46.300 --> 03:49.533 align:left position:25% line:83% size:65% And so it was sort of revolutionary at the time, 03:49.533 --> 03:54.933 align:left position:22.5% line:83% size:67.5% and again, the academic community really liked it, 03:54.933 --> 03:57.333 align:left position:15% line:89% size:75% and it made a believer of me, 03:57.333 --> 03:59.600 align:left position:30% line:83% size:60% who went into it very much skeptical. 04:00.933 --> 04:03.233 align:left position:17.5% line:71% size:72.5% So I've learned quite a bit about acupuncture 04:03.233 --> 04:08.233 align:left position:27.5% line:71% size:62.5% throughout my time as being a veterinarian, 04:08.233 --> 04:09.733 align:left position:15% line:71% size:75% not only through my master's, 04:09.733 --> 04:12.333 align:left position:27.5% line:71% size:62.5% but then I went on and got further training. 04:12.333 --> 04:15.200 align:left position:22.5% line:71% size:67.5% So what is acupuncture? 04:15.200 --> 04:18.533 align:left position:22.5% line:5% size:67.5% Acupuncture itself is, by definition, 04:18.533 --> 04:21.666 align:left position:25% line:5% size:65% it is the stimulating of specific anatomic points 04:21.666 --> 04:24.166 align:left position:22.5% line:5% size:67.5% in the body to produce therapeutic 04:24.166 --> 04:26.500 align:left position:25% line:5% size:65% or analgesic effects. 04:26.500 --> 04:28.466 align:left position:22.5% line:5% size:67.5% So what does that mean? 04:28.466 --> 04:33.466 align:left position:32.5% line:5% size:57.5% We can not only produce pain management 04:33.466 --> 04:39.266 align:left position:12.5% line:5% size:77.5% so that analgesia, where we can decrease pain in a patient, 04:39.266 --> 04:41.700 align:left position:27.5% line:5% size:62.5% but we can also get therapeutic effects 04:42.700 --> 04:48.033 align:left position:27.5% line:5% size:62.5% like regulating how the GI system is working. 04:48.033 --> 04:50.066 align:left position:22.5% line:5% size:67.5% So something like that. 04:50.066 --> 04:51.600 align:left position:22.5% line:5% size:67.5% Traditionally speaking, 04:51.600 --> 04:54.433 align:left position:27.5% line:5% size:62.5% when someone talks about acupuncture, 04:54.433 --> 04:58.400 align:left position:25% line:5% size:65% they typically think of the traditional method 04:58.400 --> 05:02.000 align:left position:20% line:5% size:70% of acupuncture, which is using fine gauge needles 05:02.000 --> 05:07.400 align:left position:15% line:5% size:75% to puncture the skin in these specific anatomic points. 05:08.933 --> 05:12.933 align:left position:20% line:5% size:70% Interestingly, we can use many different methods 05:12.933 --> 05:15.700 align:left position:27.5% line:5% size:62.5% to actually produce these effects. 05:15.700 --> 05:20.666 align:left position:15% line:5% size:75% So we can use heat, pressure, aqua, or a liquid of some sort, 05:20.666 --> 05:23.233 align:left position:20% line:5% size:70% even electroacupuncture, 05:23.233 --> 05:25.800 align:left position:30% line:5% size:60% using a low-level electrical current. 05:27.000 --> 05:30.700 align:left position:12.5% line:83% size:77.5% So if we look at some of these, we can use heat. 05:30.700 --> 05:37.733 align:left position:10% line:83% size:80% So if we start sort of clockwise in the top left corner, 05:37.733 --> 05:42.733 align:left position:25% line:83% size:65% that's actually using an herb called mugwort. 05:42.733 --> 05:46.133 align:left position:15% line:89% size:75% Mugwort burns very, very hot. 05:46.133 --> 05:52.633 align:left position:20% line:83% size:70% And so just even placing this herb over an acupoint 05:52.633 --> 05:56.300 align:left position:25% line:83% size:65% can produce an effect in this acupuncture point, 05:56.300 --> 05:59.166 align:left position:15% line:89% size:75% this specific anatomic point. 05:59.166 --> 06:01.400 align:left position:20% line:89% size:70% We can also use pressure. 06:01.400 --> 06:03.866 align:left position:22.5% line:83% size:67.5% So you can see someone is pushing on their hand 06:03.866 --> 06:06.266 align:left position:30% line:83% size:60% in a very sort of traditional spot 06:06.266 --> 06:09.500 align:left position:20% line:83% size:70% that a lot of people see when they have a headache, 06:09.500 --> 06:13.033 align:left position:32.5% line:83% size:57.5% they're pushing on their hand in this spot, 06:13.033 --> 06:17.366 align:left position:20% line:83% size:70% and that's using pressure to get an effect 06:17.366 --> 06:19.733 align:left position:30% line:89% size:60% in this acupoint. 06:19.733 --> 06:21.000 align:left position:22.5% line:89% size:67.5% What they're doing here 06:21.000 --> 06:24.500 align:left position:22.5% line:83% size:67.5% is actually stimulating a master point 06:24.500 --> 06:26.300 align:left position:22.5% line:89% size:67.5% for the head and face. 06:27.500 --> 06:30.700 align:left position:35% line:83% size:55% You can see, as we move along clockwise, 06:30.700 --> 06:32.800 align:left position:20% line:83% size:70% there's actually a needle with liquid. 06:32.800 --> 06:37.466 align:left position:25% line:83% size:65% And we can use liquid and inject that 06:37.466 --> 06:41.433 align:left position:30% line:83% size:60% into an acupoint to get an effect. 06:41.433 --> 06:46.233 align:left position:25% line:83% size:65% So we can use saline, we can use vitamin B12. 06:46.233 --> 06:51.233 align:left position:15% line:83% size:75% We can even use the patient's own blood, called hemopuncture. 06:52.633 --> 06:56.800 align:left position:15% line:71% size:75% We can even use really small amounts of a drug 06:56.800 --> 07:00.300 align:left position:25% line:71% size:65% and do what's called pharmacopuncture 07:00.300 --> 07:05.866 align:left position:12.5% line:71% size:77.5% and deliver very small amounts of a drug into an acupoint. 07:05.866 --> 07:07.800 align:left position:17.5% line:5% size:72.5% In the bottom right corner, you can see 07:07.800 --> 07:10.700 align:left position:25% line:5% size:65% that we've actually, in this, this was part 07:10.700 --> 07:12.300 align:left position:30% line:5% size:60% of my study dogs, 07:13.300 --> 07:18.133 align:left position:22.5% line:5% size:67.5% and we actually attach very small clips 07:18.133 --> 07:21.500 align:left position:20% line:5% size:70% onto acupuncture needles, 07:21.500 --> 07:26.500 align:left position:20% line:5% size:70% and we're able to deliver a very low electrical current 07:26.500 --> 07:29.800 align:left position:12.5% line:5% size:77.5% between two needles to develop 07:29.800 --> 07:35.266 align:left position:25% line:5% size:65% or enhance the effect of the acupuncture alone. 07:35.266 --> 07:39.466 align:left position:12.5% line:5% size:77.5% So this is just another method of stimulating those needles. 07:39.466 --> 07:42.633 align:left position:27.5% line:5% size:62.5% You can see in the bottom middle picture, 07:42.633 --> 07:44.966 align:left position:15% line:5% size:75% they're using pressure with, 07:45.966 --> 07:49.833 align:left position:27.5% line:5% size:62.5% those are actually motion sickness bands 07:49.833 --> 07:53.900 align:left position:27.5% line:5% size:62.5% that are being used to put pressure 07:53.900 --> 07:57.866 align:left position:15% line:5% size:75% and use acupressure on points 07:57.866 --> 08:02.700 align:left position:17.5% line:5% size:72.5% that are really beneficial for decreasing nausea. 08:02.700 --> 08:04.466 align:left position:20% line:5% size:70% And in the bottom right, you can see 08:04.466 --> 08:08.933 align:left position:17.5% line:5% size:72.5% that they've actually used that same herb, mugwort, 08:08.933 --> 08:11.500 align:left position:15% line:5% size:75% and actually put it in a cup 08:11.500 --> 08:15.133 align:left position:32.5% line:5% size:57.5% attached to the acupuncture needle itself, 08:15.133 --> 08:18.900 align:left position:12.5% line:5% size:77.5% and that warms the needle down into the acupoint. 08:18.900 --> 08:21.900 align:left position:30% line:5% size:60% So that is going to intensify the effects 08:21.900 --> 08:23.166 align:left position:27.5% line:5% size:62.5% of the acupuncture. 08:24.166 --> 08:27.100 align:left position:22.5% line:5% size:67.5% I personally don't use this method. 08:27.100 --> 08:33.633 align:left position:12.5% line:5% size:77.5% As you can see in the picture, it is a burning substance, 08:33.633 --> 08:37.000 align:left position:32.5% line:5% size:57.5% and if anyone's ever been in a barn, 08:37.000 --> 08:40.166 align:left position:15% line:5% size:75% there's usually a lot of hay and a lot of straw, 08:40.166 --> 08:43.366 align:left position:15% line:5% size:75% and it makes me a little bit nervous to do that. 08:43.366 --> 08:47.466 align:left position:25% line:71% size:65% So each practitioner develops their methods 08:47.466 --> 08:51.033 align:left position:25% line:71% size:65% for stimulating those acupuncture points. 08:52.666 --> 08:55.000 align:left position:27.5% line:71% size:62.5% So something that's been interesting 08:55.000 --> 08:58.000 align:left position:25% line:71% size:65% in more recent years, 08:58.000 --> 09:03.900 align:left position:32.5% line:71% size:57.5% even more than, not even 20 years ago, 09:03.900 --> 09:08.366 align:left position:15% line:71% size:75% you would not have found that places like Johns Hopkins 09:08.366 --> 09:11.033 align:left position:15% line:71% size:75% were advertising acupuncture and its benefits 09:11.033 --> 09:12.966 align:left position:27.5% line:71% size:62.5% on their websites. 09:12.966 --> 09:16.966 align:left position:25% line:5% size:65% But now, not only the scientific community, 09:16.966 --> 09:22.866 align:left position:20% line:5% size:70% but the medical community have really caught on 09:22.866 --> 09:25.600 align:left position:20% line:5% size:70% to the beneficial aspects of acupuncture 09:25.600 --> 09:27.200 align:left position:27.5% line:5% size:62.5% and what it can do. 09:27.200 --> 09:30.066 align:left position:32.5% line:5% size:57.5% So you can see that Johns Hopkins 09:30.066 --> 09:34.300 align:left position:15% line:5% size:75% is even touting acupuncture's beneficial effects 09:34.300 --> 09:35.800 align:left position:25% line:5% size:65% right on its website. 09:36.966 --> 09:40.033 align:left position:20% line:83% size:70% Additionally, you can see that something like the NIH 09:40.033 --> 09:44.933 align:left position:15% line:83% size:75% is advertising acupuncture's beneficial effects as well. 09:44.933 --> 09:48.166 align:left position:17.5% line:83% size:72.5% And the NIH recognizes that acupuncture is beneficial, 09:48.166 --> 09:51.666 align:left position:32.5% line:83% size:57.5% and acupuncture in all of its variations, 09:51.666 --> 09:53.700 align:left position:12.5% line:89% size:77.5% electroacupuncture, et cetera. 09:54.700 --> 09:59.366 align:left position:17.5% line:5% size:72.5% It's beneficial for things like dental pain after surgery, 09:59.366 --> 10:02.500 align:left position:17.5% line:5% size:72.5% headaches, myofascial pain. 10:02.500 --> 10:05.766 align:left position:27.5% line:5% size:62.5% So those are those real deep aches and pains 10:05.766 --> 10:10.200 align:left position:17.5% line:5% size:72.5% of your connective tissue, and even things like asthma. 10:10.200 --> 10:14.800 align:left position:10% line:5% size:80% The NIH is promoting acupuncture 10:14.800 --> 10:18.766 align:left position:15% line:5% size:75% for these various conditions within the body. 10:20.033 --> 10:21.700 align:left position:22.5% line:5% size:67.5% In a traditional sense, 10:21.700 --> 10:25.666 align:left position:22.5% line:5% size:67.5% acupuncture is based on patterns of energy flow 10:25.666 --> 10:27.466 align:left position:25% line:5% size:65% throughout the body. 10:27.466 --> 10:31.266 align:left position:15% line:5% size:75% And these were thought to be meridians in the body, 10:31.266 --> 10:36.200 align:left position:25% line:5% size:65% and it's disruptions of this energy flow 10:36.200 --> 10:37.933 align:left position:27.5% line:5% size:62.5% throughout the body 10:37.933 --> 10:41.200 align:left position:17.5% line:5% size:72.5% that was thought to be the basis of disease in the body. 10:41.200 --> 10:44.600 align:left position:32.5% line:5% size:57.5% So disruptions in these patterns of flow 10:44.600 --> 10:46.933 align:left position:20% line:5% size:70% were what caused ailments in the body. 10:48.133 --> 10:50.800 align:left position:25% line:5% size:65% Acupuncture has been described in writing 10:50.800 --> 10:53.333 align:left position:25% line:5% size:65% as early as 1,000 BC. 10:53.333 --> 10:56.900 align:left position:17.5% line:71% size:72.5% So it has been in practice 10:56.900 --> 10:59.066 align:left position:35% line:71% size:55% that we have a written history of 10:59.066 --> 11:01.600 align:left position:20% line:71% size:70% for at least 3,000 years. 11:02.600 --> 11:05.933 align:left position:30% line:71% size:60% That being said, there are artifacts 11:05.933 --> 11:09.866 align:left position:12.5% line:71% size:77.5% that indicate that acupuncture has actually been practiced 11:09.866 --> 11:12.700 align:left position:22.5% line:71% size:67.5% for thousands of years even before that. 11:12.700 --> 11:18.700 align:left position:25% line:71% size:65% Very sharp bones that were sharpened to a point 11:18.700 --> 11:21.933 align:left position:25% line:71% size:65% and even stones that were sharpened to a point 11:21.933 --> 11:25.033 align:left position:25% line:71% size:65% have been found that were most likely used 11:25.033 --> 11:29.200 align:left position:17.5% line:71% size:72.5% as acupressure modalities. 11:29.200 --> 11:34.166 align:left position:32.5% line:71% size:57.5% So acupuncture or acupressure tools 11:34.166 --> 11:37.233 align:left position:25% line:71% size:65% that go back to even 5,000 years ago. 11:39.766 --> 11:42.366 align:left position:25% line:71% size:65% So why would someone recommend acupuncture 11:42.366 --> 11:45.166 align:left position:15% line:71% size:75% or seek it out as a treatment for either themselves 11:45.166 --> 11:46.800 align:left position:30% line:71% size:60% or their animal? 11:46.800 --> 11:48.533 align:left position:20% line:71% size:70% Well, first and foremost, 11:48.533 --> 11:51.633 align:left position:20% line:83% size:70% acupuncture has virtually no side effects. 11:51.633 --> 11:54.933 align:left position:20% line:83% size:70% So it really is something that we can go into 11:54.933 --> 11:57.966 align:left position:10% line:89% size:80% with the hopes that it will help 11:57.966 --> 12:02.500 align:left position:22.5% line:83% size:67.5% and realistically know that it will not harm one, 12:03.566 --> 12:06.266 align:left position:12.5% line:89% size:77.5% either themselves or an animal. 12:07.633 --> 12:10.533 align:left position:15% line:89% size:75% Like most things that we try 12:10.533 --> 12:15.700 align:left position:20% line:83% size:70% to alleviate pain or have a therapeutic effect, 12:15.700 --> 12:19.200 align:left position:32.5% line:83% size:57.5% it might not be universally effective. 12:19.200 --> 12:24.000 align:left position:20% line:71% size:70% So when I get a headache, I take ibuprofen. 12:24.000 --> 12:27.300 align:left position:32.5% line:71% size:57.5% Ibuprofen works for my headaches, 12:27.300 --> 12:29.533 align:left position:17.5% line:71% size:72.5% whereas another individual, 12:29.533 --> 12:32.933 align:left position:17.5% line:71% size:72.5% ibuprofen is not what works for their headaches. 12:32.933 --> 12:35.133 align:left position:32.5% line:71% size:57.5% And in reality, something like Tylenol 12:35.133 --> 12:37.500 align:left position:15% line:71% size:75% might be beneficial for them. 12:37.500 --> 12:39.733 align:left position:15% line:71% size:75% Acupuncture is the same way. 12:39.733 --> 12:42.733 align:left position:20% line:71% size:70% It might really work well with one person, 12:42.733 --> 12:48.133 align:left position:30% line:71% size:60% but might not be the method of choice 12:48.133 --> 12:49.500 align:left position:27.5% line:71% size:62.5% for another person. 12:50.633 --> 12:53.233 align:left position:30% line:71% size:60% For some things, it might be the only thing 12:53.233 --> 12:54.633 align:left position:25% line:71% size:65% that we need to use. 12:54.633 --> 12:56.733 align:left position:27.5% line:71% size:62.5% And again, I'll use the headache example. 12:57.733 --> 13:01.733 align:left position:25% line:71% size:65% If I have a headache, ibuprofen is usually enough 13:01.733 --> 13:03.566 align:left position:17.5% line:71% size:72.5% for my headache to go away. 13:04.566 --> 13:09.500 align:left position:20% line:71% size:70% However, it might not be the only thing that works. 13:10.500 --> 13:13.100 align:left position:25% line:71% size:65% So if I have a really excruciating headache, 13:13.100 --> 13:16.566 align:left position:22.5% line:71% size:67.5% I might need ibuprofen and something else with it. 13:17.700 --> 13:19.633 align:left position:15% line:71% size:75% And acupuncture is the same. 13:19.633 --> 13:24.400 align:left position:22.5% line:71% size:67.5% When I talk to clients about their animal, 13:24.400 --> 13:27.466 align:left position:30% line:71% size:60% I'm never looking at just acupuncture. 13:27.466 --> 13:32.233 align:left position:20% line:71% size:70% I'm looking at everything that goes together 13:32.233 --> 13:33.733 align:left position:30% line:71% size:60% for that patient. 13:33.733 --> 13:38.566 align:left position:15% line:71% size:75% So both the Western approach and the traditional approach, 13:38.566 --> 13:42.466 align:left position:17.5% line:71% size:72.5% and I use them as adjuncts for one another. 13:45.766 --> 13:49.066 align:left position:12.5% line:71% size:77.5% When we use acupuncture needles 13:49.066 --> 13:54.066 align:left position:20% line:71% size:70% or pressure or something, whatever method we choose, 13:54.066 --> 13:58.200 align:left position:17.5% line:71% size:72.5% we are gonna be activating that acupuncture point. 13:58.200 --> 14:00.800 align:left position:12.5% line:71% size:77.5% So what are acupuncture points? 14:00.800 --> 14:05.133 align:left position:27.5% line:83% size:62.5% Well, we know that they're cutaneous areas 14:05.133 --> 14:09.566 align:left position:20% line:83% size:70% with high concentrations of specialized nerve endings. 14:09.566 --> 14:13.600 align:left position:17.5% line:83% size:72.5% There are specialized nerve endings that are responsible 14:13.600 --> 14:16.766 align:left position:15% line:89% size:75% for picking up pain impulses, 14:16.766 --> 14:19.800 align:left position:17.5% line:83% size:72.5% and those are both A delta and C fibers. 14:19.800 --> 14:23.966 align:left position:17.5% line:83% size:72.5% And acupuncture points have really high concentrations 14:23.966 --> 14:29.200 align:left position:15% line:83% size:75% of both A delta and C fibers compared to surrounding tissues. 14:29.200 --> 14:31.100 align:left position:30% line:83% size:60% We also know that acupuncture points 14:31.100 --> 14:34.366 align:left position:20% line:83% size:70% have a high concentration of mast cells. 14:34.366 --> 14:37.266 align:left position:32.5% line:71% size:57.5% Now, mast cells release histamine, 14:37.266 --> 14:40.000 align:left position:12.5% line:71% size:77.5% and so if I really get a point 14:40.000 --> 14:43.300 align:left position:25% line:71% size:65% that's really dead-on on that point, 14:43.300 --> 14:45.566 align:left position:37.5% line:71% size:52.5% I might get a little reddend area, 14:45.566 --> 14:47.733 align:left position:35% line:71% size:55% and that is a really, really small, 14:47.733 --> 14:52.766 align:left position:12.5% line:71% size:77.5% localized release of histamine from that acupuncture point. 14:52.766 --> 14:54.400 align:left position:32.5% line:71% size:57.5% There are also high concentrations 14:54.400 --> 14:59.866 align:left position:17.5% line:71% size:72.5% of capillaries and venules, so it's not entirely uncommon 14:59.866 --> 15:03.133 align:left position:15% line:71% size:75% to have a little bit of blood when you take the needle out. 15:04.966 --> 15:07.600 align:left position:30% line:71% size:60% We also know that acupuncture points 15:07.600 --> 15:11.100 align:left position:22.5% line:71% size:67.5% are areas of decreased electrical resistance. 15:11.100 --> 15:15.433 align:left position:15% line:71% size:75% So there's actually increased electrical conduction 15:15.433 --> 15:18.700 align:left position:17.5% line:71% size:72.5% within the acupoint itself. 15:18.700 --> 15:20.533 align:left position:15% line:71% size:75% So I find this so fascinating 15:20.533 --> 15:25.266 align:left position:12.5% line:71% size:77.5% because thousands of years ago, these points were discovered 15:25.266 --> 15:28.833 align:left position:20% line:71% size:70% and now science has said, "Wait a minute, 15:28.833 --> 15:30.900 align:left position:27.5% line:71% size:62.5% "there is something to these points. 15:30.900 --> 15:34.466 align:left position:12.5% line:71% size:77.5% They are anatomically different from surrounding tissue." 15:36.766 --> 15:40.000 align:left position:27.5% line:71% size:62.5% Things that we know about acupuncture 15:40.000 --> 15:43.766 align:left position:27.5% line:71% size:62.5% is that acupuncture can decrease muscle spasms. 15:43.766 --> 15:49.933 align:left position:17.5% line:71% size:72.5% So just by placing a needle within a spasming muscle 15:49.933 --> 15:54.933 align:left position:25% line:71% size:65% or an area of muscle that has a tight knot, 15:54.933 --> 15:59.900 align:left position:20% line:71% size:70% it can relax that muscle in and of itself 15:59.900 --> 16:02.033 align:left position:20% line:71% size:70% just by placing a needle. 16:02.033 --> 16:03.600 align:left position:25% line:83% size:65% So this picture that you're looking at 16:03.600 --> 16:08.566 align:left position:12.5% line:83% size:77.5% is actually, that's actually me with straight hair for the day, 16:09.766 --> 16:11.233 align:left position:22.5% line:89% size:67.5% but I am actually going 16:11.233 --> 16:13.766 align:left position:20% line:83% size:70% and having what's called trigger point therapy. 16:13.766 --> 16:18.666 align:left position:17.5% line:83% size:72.5% So other areas of medicine have caught on 16:18.666 --> 16:21.700 align:left position:30% line:83% size:60% to this effect of decreasing muscle spasms. 16:23.166 --> 16:27.400 align:left position:15% line:83% size:75% When I go in, I have someone who is in physical medicine 16:27.400 --> 16:31.466 align:left position:17.5% line:83% size:72.5% and rehab, so a specialist, who takes a needle 16:31.466 --> 16:37.133 align:left position:20% line:83% size:70% and actually pistons that needle within my muscle knots. 16:37.133 --> 16:39.300 align:left position:32.5% line:83% size:57.5% And every time those muscles fire, 16:39.300 --> 16:41.566 align:left position:27.5% line:83% size:62.5% it starts to relax those muscles. 16:42.566 --> 16:45.766 align:left position:17.5% line:71% size:72.5% Physical therapists also do what's called dry needling, 16:45.766 --> 16:48.033 align:left position:30% line:71% size:60% and they will use acupuncture needles 16:48.033 --> 16:50.233 align:left position:17.5% line:71% size:72.5% targeting the musculature. 16:50.233 --> 16:53.233 align:left position:22.5% line:71% size:67.5% So they're not actually targeting acupoints, 16:53.233 --> 16:55.666 align:left position:25% line:71% size:65% so they can't call it acupuncture, 16:55.666 --> 16:57.766 align:left position:30% line:71% size:60% but they're using acupuncture needles 16:57.766 --> 16:59.833 align:left position:12.5% line:71% size:77.5% to decrease the muscle spasms. 16:59.833 --> 17:03.433 align:left position:10% line:71% size:80% So this is starting to translate into other areas of medicine. 17:04.433 --> 17:07.733 align:left position:15% line:5% size:75% We also know that acupuncture can induce the release 17:07.733 --> 17:09.400 align:left position:25% line:5% size:65% of neurotransmitters. 17:09.400 --> 17:13.000 align:left position:25% line:5% size:65% So neurotransmitters will be released, 17:13.000 --> 17:17.200 align:left position:25% line:5% size:65% and that will affect how the body responds to pain. 17:17.200 --> 17:21.100 align:left position:30% line:5% size:60% So we can release neurotransmitters 17:21.100 --> 17:24.666 align:left position:10% line:5% size:80% and decrease the pain experience overall. 17:24.666 --> 17:27.900 align:left position:25% line:5% size:65% Some of the big ones that we would talk about 17:27.900 --> 17:30.633 align:left position:27.5% line:5% size:62.5% would be endorphins and dynorphins. 17:30.633 --> 17:35.000 align:left position:12.5% line:5% size:77.5% So that's working on the body's endogenous opioid system. 17:35.000 --> 17:39.500 align:left position:15% line:5% size:75% And when we talk about that, one of the things that often 17:39.500 --> 17:41.266 align:left position:30% line:5% size:60% is brought up is with endorphins, 17:41.266 --> 17:43.566 align:left position:12.5% line:5% size:77.5% we talk about a runner's high. 17:43.566 --> 17:48.433 align:left position:15% line:71% size:75% So that release of endorphins causing a runner's high. 17:48.433 --> 17:52.600 align:left position:12.5% line:71% size:77.5% Well, I can get a runner's high without having to run, 17:52.600 --> 17:55.800 align:left position:20% line:71% size:70% which is a delightful way for me to get a runner's high. 17:55.800 --> 17:57.933 align:left position:27.5% line:71% size:62.5% All I have to do is place acupuncture needles 17:57.933 --> 18:02.000 align:left position:25% line:71% size:65% and get that release of endogenous endorphins. 18:02.000 --> 18:07.000 align:left position:15% line:71% size:75% I also know that acupuncture then can be reversed 18:07.000 --> 18:11.433 align:left position:17.5% line:71% size:72.5% with the opioid antagonist naloxone. 18:11.433 --> 18:15.666 align:left position:15% line:71% size:75% So something that we can use to get rid of opioids 18:15.666 --> 18:20.500 align:left position:17.5% line:71% size:72.5% within the body, and we can reverse the effect of opioids 18:20.500 --> 18:23.433 align:left position:20% line:71% size:70% in the cases of overdoses or something like that. 18:23.433 --> 18:26.500 align:left position:12.5% line:71% size:77.5% That drug can actually be used 18:27.500 --> 18:30.000 align:left position:22.5% line:71% size:67.5% to reverse the effects of acupuncture. 18:30.000 --> 18:33.866 align:left position:17.5% line:71% size:72.5% So we can actually reverse acupuncture's effects 18:33.866 --> 18:35.033 align:left position:25% line:71% size:65% through pharmacology. 18:36.466 --> 18:39.866 align:left position:15% line:71% size:75% So to understand acupuncture and its mechanism of action, 18:39.866 --> 18:43.300 align:left position:15% line:71% size:75% we really need to understand the pain pathway. 18:43.300 --> 18:48.166 align:left position:17.5% line:71% size:72.5% So pain starts at the area of a noxious stimulus. 18:48.166 --> 18:51.033 align:left position:20% line:71% size:70% So that's just something that causes pain. 18:51.033 --> 18:53.833 align:left position:20% line:71% size:70% That could be mechanical, chemical, thermal, 18:53.833 --> 18:57.700 align:left position:12.5% line:71% size:77.5% placing your hand on a hot pot, 18:57.700 --> 19:01.133 align:left position:32.5% line:83% size:57.5% or in our case, we'll say that this dog 19:01.133 --> 19:03.466 align:left position:20% line:89% size:70% has its foot stepped on. 19:03.466 --> 19:07.066 align:left position:20% line:83% size:70% So we take that impulse, that mechanical impulse 19:07.066 --> 19:09.533 align:left position:20% line:83% size:70% of having the dog's foot stepped on, 19:09.533 --> 19:14.533 align:left position:20% line:83% size:70% and it will be transduced into an electrical signal. 19:14.533 --> 19:20.033 align:left position:17.5% line:5% size:72.5% It then will be transmitted through transmission 19:20.033 --> 19:23.266 align:left position:12.5% line:5% size:77.5% to the level of the dorsal horn of the spinal cord. 19:24.466 --> 19:27.700 align:left position:15% line:5% size:75% That transmission will occur 19:27.700 --> 19:31.066 align:left position:20% line:5% size:70% by those two specialized nociceptive fibers. 19:31.066 --> 19:34.966 align:left position:20% line:5% size:70% So those two nerve fibers that are responsible 19:34.966 --> 19:37.366 align:left position:25% line:5% size:65% for delivering pain. 19:37.366 --> 19:39.300 align:left position:17.5% line:5% size:72.5% The first are the A delta. 19:39.300 --> 19:41.766 align:left position:30% line:5% size:60% Those are large, myelinated fibers 19:41.766 --> 19:45.766 align:left position:12.5% line:5% size:77.5% that are responsible for fast, pinprick pain. 19:45.766 --> 19:48.300 align:left position:15% line:5% size:75% And the second are C fibers. 19:48.300 --> 19:53.466 align:left position:15% line:5% size:75% Those are small, unmyelinated fibers that are responsible 19:53.466 --> 19:56.500 align:left position:22.5% line:5% size:67.5% for slow, burning pain. 19:57.933 --> 20:00.433 align:left position:12.5% line:5% size:77.5% So again, we have our impulse, 20:00.433 --> 20:04.633 align:left position:27.5% line:5% size:62.5% it gets transduced into an electrical stimulus 20:04.633 --> 20:06.533 align:left position:20% line:5% size:70% that then is transmitted to the level 20:06.533 --> 20:09.466 align:left position:27.5% line:5% size:62.5% of the dorsal horn of the spinal cord. 20:09.466 --> 20:13.233 align:left position:25% line:5% size:65% At that point, we can modulate the pain impulse. 20:13.233 --> 20:17.000 align:left position:20% line:5% size:70% So we can have excitatory neurotransmitters 20:17.000 --> 20:21.266 align:left position:27.5% line:5% size:62.5% that will intensify the pain experience, 20:21.266 --> 20:25.333 align:left position:17.5% line:5% size:72.5% or we can have the release of inhibitory neurotransmitters 20:25.333 --> 20:27.600 align:left position:27.5% line:5% size:62.5% like the endorphins 20:27.600 --> 20:30.633 align:left position:27.5% line:5% size:62.5% that will decrease the pain experience. 20:32.233 --> 20:36.400 align:left position:12.5% line:5% size:77.5% Then that impulse is projected to higher levels 20:36.400 --> 20:38.066 align:left position:20% line:5% size:70% of conscious perception. 20:39.800 --> 20:42.333 align:left position:25% line:71% size:65% So with that in mind, 20:42.333 --> 20:44.766 align:left position:27.5% line:71% size:62.5% we can look at one of the theories 20:44.766 --> 20:48.166 align:left position:17.5% line:71% size:72.5% for how acupuncture creates its analgesic effects, 20:48.166 --> 20:50.833 align:left position:27.5% line:71% size:62.5% and that is called the gate control theory. 20:50.833 --> 20:53.466 align:left position:12.5% line:71% size:77.5% The gate control theory states 20:53.466 --> 20:57.933 align:left position:10% line:71% size:80% that when we place these needles into the skin, 20:57.933 --> 21:02.833 align:left position:27.5% line:71% size:62.5% we stimulate those large, myelinated fibers 21:02.833 --> 21:05.766 align:left position:27.5% line:71% size:62.5%   responsible for fast, pinprick pain. 21:06.766 --> 21:10.266 align:left position:12.5% line:5% size:77.5% That gets carried to the level of the spinal cord, 21:11.266 --> 21:15.533 align:left position:15% line:5% size:75% and the release of inhibitory neurotransmitters occurs, 21:15.533 --> 21:18.800 align:left position:25% line:5% size:65% so we release things like endorphins, 21:20.200 --> 21:26.766 align:left position:20% line:5% size:70% which will close the gate and decrease the pain experience 21:26.766 --> 21:32.566 align:left position:12.5% line:5% size:77.5% from those slow, burning, more pathologic pain nociceptors, 21:32.566 --> 21:34.333 align:left position:35% line:5% size:55% the C fibers. 21:34.333 --> 21:37.900 align:left position:12.5% line:5% size:77.5% The small, unmyelinated fibers responsible 21:37.900 --> 21:39.633 align:left position:22.5% line:5% size:67.5% for slow, burning pain. 21:41.900 --> 21:46.266 align:left position:20% line:83% size:70% The points themselves are based on the meridian system 21:46.266 --> 21:48.166 align:left position:25% line:89% size:65% of human acupuncture. 21:48.166 --> 21:50.866 align:left position:22.5% line:83% size:67.5% So it's the same names and the same codes 21:50.866 --> 21:53.933 align:left position:37.5% line:83% size:52.5% that we use in human acupuncture, 21:53.933 --> 21:57.933 align:left position:20% line:83% size:70% and everything has a very specific anatomic location 21:57.933 --> 21:59.500 align:left position:27.5% line:89% size:62.5% associated with it. 21:59.500 --> 22:04.300 align:left position:35% line:5% size:55% For example, if I were to read spleen 6 22:04.300 --> 22:08.933 align:left position:17.5% line:5% size:72.5% is three cun directly above the tip of the medial malleolus 22:08.933 --> 22:11.333 align:left position:22.5% line:5% size:67.5% on the posterior border of the tibia. 22:12.733 --> 22:18.533 align:left position:20% line:5% size:70% Now, when I look at these different anatomic locations, 22:18.533 --> 22:23.100 align:left position:22.5% line:5% size:67.5% I can look and say that the interior of the tibia 22:23.100 --> 22:24.833 align:left position:37.5% line:5% size:52.5% is 13 cun, 22:24.833 --> 22:29.500 align:left position:15% line:5% size:75% whereas the external portion of the tibia is 16 cun. 22:30.500 --> 22:33.566 align:left position:20% line:5% size:70% But keeping that in mind that it's 13 cun, 22:33.566 --> 22:36.333 align:left position:30% line:5% size:60% then I know that this point, spleen 6, 22:36.333 --> 22:40.766 align:left position:30% line:5% size:60% is approximately 25% more proximal 22:40.766 --> 22:42.633 align:left position:17.5% line:5% size:72.5% up the level of the tibia. 22:42.633 --> 22:44.333 align:left position:10% line:5% size:80% So working our way up the tibia, 22:44.333 --> 22:48.366 align:left position:17.5% line:5% size:72.5% it's gonna be approximately 25% up the level of the tibia. 22:49.500 --> 22:51.466 align:left position:32.5% line:71% size:57.5% And so we find most of our points 22:51.466 --> 22:54.200 align:left position:32.5% line:71% size:57.5% based on these anatomic descriptions. 22:55.200 --> 22:57.933 align:left position:10% line:71% size:80% You can also use something like a point finder. 22:57.933 --> 23:02.866 align:left position:27.5% line:71% size:62.5% A point finder is, it's a small machine 23:02.866 --> 23:05.200 align:left position:27.5% line:71% size:62.5% that actually looks for electrical resistance 23:05.200 --> 23:06.966 align:left position:30% line:71% size:60% within the skin. 23:06.966 --> 23:08.466 align:left position:15% line:71% size:75% This is beneficial in people. 23:08.466 --> 23:11.166 align:left position:22.5% line:71% size:67.5% It's not as beneficial in our veterinary patients 23:11.166 --> 23:13.500 align:left position:30% line:71% size:60% that are covered with hair or fur. 23:15.866 --> 23:19.000 align:left position:20% line:71% size:70% When looking at something like chronic pain, 23:19.000 --> 23:25.900 align:left position:17.5% line:71% size:72.5% we look at it like we would any other method of analgesia, 23:25.900 --> 23:31.233 align:left position:25% line:71% size:65% in that I don't look at an animal 23:31.233 --> 23:35.433 align:left position:15% line:71% size:75% that has been suffering pain for weeks or months 23:35.433 --> 23:40.100 align:left position:20% line:71% size:70% and expect that one pill of a pain medication 23:40.100 --> 23:42.333 align:left position:30% line:71% size:60% is going to treat all of its pain. 23:42.333 --> 23:45.833 align:left position:15% line:71% size:75% I know that I'm going to have to give continued treatment 23:45.833 --> 23:49.500 align:left position:12.5% line:71% size:77.5% to see improvement, and that's the same with acupuncture. 23:49.500 --> 23:53.400 align:left position:30% line:5% size:60% So we really need to approach chronic pain 23:53.400 --> 23:55.233 align:left position:22.5% line:5% size:67.5% with several treatments 23:55.233 --> 23:59.833 align:left position:12.5% line:5% size:77.5% and know that these treatments will build upon each other 23:59.833 --> 24:02.433 align:left position:10% line:5% size:80% and the effect will be additive, 24:02.433 --> 24:05.300 align:left position:17.5% line:5% size:72.5% and that we should give it a number of treatments 24:05.300 --> 24:08.566 align:left position:22.5% line:5% size:67.5% before we really assess whether the acupuncture 24:08.566 --> 24:11.200 align:left position:17.5% line:5% size:72.5% is working or not for that particular patient. 24:13.166 --> 24:18.166 align:left position:15% line:5% size:75% Electroacupuncture is simply, I pointed out earlier, 24:18.166 --> 24:22.833 align:left position:15% line:5% size:75% is simply adding small clips to the needles themselves 24:22.833 --> 24:26.033 align:left position:25% line:5% size:65% and adding a very low electrical current 24:26.033 --> 24:28.200 align:left position:22.5% line:5% size:67.5% between those needles. 24:28.200 --> 24:30.866 align:left position:17.5% line:5% size:72.5% The stimulation of needles 24:30.866 --> 24:34.733 align:left position:22.5% line:5% size:67.5% creates a more profound analgesic effect. 24:34.733 --> 24:36.700 align:left position:10% line:71% size:80% So I say that electroacupuncture 24:36.700 --> 24:40.333 align:left position:12.5% line:71% size:77.5% is simply taking a highlighter to that effect, 24:40.333 --> 24:42.300 align:left position:32.5% line:71% size:57.5% and we're just highlighting that effect. 24:43.300 --> 24:44.966 align:left position:25% line:71% size:65% Now, we can stimulate the needles 24:44.966 --> 24:46.333 align:left position:17.5% line:71% size:72.5% a couple of different ways. 24:46.333 --> 24:48.433 align:left position:17.5% line:71% size:72.5% So you can rotate needles. 24:49.433 --> 24:52.133 align:left position:22.5% line:71% size:67.5% They used to have women that would sit in a room, 24:52.133 --> 24:53.733 align:left position:27.5% line:71% size:62.5% and they'd actually spin the needles 24:53.733 --> 24:56.300 align:left position:20% line:71% size:70% up to 200 times a minute. 24:57.733 --> 25:02.100 align:left position:20% line:71% size:70% I jokingly say that their carpal tunnel then kicked in 25:02.100 --> 25:04.633 align:left position:20% line:71% size:70% and they could no longer spin the needles for them 25:04.633 --> 25:06.500 align:left position:22.5% line:71% size:67.5% and needed acupuncture themselves. 25:07.500 --> 25:11.200 align:left position:20% line:71% size:70% Other methods, if anybody has ever had acupuncture, 25:12.200 --> 25:13.800 align:left position:20% line:71% size:70% sometimes, practitioners will come in 25:13.800 --> 25:16.066 align:left position:25% line:71% size:65% and spin the needles periodically, 25:16.066 --> 25:18.533 align:left position:25% line:71% size:65% or they're actually, some individuals will come in 25:18.533 --> 25:20.233 align:left position:17.5% line:71% size:72.5% and actually flick needles. 25:21.866 --> 25:26.133 align:left position:12.5% line:71% size:77.5% But the most consistent method for stimulating a needle 25:26.133 --> 25:29.166 align:left position:32.5% line:71% size:57.5% is adding that electrical stimulation. 25:29.166 --> 25:33.033 align:left position:25% line:5% size:65% It is very repeatable in every patient. 25:34.033 --> 25:37.100 align:left position:12.5% line:5% size:77.5% And that electrical stimulation is more intense 25:37.100 --> 25:39.900 align:left position:32.5% line:5% size:57.5% than any of the manual manipulation could be. 25:41.466 --> 25:48.100 align:left position:12.5% line:5% size:77.5% I point out this study, and you can see just as a fun aside, 25:48.100 --> 25:51.900 align:left position:22.5% line:5% size:67.5% this is actually doing electroacupuncture on a giraffe 25:51.900 --> 25:53.633 align:left position:22.5% line:5% size:67.5% that was anesthetized. 25:53.633 --> 25:57.066 align:left position:30% line:5% size:60% They tend to have muscle contraction 25:57.066 --> 25:58.666 align:left position:17.5% line:5% size:72.5% while they're anesthetized. 25:58.666 --> 26:01.066 align:left position:25% line:5% size:65% And so we were using electroacupuncture 26:01.066 --> 26:04.433 align:left position:27.5% line:5% size:62.5% to keep the muscles soft and supple 26:04.433 --> 26:06.933 align:left position:27.5% line:5% size:62.5% so that the giraffe could stand up 26:06.933 --> 26:08.666 align:left position:10% line:5% size:80% without any complications there. 26:09.833 --> 26:11.300 align:left position:17.5% line:89% size:72.5% And I point out this study 26:11.300 --> 26:16.100 align:left position:17.5% line:83% size:72.5% because it's really looking at the neurotransmitters 26:16.100 --> 26:20.066 align:left position:20% line:83% size:70% that are released in the presence of electroacupuncture 26:20.066 --> 26:21.566 align:left position:30% line:89% size:60% and acupuncture. 26:21.566 --> 26:25.300 align:left position:10% line:83% size:80% And the point is not to read off all of these neurotransmitters, 26:25.300 --> 26:29.833 align:left position:17.5% line:83% size:72.5% but you can see that there are different types of pain 26:29.833 --> 26:31.600 align:left position:27.5% line:89% size:62.5% that was looked at, 26:31.600 --> 26:36.366 align:left position:27.5% line:83% size:62.5% and looking at the periphery versus the spinal 26:36.366 --> 26:39.833 align:left position:27.5% line:83% size:62.5% versus the central nervous system, 26:39.833 --> 26:43.566 align:left position:22.5% line:83% size:67.5% and looking at all the different neurotransmitters 26:43.566 --> 26:47.033 align:left position:25% line:83% size:65% that can be affected by using acupuncture 26:47.033 --> 26:50.033 align:left position:22.5% line:89% size:67.5% and electroacupuncture, 26:50.033 --> 26:52.900 align:left position:25% line:83% size:65% and how all of these neurotransmitters 26:52.900 --> 26:58.400 align:left position:17.5% line:71% size:72.5% can affect the pain impulse and decrease the pain experience 26:58.400 --> 27:00.800 align:left position:15% line:71% size:75% for both humans and animals. 27:02.966 --> 27:07.633 align:left position:17.5% line:71% size:72.5% So science has a lot to say about acupuncture. 27:07.633 --> 27:13.066 align:left position:12.5% line:71% size:77.5% We know that neurotransmitters are heavily involved 27:13.066 --> 27:20.033 align:left position:17.5% line:71% size:72.5% in the pain reduction that acupuncture can produce. 27:20.033 --> 27:22.200 align:left position:32.5% line:71% size:57.5% We know that it decreases muscle spasms 27:22.200 --> 27:24.200 align:left position:25% line:71% size:65% and improves comfort in patients. 27:25.200 --> 27:30.233 align:left position:12.5% line:71% size:77.5% I've not really even discussed the therapeutic benefits, 27:30.233 --> 27:34.600 align:left position:20% line:71% size:70% but the science community is aware 27:34.600 --> 27:36.533 align:left position:20% line:71% size:70% that all of these things are happening. 27:37.666 --> 27:39.866 align:left position:12.5% line:71% size:77.5% What I think is really fun then 27:39.866 --> 27:45.666 align:left position:22.5% line:71% size:67.5% is to pay homage to the history of acupuncture 27:45.666 --> 27:46.866 align:left position:15% line:71% size:75% and to really talk about some 27:46.866 --> 27:49.566 align:left position:27.5% line:71% size:62.5% of the traditional Chinese medicine as well. 27:49.566 --> 27:52.733 align:left position:22.5% line:71% size:67.5% This is often, when we talk about acupuncture, 27:52.733 --> 27:55.833 align:left position:22.5% line:71% size:67.5% this is where we start to lose people a little bit 27:55.833 --> 28:01.166 align:left position:12.5% line:71% size:77.5% is when we start to talk about traditional Chinese medicine 28:01.166 --> 28:04.033 align:left position:27.5% line:71% size:62.5% and the aspects of traditional Chinese medicine. 28:05.200 --> 28:08.133 align:left position:30% line:71% size:60% People tend to go towards the science side 28:08.133 --> 28:12.166 align:left position:27.5% line:71% size:62.5% and the traditional Chinese medicine loses them 28:12.166 --> 28:14.400 align:left position:35% line:71% size:55% a little bit, which is one of the reasons 28:14.400 --> 28:17.666 align:left position:35% line:71% size:55%   that I love talking about it with all of the clients 28:17.666 --> 28:19.466 align:left position:27.5% line:83% size:62.5% while I'm treating their patients 28:19.466 --> 28:24.433 align:left position:20% line:83% size:70% and to really incorporate the history with the science. 28:25.433 --> 28:29.833 align:left position:12.5% line:83% size:77.5% So traditional Chinese medicine has five components, 28:29.833 --> 28:32.700 align:left position:30% line:83% size:60% with acupuncture just being one component. 28:32.700 --> 28:34.533 align:left position:25% line:83% size:65% So you can see that, obviously, acupuncture 28:34.533 --> 28:37.766 align:left position:17.5% line:83% size:72.5% is one of the components of traditional Chinese medicine. 28:38.766 --> 28:41.900 align:left position:20% line:83% size:70% But the other components include herbal medicine. 28:42.900 --> 28:46.200 align:left position:25% line:83% size:65% And herbal medicine, again, this is something 28:46.200 --> 28:47.933 align:left position:30% line:83% size:60% where some people sort of glaze over 28:47.933 --> 28:51.166 align:left position:25% line:83% size:65% and they don't quite, you know, treating things 28:51.166 --> 28:53.466 align:left position:12.5% line:89% size:77.5% with herbs seems very difficult 28:53.466 --> 28:57.200 align:left position:22.5% line:83% size:67.5% for certain individuals to wrap their head around. 28:58.200 --> 29:00.566 align:left position:37.5% line:71% size:52.5% But really, I could go back and say 29:00.566 --> 29:04.900 align:left position:17.5% line:71% size:72.5% that morphine is actually a derivative of the poppy plant. 29:04.900 --> 29:10.700 align:left position:10% line:71% size:80% And so morphine in and of itself is a type of herbal remedy. 29:10.700 --> 29:17.033 align:left position:17.5% line:71% size:72.5% So we can develop synthetic opioids following that, 29:17.033 --> 29:22.266 align:left position:15% line:71% size:75% but really, the gold standard opioid morphine 29:22.266 --> 29:24.266 align:left position:25% line:71% size:65% is an herbal remedy. 29:24.266 --> 29:27.566 align:left position:15% line:71% size:75% And so herbal medicine really targets what's happening 29:27.566 --> 29:30.733 align:left position:10% line:71% size:80% within the body, and individuals 29:30.733 --> 29:34.466 align:left position:30% line:71% size:60% would describe it as daily acupuncture, 29:34.466 --> 29:36.700 align:left position:10% line:71% size:80% very specific daily acupuncture. 29:36.700 --> 29:40.266 align:left position:30% line:71% size:60% So really getting targeted therapy 29:40.266 --> 29:42.100 align:left position:25% line:71% size:65% to what is happening within the body. 29:43.100 --> 29:46.066 align:left position:25% line:71% size:65%   Another component of traditional Chinese medicine 29:46.066 --> 29:49.166 align:left position:25% line:83% size:65% is massage, and this is called tui na. 29:49.166 --> 29:56.500 align:left position:17.5% line:83% size:72.5% And tui na is not a lovely, relaxing massage. 29:56.500 --> 29:59.733 align:left position:32.5% line:83% size:57.5% It is actually a very intense massage, 29:59.733 --> 30:02.166 align:left position:30% line:71% size:60% where most people will describe it 30:02.166 --> 30:05.500 align:left position:12.5% line:71% size:77.5% as the end justifies the means. 30:05.500 --> 30:08.900 align:left position:15% line:71% size:75% It can be quite uncomfortable during the process, 30:08.900 --> 30:12.033 align:left position:35% line:71% size:55% but produces very beneficial effects 30:12.033 --> 30:16.933 align:left position:22.5% line:71% size:67.5% in targeting meridians and targeting pressure points 30:16.933 --> 30:18.100 align:left position:30% line:71% size:60% within the body. 30:19.100 --> 30:23.033 align:left position:12.5% line:83% size:77.5% Another component is exercise, which is qigong, 30:23.033 --> 30:27.966 align:left position:20% line:83% size:70% which is an exercise that is very similar to Tai chi 30:27.966 --> 30:33.300 align:left position:22.5% line:83% size:67.5% and really incorporates the mind-body connection. 30:34.633 --> 30:36.566 align:left position:22.5% line:71% size:67.5% So it is slow movements 30:36.566 --> 30:40.200 align:left position:27.5% line:71% size:62.5% that promote health in the joints, 30:40.200 --> 30:43.933 align:left position:22.5% line:71% size:67.5% as well as having that mind-body connection. 30:45.033 --> 30:48.333 align:left position:12.5% line:71% size:77.5% I jokingly say that I have yet 30:48.333 --> 30:52.800 align:left position:17.5% line:71% size:72.5% to get my dog to do Tai chi with me in the morning, 30:53.800 --> 30:55.233 align:left position:30% line:71% size:60% but what I can do 30:55.233 --> 30:58.133 align:left position:22.5% line:71% size:67.5% is have a relaxing walk with my dog 30:58.133 --> 31:00.333 align:left position:15% line:71% size:75% to incorporate that exercise. 31:00.333 --> 31:04.466 align:left position:20% line:71% size:70% So it's not about running and getting his heart rate up 31:04.466 --> 31:06.733 align:left position:25% line:71% size:65% and moving as quickly as possible, 31:06.733 --> 31:10.600 align:left position:12.5% line:71% size:77.5% but it is about more relaxation and movement of the body. 31:11.600 --> 31:14.600 align:left position:17.5% line:71% size:72.5% And then the last component is food therapy. 31:14.600 --> 31:18.766 align:left position:20% line:71% size:70% Food therapy is a really interesting topic. 31:20.166 --> 31:27.000 align:left position:20% line:71% size:70% It is much more than just eat the right thing 31:27.000 --> 31:28.800 align:left position:22.5% line:71% size:67.5% and you'll feel better. 31:28.800 --> 31:32.900 align:left position:17.5% line:71% size:72.5% Food therapy really targets cooling food and warming food, 31:32.900 --> 31:34.900 align:left position:17.5% line:71% size:72.5% and looking at individuals. 31:35.900 --> 31:39.766 align:left position:15% line:71% size:75% It's using food as medicine. 31:39.766 --> 31:43.233 align:left position:20% line:71% size:70% And when I talk to people about this, 31:43.233 --> 31:45.100 align:left position:32.5% line:71% size:57.5% I usually have, if I'm in a group, 31:45.100 --> 31:50.000 align:left position:15% line:71% size:75% I'll have people raise their hand if they're always cold. 31:50.000 --> 31:52.533 align:left position:17.5% line:71% size:72.5% And inevitably, there will be people in the group 31:52.533 --> 31:54.333 align:left position:22.5% line:71% size:67.5% that raise their hand, 31:54.333 --> 31:58.800 align:left position:17.5% line:71% size:72.5% and I can say, "One of the things you can try 31:58.800 --> 32:03.100 align:left position:17.5% line:71% size:72.5% is to incorporate cinnamon into your diet." 32:03.100 --> 32:06.166 align:left position:17.5% line:71% size:72.5% Cinnamon is a warming herb, 32:06.166 --> 32:09.766 align:left position:20% line:71% size:70% and it can actually warm the body from the inside. 32:09.766 --> 32:13.300 align:left position:25% line:71% size:65% Then you can ask the same question in opposite 32:13.300 --> 32:16.000 align:left position:20% line:71% size:70% and say, "How many people are hot all the time?" 32:16.000 --> 32:19.166 align:left position:20% line:71% size:70% And inevitably, there are people that raise their hand. 32:20.333 --> 32:23.633 align:left position:22.5% line:71% size:67.5% Try incorporating mint into your diet. 32:23.633 --> 32:26.700 align:left position:22.5% line:71% size:67.5% Mint is a cooling herb. 32:26.700 --> 32:28.433 align:left position:27.5% line:71% size:62.5% Well, beyond herbs, 32:29.433 --> 32:32.833 align:left position:20% line:71% size:70% there are proteins that are cooling and warming, 32:32.833 --> 32:38.633 align:left position:20% line:71% size:70% and spice and spice level plays a component in this. 32:38.633 --> 32:43.433 align:left position:17.5% line:71% size:72.5% And so it's really looking at food as medicine 32:43.433 --> 32:45.633 align:left position:12.5% line:71% size:77.5% to treat what is ailing someone in the body. 32:47.766 --> 32:50.166 align:left position:12.5% line:71% size:77.5%   On a traditional basis, as I mentioned, 32:50.166 --> 32:52.866 align:left position:15% line:89% size:75% acupuncture has been utilized 32:52.866 --> 32:56.733 align:left position:25% line:83% size:65% in writing, at least, for 3,000 years, 32:56.733 --> 32:58.766 align:left position:27.5% line:83% size:62.5% and realistically, it's probably been practiced 32:58.766 --> 33:00.300 align:left position:25% line:89% size:65% for longer than that. 33:01.700 --> 33:04.200 align:left position:30% line:83% size:60% It's thought that traditionally speaking, 33:04.200 --> 33:07.900 align:left position:22.5% line:83% size:67.5% a decrease or increase in energy flow or qi 33:07.900 --> 33:13.300 align:left position:20% line:83% size:70% along hypothesized lines or channels within the body 33:13.300 --> 33:16.000 align:left position:20% line:83% size:70% are the basis for disease within the body. 33:17.000 --> 33:20.866 align:left position:12.5% line:83% size:77.5% And these hypothesized channels are called meridians. 33:20.866 --> 33:22.400 align:left position:20% line:89% size:70% In reality, the meridians 33:22.400 --> 33:25.566 align:left position:15% line:83% size:75% have never been demonstrated to exist. 33:26.700 --> 33:28.500 align:left position:30% line:89% size:60% That being said, 33:29.700 --> 33:31.400 align:left position:30% line:71% size:60% there are studies out there that say 33:31.400 --> 33:33.733 align:left position:12.5% line:71% size:77.5% that there's something to them. 33:33.733 --> 33:37.433 align:left position:30% line:71% size:60% So we have found, scientifically, we've found 33:37.433 --> 33:41.266 align:left position:20% line:71% size:70% that the meridian systems themselves, 33:41.266 --> 33:43.400 align:left position:15% line:71% size:75% there are multiple meridians in the body, 33:43.400 --> 33:48.033 align:left position:27.5% line:71% size:62.5% but those meridians follow nerve pathways 33:48.033 --> 33:52.533 align:left position:10% line:71% size:80% or they follow connective tissue in the body. 33:52.533 --> 33:55.933 align:left position:27.5% line:71% size:62.5% So they're actually following anatomic structures 33:55.933 --> 33:57.100 align:left position:30% line:71% size:60% within the body. 33:58.100 --> 34:01.000 align:left position:15% line:71% size:75% And they actually have found 34:01.000 --> 34:04.600 align:left position:22.5% line:71% size:67.5% that some of the points themselves 34:04.600 --> 34:09.166 align:left position:10% line:71% size:80% are right over major connections 34:09.166 --> 34:11.500 align:left position:25% line:71% size:65% of connective tissue within the body, 34:11.500 --> 34:15.033 align:left position:20% line:71% size:70% and even over areas where there is connective tissue 34:15.033 --> 34:20.366 align:left position:32.5% line:71% size:57.5% that dives deep in between musculature 34:20.366 --> 34:23.900 align:left position:22.5% line:71% size:67.5% and incorporates a lot of the nerve fibers. 34:23.900 --> 34:29.500 align:left position:15% line:71% size:75% So these points follow these fascial planes in the body. 34:30.500 --> 34:32.166 align:left position:15% line:71% size:75% These meridians follow them. 34:32.166 --> 34:37.666 align:left position:22.5% line:71% size:67.5% We also have found that the meridians tend to be 34:37.666 --> 34:42.566 align:left position:12.5% line:71% size:77.5% right over big neuronal bundles within the body. 34:42.566 --> 34:44.933 align:left position:25% line:5% size:65% So these two studies are looking at those 34:44.933 --> 34:47.266 align:left position:22.5% line:5% size:67.5% and saying that there's actually something 34:47.266 --> 34:48.700 align:left position:27.5% line:5% size:62.5% to these meridians. 34:48.700 --> 34:53.066 align:left position:15% line:5% size:75% Although we can't prove that they anatomically really exist, 34:53.066 --> 34:56.666 align:left position:20% line:5% size:70% we know that they follow structures that exist. 34:59.166 --> 35:00.766 align:left position:22.5% line:5% size:67.5% On a traditional basis, 35:00.766 --> 35:04.133 align:left position:30% line:5% size:60% pain is a result of excess conditions 35:04.133 --> 35:06.633 align:left position:22.5% line:5% size:67.5% leading to obstruction of circulation 35:06.633 --> 35:09.133 align:left position:25% line:5% size:65% within that meridian. 35:09.133 --> 35:13.000 align:left position:22.5% line:5% size:67.5% So we can have exterior pathogenic factors. 35:14.100 --> 35:15.900 align:left position:20% line:5% size:70% Scientifically speaking, we could say that 35:15.900 --> 35:19.733 align:left position:20% line:5% size:70% that's a heavy flu season 35:19.733 --> 35:23.866 align:left position:17.5% line:5% size:72.5% or a high level of ragweed in the air. 35:24.866 --> 35:27.133 align:left position:25% line:5% size:65% Those would be those exterior factors. 35:28.233 --> 35:31.333 align:left position:20% line:5% size:70% It could be interior cold or heat, 35:31.333 --> 35:33.766 align:left position:17.5% line:5% size:72.5% stagnation of qi or blood. 35:34.766 --> 35:38.633 align:left position:25% line:5% size:65% And all of this is a little hard to understand 35:38.633 --> 35:40.166 align:left position:25% line:5% size:65% at first, of course, 35:40.166 --> 35:43.333 align:left position:20% line:5% size:70% because it's really just learning a new language 35:43.333 --> 35:45.133 align:left position:15% line:5% size:75% associated with acupuncture, 35:46.300 --> 35:49.500 align:left position:22.5% line:71% size:67.5% and it's this language of internal medicine 35:49.500 --> 35:52.266 align:left position:30% line:71% size:60% before there was internal medicine. 35:52.266 --> 35:57.200 align:left position:22.5% line:71% size:67.5% So although it sounds, talking about something 35:57.200 --> 36:00.100 align:left position:30% line:71% size:60% like qi might be a little bit hard 36:00.100 --> 36:05.200 align:left position:20% line:71% size:70% to wrap your head around, it's really describing things 36:05.200 --> 36:09.600 align:left position:22.5% line:71% size:67.5% before Western medicine described it in a different way. 36:09.600 --> 36:12.133 align:left position:22.5% line:71% size:67.5% It's really just using a different language 36:12.133 --> 36:14.500 align:left position:10% line:71% size:80% to describe very similar things. 36:14.500 --> 36:16.600 align:left position:35% line:71% size:55% And so again, I think it's important 36:16.600 --> 36:18.700 align:left position:27.5% line:71% size:62.5% that we learn some of this language 36:18.700 --> 36:21.000 align:left position:27.5% line:71% size:62.5% so we can translate between the two. 36:23.200 --> 36:24.400 align:left position:22.5% line:5% size:67.5% On a traditional basis, 36:24.400 --> 36:28.200 align:left position:20% line:5% size:70% pain can also be a result of deficiency conditions. 36:28.200 --> 36:33.300 align:left position:17.5% line:5% size:72.5% So deficiency of qi, blood, consumption of bodily fluids. 36:34.300 --> 36:35.800 align:left position:15% line:5% size:75% You can also have a situation 36:35.800 --> 36:38.966 align:left position:27.5% line:5% size:62.5% where you just have stagnation of qi, 36:38.966 --> 36:41.166 align:left position:12.5% line:5% size:77.5% which causes a distending pain 36:41.166 --> 36:45.233 align:left position:12.5% line:5% size:77.5% with no real pinpoint location to that pain. 36:45.233 --> 36:48.966 align:left position:10% line:5% size:80% And the best description I could give of that is depression. 36:49.966 --> 36:53.800 align:left position:22.5% line:5% size:67.5% People with depression often describe pain 36:53.800 --> 36:56.133 align:left position:15% line:5% size:75% without a real fixed location 36:56.133 --> 36:58.000 align:left position:27.5% line:5% size:62.5% for where that pain is occurring. 36:59.766 --> 37:02.400 align:left position:27.5% line:5% size:62.5% So the idea is that we wanna restore balance 37:02.400 --> 37:03.566 align:left position:30% line:5% size:60% within the body. 37:03.566 --> 37:05.966 align:left position:22.5% line:71% size:67.5% We wanna take the body to homeostasis. 37:05.966 --> 37:07.566 align:left position:20% line:71% size:70% And what is homeostasis? 37:07.566 --> 37:11.966 align:left position:17.5% line:71% size:72.5% I got into this discussion not long ago with an individual. 37:11.966 --> 37:14.166 align:left position:25% line:71% size:65% What is homeostasis? 37:14.166 --> 37:19.000 align:left position:12.5% line:71% size:77.5% Homeostasis is not a universal term for every individual, 37:19.000 --> 37:22.066 align:left position:30% line:71% size:60% but it's for that specific individual. 37:22.066 --> 37:24.100 align:left position:30% line:71% size:60% So we wanna take that individual, 37:24.100 --> 37:27.366 align:left position:22.5% line:71% size:67.5% that individual animal, that individual person, 37:27.366 --> 37:31.200 align:left position:22.5% line:71% size:67.5% we wanna take them back to their baseline 37:31.200 --> 37:37.300 align:left position:15% line:71% size:75% at which their body performs in the best way possible. 37:37.300 --> 37:40.366 align:left position:17.5% line:71% size:72.5% So we are trying to take it to their baseline 37:40.366 --> 37:43.900 align:left position:30% line:71% size:60% that allows them to have optimum health. 37:43.900 --> 37:46.633 align:left position:30% line:71% size:60%   So needles placed in appropriate locations will help 37:46.633 --> 37:50.133 align:left position:20% line:83% size:70% to alleviate any of these underlying causes of pain, 37:50.133 --> 37:52.500 align:left position:32.5% line:83% size:57.5% or obstruction, or decreased circulation 37:52.500 --> 37:54.600 align:left position:25% line:89% size:65% within the meridians. 37:54.600 --> 37:57.400 align:left position:32.5% line:83% size:57.5% And, therefore, we can alleviate pain, 37:57.400 --> 38:00.100 align:left position:30% line:83% size:60% and we can create therapeutic effects. 38:02.200 --> 38:03.433 align:left position:22.5% line:5% size:67.5% So how do we get there? 38:03.433 --> 38:07.433 align:left position:25% line:5% size:65% How do we know where to place our needles? 38:08.633 --> 38:09.866 align:left position:30% line:5% size:60% Well, we do that 38:09.866 --> 38:12.700 align:left position:17.5% line:5% size:72.5% by developing what's called a pattern diagnosis. 38:12.700 --> 38:13.966 align:left position:27.5% line:5% size:62.5% A pattern diagnosis 38:13.966 --> 38:18.033 align:left position:22.5% line:5% size:67.5% is simply a traditional Chinese medicine diagnosis. 38:19.033 --> 38:23.100 align:left position:30% line:71% size:60% We do that using some terminology 38:23.100 --> 38:25.033 align:left position:12.5% line:71% size:77.5% that's a little bit different. 38:25.033 --> 38:27.100 align:left position:17.5% line:71% size:72.5% The first is yin and yang. 38:27.100 --> 38:30.633 align:left position:12.5% line:71% size:77.5% Yin and yang are in opposition of one another. 38:31.633 --> 38:35.666 align:left position:27.5% line:5% size:62.5% And I think of yin as cool and dark. 38:35.666 --> 38:38.666 align:left position:27.5% line:5% size:62.5% So it is nighttime, it is the moon, 38:38.666 --> 38:40.166 align:left position:17.5% line:5% size:72.5% associated with nighttime. 38:40.166 --> 38:45.066 align:left position:12.5% line:5% size:77.5% It is cold, and so it is winter as far as a season. 38:45.066 --> 38:47.066 align:left position:12.5% line:5% size:77.5% Things slow down in the winter. 38:48.933 --> 38:51.333 align:left position:25% line:5% size:65% As compared to yang, 38:51.333 --> 38:55.733 align:left position:30% line:5% size:60% which is bright, and sunny, and warm, 38:55.733 --> 38:59.533 align:left position:17.5% line:5% size:72.5% and things are moving fast, and it's summer. 38:59.533 --> 39:01.700 align:left position:22.5% line:5% size:67.5% And so we look at these different things. 39:02.700 --> 39:05.600 align:left position:30% line:5% size:60% And how does this come into play? 39:05.600 --> 39:07.033 align:left position:30% line:5% size:60% Well, I might... 39:08.200 --> 39:11.000 align:left position:15% line:5% size:75% Well, I can use the example, I should say, 39:11.000 --> 39:15.600 align:left position:30% line:5% size:60% of something that creates yang excess. 39:15.600 --> 39:18.566 align:left position:20% line:71% size:70% So an animal that is hot, 39:18.566 --> 39:22.266 align:left position:20% line:71% size:70% that can be yang excess, meaning a fever, 39:22.266 --> 39:26.466 align:left position:15% line:71% size:75% or we can have an individual that is hot 39:26.466 --> 39:28.900 align:left position:17.5% line:71% size:72.5% because of yin deficiency. 39:28.900 --> 39:33.900 align:left position:30% line:71% size:60% So a woman going through menopause, 39:33.900 --> 39:38.500 align:left position:15% line:71% size:75% she does not actually have a fever, she is not excess yang. 39:38.500 --> 39:42.933 align:left position:17.5% line:71% size:72.5% Instead, her cooling system is broken, 39:42.933 --> 39:46.333 align:left position:22.5% line:71% size:67.5% causing her to be warm from time to time. 39:46.333 --> 39:48.600 align:left position:17.5% line:71% size:72.5% So she has yin deficiency. 39:48.600 --> 39:51.233 align:left position:17.5% line:71% size:72.5% So it's just looking at it in two different ways. 39:52.800 --> 39:56.766 align:left position:17.5% line:71% size:72.5%   So we can apply yin and yang when looking at a patient. 39:57.766 --> 39:59.166 align:left position:15% line:89% size:75% We can apply it to the body. 39:59.166 --> 40:03.100 align:left position:20% line:83% size:70% So parts that see the sun on one of our patients, 40:03.100 --> 40:05.800 align:left position:25% line:83% size:65% a veterinary patient, that's gonna be the back, 40:05.800 --> 40:09.066 align:left position:17.5% line:83% size:72.5% that's gonna be the outside of the limbs. 40:09.066 --> 40:14.066 align:left position:15% line:83% size:75% Those are yang meridians that pass through those areas. 40:14.066 --> 40:16.333 align:left position:17.5% line:89% size:72.5% We also have yin meridians. 40:16.333 --> 40:19.166 align:left position:12.5% line:83% size:77.5% The yin meridians are gonna be on the abdomen, 40:19.166 --> 40:21.433 align:left position:30% line:83% size:60% they're gonna be on the inside of the legs, 40:21.433 --> 40:24.566 align:left position:20% line:83% size:70% the areas that are dark; they don't see the sun. 40:24.566 --> 40:27.600 align:left position:27.5% line:71% size:62.5% And if I'm looking at a situation 40:27.600 --> 40:32.233 align:left position:32.5% line:71% size:57.5% where a patient has a yin deficiency, 40:32.233 --> 40:36.033 align:left position:20% line:71% size:70% I'm probably gonna wanna stimulate yin points 40:36.033 --> 40:38.766 align:left position:17.5% line:71% size:72.5% to build up the yin system. 40:38.766 --> 40:40.766 align:left position:22.5% line:71% size:67.5% And it's gonna help us in determining 40:40.766 --> 40:44.666 align:left position:25% line:71% size:65% our pattern diagnosis or our diagnosis. 40:45.866 --> 40:49.700 align:left position:27.5% line:5% size:62.5% We can also use the five element theory. 40:49.700 --> 40:53.966 align:left position:17.5% line:5% size:72.5% And the five element theory is really fun to talk about 40:54.966 --> 40:59.900 align:left position:25% line:5% size:65% because I'll discuss the five elements, 41:00.900 --> 41:03.866 align:left position:15% line:5% size:75% and then sort of get to some of the fun parts as well. 41:05.066 --> 41:07.633 align:left position:25% line:5% size:65% But the five elements go in this order. 41:07.633 --> 41:11.033 align:left position:27.5% line:5% size:62.5% Wood, fire, earth, metal, and water. 41:11.033 --> 41:16.033 align:left position:12.5% line:83% size:77.5% And each of those elements has a color associated with it, 41:16.033 --> 41:21.300 align:left position:20% line:83% size:70% it has a taste associated with it, and it has organs. 41:22.300 --> 41:25.933 align:left position:25% line:5% size:65% So the zang-fu organs associated with each. 41:25.933 --> 41:30.400 align:left position:22.5% line:5% size:67.5% Each of those has a yin and a yang organ. 41:32.066 --> 41:36.733 align:left position:10% line:5% size:80% So I can choose the organ system 41:36.733 --> 41:41.633 align:left position:20% line:5% size:70% that would be yin or yang for that particular animal. 41:42.633 --> 41:45.033 align:left position:17.5% line:5% size:72.5% There are also sense organs and body parts, 41:45.033 --> 41:47.400 align:left position:35% line:5% size:55% and we can go through all of these, 41:47.400 --> 41:49.866 align:left position:25% line:5% size:65% and you can see that there are, as I said, 41:49.866 --> 41:53.600 align:left position:17.5% line:5% size:72.5% specific organs associated with the different elements. 41:53.600 --> 41:57.166 align:left position:12.5% line:5% size:77.5% But that doesn't mean much yet. 41:57.166 --> 41:59.800 align:left position:12.5% line:71% size:77.5% But we can actually apply these 41:59.800 --> 42:04.266 align:left position:15% line:71% size:75% to conditions within the body and personality, 42:04.266 --> 42:06.066 align:left position:15% line:71% size:75% and that's where it gets fun. 42:06.066 --> 42:08.800 align:left position:30% line:71% size:60% When I teach this in the vet school, 42:08.800 --> 42:15.566 align:left position:12.5% line:71% size:77.5% I actually add links to quizzes that you can take online 42:15.566 --> 42:20.566 align:left position:17.5% line:71% size:72.5% that tell you which element you are, your personality. 42:20.566 --> 42:21.900 align:left position:27.5% line:71% size:62.5% So I'll go through. 42:21.900 --> 42:28.333 align:left position:20% line:71% size:70% The wood personality is a very take-charge personality. 42:28.333 --> 42:30.600 align:left position:15% line:71% size:75% They are the cruise director. 42:30.600 --> 42:32.833 align:left position:17.5% line:71% size:72.5% They're gonna tell everyone where we're going, 42:32.833 --> 42:35.866 align:left position:12.5% line:71% size:77.5% and what we're doing, and this is when we're gonna go, 42:35.866 --> 42:38.366 align:left position:22.5% line:71% size:67.5% and please be on time. 42:40.133 --> 42:47.266 align:left position:10% line:71% size:80% For animals, I think of a police horse needing to be a wood. 42:47.266 --> 42:51.700 align:left position:17.5% line:71% size:72.5% They need to be take-charge and they need to not back down 42:51.700 --> 42:54.033 align:left position:12.5% line:71% size:77.5% when people are coming at them. 42:54.033 --> 42:59.033 align:left position:17.5% line:71% size:72.5% So that's kind of your wood personality in a nutshell. 42:59.033 --> 43:03.333 align:left position:15% line:71% size:75% When they are out of balance, when woods are out of balance, 43:03.333 --> 43:07.400 align:left position:22.5% line:71% size:67.5% they're prone to tendon and ligament issues. 43:07.400 --> 43:10.933 align:left position:25% line:71% size:65% The fires, those are the social butterflies. 43:10.933 --> 43:15.700 align:left position:22.5% line:71% size:67.5% And they are the poodle that comes up 43:15.700 --> 43:18.166 align:left position:27.5% line:71% size:62.5% and greets everyone at the dog park. 43:18.166 --> 43:20.800 align:left position:27.5% line:71% size:62.5% Dog park, every dog at the dog park, 43:20.800 --> 43:22.300 align:left position:15% line:71% size:75% every person at the dog park, 43:22.300 --> 43:24.266 align:left position:27.5% line:71% size:62.5% and they're friends with everyone. 43:24.266 --> 43:26.800 align:left position:27.5% line:71% size:62.5% They wanna come up and lick your face. 43:26.800 --> 43:29.200 align:left position:30% line:71% size:60% That's your fire. 43:29.200 --> 43:33.733 align:left position:12.5% line:71% size:77.5% We all know social butterflies as well, and oftentimes, 43:33.733 --> 43:38.733 align:left position:32.5% line:71% size:57.5% they are prone to having arrhythmias. 43:38.733 --> 43:41.200 align:left position:22.5% line:71% size:67.5% They also can be prone to anxiety. 43:42.366 --> 43:46.133 align:left position:22.5% line:71% size:67.5% The earths, they're the laid-back individuals. 43:46.133 --> 43:50.266 align:left position:30% line:71% size:60% So the earths are the very mellow Lab 43:50.266 --> 43:52.633 align:left position:20% line:71% size:70% who is extremely friendly 43:52.633 --> 43:55.533 align:left position:20% line:71% size:70% but doesn't feel the need to be in your face. 43:55.533 --> 43:57.666 align:left position:17.5% line:71% size:72.5% They're going to greet you eventually 43:57.666 --> 43:59.100 align:left position:17.5% line:71% size:72.5% when you come to the door, 44:00.300 --> 44:02.233 align:left position:22.5% line:71% size:67.5% but again, they're not gonna charge you down 44:02.233 --> 44:03.966 align:left position:17.5% line:71% size:72.5% and try and lick your face. 44:03.966 --> 44:05.900 align:left position:32.5% line:71% size:57.5% So very mellow. 44:05.900 --> 44:08.200 align:left position:12.5% line:71% size:77.5% Older Lab is a classic example. 44:09.700 --> 44:17.033 align:left position:15% line:71% size:75% And they are prone to worry, and they're prone to overeating. 44:17.033 --> 44:18.900 align:left position:27.5% line:71% size:62.5% So they're actually prone to weight gain 44:18.900 --> 44:21.033 align:left position:15% line:71% size:75% when they are out of balance. 44:21.033 --> 44:23.866 align:left position:15% line:71% size:75% I myself am mostly an earth, 44:25.033 --> 44:28.000 align:left position:22.5% line:71% size:67.5% and do consider myself to be pretty laid-back. 44:28.000 --> 44:31.233 align:left position:10% line:71% size:80% And sure, I like to eat as well. 44:32.533 --> 44:38.400 align:left position:15% line:71% size:75% The metals are best described in animals as aloof. 44:39.400 --> 44:44.166 align:left position:27.5% line:71% size:62.5% In humans, we would describe them as individuals 44:44.166 --> 44:50.100 align:left position:15% line:71% size:75% that are a little antisocial or introverted, 44:51.100 --> 44:53.433 align:left position:17.5% line:71% size:72.5% individuals that like to be by themselves, 44:53.433 --> 44:56.800 align:left position:35% line:71% size:55% and they are extremely meticulous. 44:56.800 --> 45:02.600 align:left position:20% line:71% size:70% So individuals that will unpack the dishwasher 45:02.600 --> 45:04.800 align:left position:17.5% line:71% size:72.5% to put it in the right way. 45:05.800 --> 45:07.266 align:left position:22.5% line:71% size:67.5% Those are your metals. 45:07.266 --> 45:09.933 align:left position:12.5% line:71% size:77.5% In animals, how that manifests 45:09.933 --> 45:12.066 align:left position:17.5% line:71% size:72.5% is that they're the animals that wake up 45:12.066 --> 45:13.766 align:left position:17.5% line:71% size:72.5% at the same time every day, 45:13.766 --> 45:16.000 align:left position:22.5% line:71% size:67.5% they eat from the same food bowl every day. 45:16.000 --> 45:19.600 align:left position:20% line:71% size:70% If you incorporate a new food bowl, they won't eat. 45:19.600 --> 45:23.100 align:left position:27.5% line:71% size:62.5% And so they're very routined animals. 45:23.100 --> 45:26.833 align:left position:15% line:71% size:75% When they are out of balance, they're prone to skin issues 45:26.833 --> 45:29.700 align:left position:20% line:71% size:70% and allergies and asthma. 45:30.866 --> 45:32.666 align:left position:30% line:71% size:60% And then the last are the waters. 45:32.666 --> 45:36.700 align:left position:22.5% line:71% size:67.5% They're extremely loyal to a small group of people. 45:36.700 --> 45:39.433 align:left position:25% line:71% size:65% So they're very loyal family animals, 45:39.433 --> 45:41.033 align:left position:20% line:71% size:70% but not the most social. 45:42.200 --> 45:45.866 align:left position:20% line:71% size:70% They are extremely loyal in people 45:45.866 --> 45:48.266 align:left position:17.5% line:71% size:72.5% to a small group of friends 45:48.266 --> 45:50.666 align:left position:22.5% line:71% size:67.5% and don't feel the need to be friends with everyone, 45:50.666 --> 45:54.533 align:left position:25% line:71% size:65% but profoundly loyal to their group. 45:54.533 --> 45:59.033 align:left position:15% line:71% size:75% In animals, we describe them a little bit as fear biters. 46:00.333 --> 46:03.133 align:left position:27.5% line:71% size:62.5% And then when they are out of balance, 46:03.133 --> 46:06.100 align:left position:32.5% line:71% size:57.5% they are prone to osteoarthritis, 46:06.100 --> 46:10.000 align:left position:25% line:71% size:65% and they can be prone to some kidney concerns. 46:10.000 --> 46:14.833 align:left position:17.5% line:71% size:72.5% So there are personalities associated with all of these. 46:14.833 --> 46:19.833 align:left position:35% line:71% size:55% Additionally, they are phases of life. 46:19.833 --> 46:22.866 align:left position:30% line:71% size:60% So wood being the first phase of life, 46:22.866 --> 46:25.066 align:left position:20% line:71% size:70% going through the phases of life, 46:25.066 --> 46:27.400 align:left position:10% line:71% size:80% lastly, the water phase of life. 46:27.400 --> 46:30.566 align:left position:22.5% line:71% size:67.5% So if you look at water as the last phase 46:30.566 --> 46:32.200 align:left position:20% line:71% size:70% of an individual's life, 46:32.200 --> 46:36.200 align:left position:27.5% line:71% size:62.5% a geriatric animal, or a geriatric individual, 46:36.200 --> 46:42.000 align:left position:20% line:71% size:70% a geriatric human, you'll see osteoarthritis is there 46:42.000 --> 46:44.466 align:left position:12.5% line:71% size:77.5% 'cause bones are the body part. 46:44.466 --> 46:46.266 align:left position:15% line:71% size:75% The sense organ is the ears. 46:46.266 --> 46:49.700 align:left position:10% line:71% size:80% It's very common for individuals to lose their hearing. 46:50.700 --> 46:52.300 align:left position:27.5% line:71% size:62.5% Kidney and bladder; 46:52.300 --> 46:55.933 align:left position:17.5% line:71% size:72.5% we see urinary incontinence occur much more 46:55.933 --> 46:58.066 align:left position:20% line:71% size:70% in our older populations. 46:58.066 --> 47:03.933 align:left position:17.5% line:71% size:72.5% So we use these to help us develop that pattern diagnosis. 47:03.933 --> 47:09.200 align:left position:17.5% line:71% size:72.5% So I ask a lot of questions about an animal's personality. 47:09.200 --> 47:12.366 align:left position:22.5% line:71% size:67.5% So to see what they're predisposed to. 47:13.666 --> 47:16.866 align:left position:15% line:71% size:75% It also helps in determining how we can balance 47:16.866 --> 47:18.366 align:left position:30% line:71% size:60% that individual. 47:18.366 --> 47:21.333 align:left position:17.5% line:71% size:72.5% Because the ideal situation 47:21.333 --> 47:24.400 align:left position:22.5% line:71% size:67.5% is that someone is such a perfect combination 47:24.400 --> 47:27.766 align:left position:37.5% line:71% size:52.5% of all five of these personalities 47:27.766 --> 47:30.233 align:left position:25% line:71% size:65% that nobody can tell what they are 47:30.233 --> 47:32.966 align:left position:30% line:71% size:60% because they are so well-balanced 47:32.966 --> 47:35.866 align:left position:15% line:71% size:75% between all of the elements. 47:37.600 --> 47:39.166 align:left position:22.5% line:71% size:67.5% Oftentimes when people take the quiz, 47:39.166 --> 47:41.166 align:left position:30% line:71% size:60% they'll find that is not the case. 47:43.133 --> 47:45.066 align:left position:20% line:71% size:70% So we also talk about qi, 47:45.066 --> 47:47.533 align:left position:12.5% line:71% size:77.5% and qi is one of those things, as I said, 47:47.533 --> 47:50.566 align:left position:10% line:71% size:80% that gets really hard for people to wrap their head around. 47:51.566 --> 47:55.266 align:left position:15% line:71% size:75% Well, qi is best if we really just break it down 47:55.266 --> 47:59.500 align:left position:17.5% line:71% size:72.5% into the words like energy or health. 47:59.500 --> 48:02.066 align:left position:32.5% line:71% size:57.5% I'd really like to use the word health 48:02.066 --> 48:04.300 align:left position:32.5% line:71% size:57.5% in place of qi. 48:04.300 --> 48:08.433 align:left position:25% line:71% size:65% So when I talk about improving qi in a limb, 48:08.433 --> 48:10.300 align:left position:15% line:71% size:75% what I might really be saying 48:10.300 --> 48:14.000 align:left position:25% line:71% size:65% is I want to improve the health of that limb 48:14.000 --> 48:15.466 align:left position:27.5% line:71% size:62.5% because in reality, 48:15.466 --> 48:20.866 align:left position:25% line:71% size:65% qi is an overarching, all-encompassing term 48:20.866 --> 48:24.500 align:left position:25% line:71% size:65%   for many smaller components of qi. 48:24.500 --> 48:28.633 align:left position:25% line:5% size:65% For example, there's something called gu qi. 48:28.633 --> 48:32.533 align:left position:12.5% line:5% size:77.5% And on my diagram, you can see it's sort of in the top left. 48:32.533 --> 48:35.566 align:left position:17.5% line:5% size:72.5% Gu qi, and that is food qi. 48:35.566 --> 48:40.066 align:left position:20% line:5% size:70% That is the energy or the health that you get from food. 48:41.066 --> 48:47.300 align:left position:27.5% line:5% size:62.5% So we all know that if you eat healthy food, 48:47.300 --> 48:48.866 align:left position:15% line:5% size:75% you will be in better health 48:48.866 --> 48:53.733 align:left position:20% line:5% size:70% than if you eat food that is not as healthy for you. 48:53.733 --> 48:56.733 align:left position:15% line:5% size:75% That is something that's been proven time and time again, 48:56.733 --> 49:00.766 align:left position:32.5% line:5% size:57.5% and we know it from elementary school on. 49:00.766 --> 49:04.333 align:left position:17.5% line:5% size:72.5% There's also qi associated with environmental factors. 49:04.333 --> 49:07.066 align:left position:27.5% line:5% size:62.5% So when the pollen is really high, 49:07.066 --> 49:10.200 align:left position:30% line:5% size:60% I am not gonna be in as good of health 49:10.200 --> 49:12.733 align:left position:32.5% line:5% size:57.5% because I have seasonal allergies. 49:12.733 --> 49:16.500 align:left position:30% line:5% size:60% There's also the immune system qi. 49:16.500 --> 49:21.300 align:left position:20% line:5% size:70% So all of these different components that make up qi. 49:21.300 --> 49:24.566 align:left position:22.5% line:5% size:67.5% So when I am saying qi, 49:24.566 --> 49:26.800 align:left position:35% line:5% size:55% I'm actually describing something 49:26.800 --> 49:30.266 align:left position:30% line:5% size:60% that has multiple smaller components to it. 49:30.266 --> 49:34.000 align:left position:12.5% line:5% size:77.5% And when we start to break that down and really look at it, 49:34.000 --> 49:37.800 align:left position:30% line:5% size:60% we can understand how qi can be the, 49:37.800 --> 49:39.933 align:left position:17.5% line:5% size:72.5% it's all-encompassing word, 49:39.933 --> 49:43.000 align:left position:15% line:5% size:75% and it makes it a little bit more digestible for people 49:43.000 --> 49:47.100 align:left position:25% line:5% size:65% that have a hard time talking about qi 49:47.100 --> 49:48.866 align:left position:20% line:5% size:70% or energy within a body. 49:50.666 --> 49:52.733 align:left position:30% line:83% size:60% So we use things like yin and yang, 49:52.733 --> 49:56.133 align:left position:22.5% line:83% size:67.5% and our organ systems, and our five element, 49:56.133 --> 49:59.300 align:left position:10% line:89% size:80% and we make a pattern diagnosis. 49:59.300 --> 50:00.900 align:left position:25% line:89% size:65% And when we do that, 50:00.900 --> 50:03.966 align:left position:20% line:83% size:70% we might also incorporate a few other things 50:03.966 --> 50:06.966 align:left position:10% line:83% size:80% in addition to their personality and things like that. 50:06.966 --> 50:09.966 align:left position:22.5% line:89% size:67.5% We can include pulses. 50:09.966 --> 50:13.133 align:left position:30% line:83% size:60% So practitioners that are really adept 50:13.133 --> 50:15.200 align:left position:12.5% line:89% size:77.5% at traditional Chinese medicine 50:15.200 --> 50:20.200 align:left position:20% line:71% size:70% can actually feel pulses differently in three locations. 50:21.200 --> 50:24.333 align:left position:32.5% line:71% size:57.5% Along the wrist and the wrist here. 50:24.333 --> 50:29.133 align:left position:20% line:71% size:70% In animals, we might use their femoral pulses, 50:29.133 --> 50:31.900 align:left position:25% line:71% size:65% so just on the inside of the back legs. 50:31.900 --> 50:34.000 align:left position:20% line:5% size:70% But you can actually feel the pulse differently 50:34.000 --> 50:35.533 align:left position:30% line:5% size:60% in each location, 50:35.533 --> 50:39.100 align:left position:17.5% line:5% size:72.5% and you can actually start to interpret what is happening 50:39.100 --> 50:42.733 align:left position:20% line:5% size:70% within the body based on the strength of the pulses 50:42.733 --> 50:44.933 align:left position:15% line:5% size:75% in these different locations. 50:44.933 --> 50:46.133 align:left position:17.5% line:5% size:72.5% I've been doing acupuncture 50:46.133 --> 50:50.666 align:left position:25% line:5% size:65% for many, many years, 15 years-ish, 50:51.666 --> 50:54.633 align:left position:27.5% line:5% size:62.5% and I am not adept at doing this. 50:54.633 --> 50:57.733 align:left position:22.5% line:71% size:67.5% There are practitioners that will feel pulses 50:57.733 --> 50:59.100 align:left position:25% line:71% size:65% for 10 to 15 minutes, 50:59.100 --> 51:01.600 align:left position:27.5% line:71% size:62.5% and they'll be able to list off all the things 51:01.600 --> 51:06.600 align:left position:22.5% line:71% size:67.5% that are wrong with you with a high degree of accuracy. 51:06.600 --> 51:09.333 align:left position:20% line:71% size:70% So there are people that are extremely skilled 51:09.333 --> 51:10.900 align:left position:27.5% line:71% size:62.5% at feeling pulses. 51:12.033 --> 51:13.833 align:left position:25% line:71% size:65% I do look at tongue. 51:13.833 --> 51:15.900 align:left position:12.5% line:71% size:77.5% So we don't think of the tongue 51:15.900 --> 51:19.400 align:left position:17.5% line:71% size:72.5% as having changes in color necessarily, 51:19.400 --> 51:21.900 align:left position:22.5% line:71% size:67.5% but there are actually locations of the tongue 51:21.900 --> 51:25.533 align:left position:22.5% line:71% size:67.5%   that are associated with different elements, 51:25.533 --> 51:30.500 align:left position:20% line:89% size:70% or we can say the organs 51:30.500 --> 51:33.066 align:left position:27.5% line:83% size:62.5% that are associated with those elements. 51:33.066 --> 51:36.200 align:left position:25% line:83% size:65% So you can see spleen and stomach in the center. 51:36.200 --> 51:37.733 align:left position:17.5% line:5% size:72.5% And so we can look at that, 51:37.733 --> 51:41.533 align:left position:22.5% line:5% size:67.5% and we can look at the color changes of the tongue 51:41.533 --> 51:43.733 align:left position:15% line:5% size:75% in these different locations 51:43.733 --> 51:46.966 align:left position:20% line:5% size:70% to see what is happening within the body. 51:46.966 --> 51:49.766 align:left position:20% line:5% size:70% So a really good example 51:49.766 --> 51:52.833 align:left position:30% line:5% size:60% is a pale tongue being qi deficient. 51:54.233 --> 51:58.100 align:left position:25% line:5% size:65% So when I look at the color of the tongue, 51:59.266 --> 52:03.000 align:left position:20% line:5% size:70% when veterinary students are going through finals, 52:03.000 --> 52:06.333 align:left position:32.5% line:5% size:57.5% they almost all have qi stagnation, 52:06.333 --> 52:08.800 align:left position:12.5% line:5% size:77.5% which is the lower left corner. 52:08.800 --> 52:11.366 align:left position:25% line:5% size:65% That is a pale tongue in the middle, 52:11.366 --> 52:14.866 align:left position:15% line:5% size:75% so that's that qi deficiency in the middle, 52:14.866 --> 52:16.966 align:left position:22.5% line:5% size:67.5% but where the heart is, 52:16.966 --> 52:19.300 align:left position:27.5% line:5% size:62.5% and I said anxiety is associated with heart, 52:19.300 --> 52:24.300 align:left position:22.5% line:5% size:67.5% with that fire element, they get a bright red tongue. 52:24.300 --> 52:26.800 align:left position:17.5% line:5% size:72.5% And so during finals time, 52:26.800 --> 52:28.900 align:left position:22.5% line:5% size:67.5% almost all the students have a pale tongue 52:28.900 --> 52:31.200 align:left position:22.5% line:5% size:67.5% with a bright red tip. 52:31.200 --> 52:34.000 align:left position:15% line:71% size:75% And so we see these changes, 52:34.000 --> 52:36.233 align:left position:15% line:71% size:75% and it can help us determine what is happening 52:36.233 --> 52:37.866 align:left position:30% line:71% size:60% within the body. 52:37.866 --> 52:39.200 align:left position:35% line:71% size:55% And you say, 52:39.200 --> 52:41.900 align:left position:20% line:71% size:70% "Well, how can the tongue actually look that different?" 52:41.900 --> 52:43.600 align:left position:20% line:71% size:70%   Well, it can look quite different. 52:44.600 --> 52:47.766 align:left position:20% line:5% size:70% So you can see our friend in the top left corner 52:48.866 --> 52:51.266 align:left position:25% line:5% size:65% has a little bit more of a pale center 52:51.266 --> 52:54.633 align:left position:20% line:5% size:70% with a brighter red tip. 52:55.966 --> 53:00.700 align:left position:32.5% line:5% size:57.5% The ideal color is called peach petal. 53:00.700 --> 53:05.100 align:left position:20% line:5% size:70% And the dog on the bottom has that color more 53:05.100 --> 53:07.433 align:left position:12.5% line:5% size:77.5% around the edge of the tongue, 53:07.433 --> 53:11.533 align:left position:17.5% line:5% size:72.5% with it being a little bit more pale in the spleen center. 53:12.700 --> 53:15.500 align:left position:20% line:5% size:70% The dog in the top right 53:15.500 --> 53:19.466 align:left position:25% line:5% size:65% has more of that red, dark red color, 53:19.466 --> 53:23.600 align:left position:20% line:5% size:70% which if it starts going a little bit towards a purple 53:23.600 --> 53:25.800 align:left position:12.5% line:5% size:77.5% is an indication of stagnation, 53:25.800 --> 53:28.333 align:left position:22.5% line:5% size:67.5% which is usually stress or pain in the body. 53:28.333 --> 53:30.400 align:left position:17.5% line:5% size:72.5% So I'm definitely gonna be looking for pain 53:30.400 --> 53:31.866 align:left position:25% line:5% size:65% within that patient. 53:34.333 --> 53:37.933 align:left position:12.5% line:71% size:77.5% So I take all of these factors into account 53:37.933 --> 53:40.800 align:left position:25% line:71% size:65% when I am looking at a particular patient, 53:40.800 --> 53:46.800 align:left position:22.5% line:71% size:67.5% and I develop a pattern diagnoses or a diagnosis, 53:46.800 --> 53:50.833 align:left position:12.5% line:71% size:77.5% so that I can treat the patient as an individual. 53:50.833 --> 53:52.433 align:left position:10% line:71% size:80% So if I'm looking at acupuncture 53:52.433 --> 53:55.900 align:left position:27.5% line:71% size:62.5% for something like osteoarthritis, 53:55.900 --> 53:59.600 align:left position:17.5% line:71% size:72.5% I'm gonna look at each case individually. 53:59.600 --> 54:03.933 align:left position:15% line:71% size:75% Western medicine might treat patients very similarly, 54:03.933 --> 54:08.800 align:left position:12.5% line:71% size:77.5% whereas the acupuncture in the traditional Chinese medicine 54:08.800 --> 54:11.200 align:left position:25% line:71% size:65% is gonna parse it out a little bit more. 54:12.400 --> 54:15.333 align:left position:12.5% line:5% size:77.5% So I might look at two patients 54:15.333 --> 54:19.900 align:left position:12.5% line:5% size:77.5% that actually are very similar in their presentation. 54:19.900 --> 54:24.400 align:left position:17.5% line:5% size:72.5% So they both have a history of osteoarthritis. 54:24.400 --> 54:27.300 align:left position:20% line:5% size:70% NSAID's help, but lately, it hasn't been helping. 54:29.866 --> 54:34.500 align:left position:12.5% line:5% size:77.5% I then gather more information about each of these patients. 54:35.500 --> 54:38.200 align:left position:25% line:5% size:65% I ask questions about their personality. 54:38.200 --> 54:41.433 align:left position:22.5% line:83% size:67.5% So it looks like Max is pretty mellow and easygoing, 54:41.433 --> 54:43.033 align:left position:25% line:89% size:65% more likely an earth, 54:43.033 --> 54:46.533 align:left position:10% line:83% size:80% whereas Hank is that fear biter; he's a water. 54:46.533 --> 54:52.533 align:left position:17.5% line:83% size:72.5% And I start to see that Max is seeking out warm locations. 54:52.533 --> 54:57.566 align:left position:27.5% line:83% size:62.5% So he's cold a lot, whereas Hank is the opposite. 54:59.000 --> 55:03.500 align:left position:17.5% line:5% size:72.5% And I look at their tongue and I make a pattern diagnosis. 55:04.500 --> 55:09.166 align:left position:20% line:5% size:70% And these two cases that come in looking very similar 55:09.166 --> 55:12.266 align:left position:17.5% line:5% size:72.5% actually have two different pattern diagnoses. 55:13.400 --> 55:17.100 align:left position:12.5% line:89% size:77.5% Max has kidney yang deficiency, 55:17.100 --> 55:21.266 align:left position:30% line:83% size:60% whereas Hank has kidney yin deficiency. 55:21.266 --> 55:23.166 align:left position:17.5% line:89% size:72.5% So they sound very similar, 55:23.166 --> 55:26.266 align:left position:32.5% line:83% size:57.5% but they can be treated individually. 55:28.066 --> 55:31.000 align:left position:15% line:83% size:75% So I can pick points that are very similar for both of them 55:31.000 --> 55:32.500 align:left position:10% line:89% size:80% that are just going to be points 55:32.500 --> 55:35.733 align:left position:17.5% line:83% size:72.5% that are gonna work on the areas of the body that hurt, 55:37.433 --> 55:40.866 align:left position:15% line:89% size:75% but I also can work on points 55:40.866 --> 55:45.266 align:left position:17.5% line:83% size:72.5% that treat that underlying pattern diagnosis. 55:45.266 --> 55:49.166 align:left position:22.5% line:83% size:67.5% So, for one, increasing the yin within the body. 55:49.166 --> 55:54.166 align:left position:12.5% line:83% size:77.5% The other is really toning down the yang within the body. 55:55.166 --> 55:58.333 align:left position:15% line:5% size:75% And so we start to balance it that way, 55:58.333 --> 56:02.066 align:left position:10% line:5% size:80% and we treat them as individuals with the points that we choose. 56:03.066 --> 56:04.966 align:left position:12.5% line:89% size:77.5% And there are nice flow charts 56:04.966 --> 56:07.633 align:left position:22.5% line:83% size:67.5% that help us with this in the beginning 56:07.633 --> 56:12.633 align:left position:15% line:83% size:75% because it is a lot to learn, and a lot to understand, 56:12.633 --> 56:15.333 align:left position:12.5% line:83% size:77.5% and a whole different language, as I said, 56:15.333 --> 56:19.066 align:left position:20% line:83% size:70% from the Western medicine perspective, 56:19.066 --> 56:22.666 align:left position:20% line:83% size:70% and the Western medicine approach, 56:22.666 --> 56:25.833 align:left position:27.5% line:83% size:62.5% and the traditional Chinese medicine approach. 56:28.600 --> 56:31.600 align:left position:20% line:83% size:70% So I wanted to share this with you 56:31.600 --> 56:35.433 align:left position:22.5% line:83% size:67.5% because I'm passionate about acupuncture, 56:35.433 --> 56:38.700 align:left position:12.5% line:89% size:77.5% and I want people to understand 56:38.700 --> 56:40.400 align:left position:22.5% line:71% size:67.5% that we can talk about the history 56:40.400 --> 56:44.000 align:left position:17.5% line:71% size:72.5% and we can talk about these things like yin and yang 56:44.000 --> 56:47.600 align:left position:27.5% line:71% size:62.5% without alienating the Western medicine 56:47.600 --> 56:52.400 align:left position:17.5% line:71% size:72.5% and the science that comes and goes hand in hand 56:52.400 --> 56:53.566 align:left position:30% line:71% size:60% with acupuncture. 56:54.566 --> 56:56.433 align:left position:22.5% line:71% size:67.5% So it's really marrying 56:56.433 --> 56:59.100 align:left position:22.5% line:71% size:67.5% the traditional Chinese medicine approach 56:59.100 --> 57:01.266 align:left position:15% line:71% size:75% and the scientific approach, 57:01.266 --> 57:03.833 align:left position:27.5% line:71% size:62.5% and using them both in combination 57:03.833 --> 57:06.900 align:left position:27.5% line:71% size:62.5% to do what is best for the patient. 57:06.900 --> 57:12.300 align:left position:17.5% line:71% size:72.5% So I thank you for sticking with me throughout this talk. 57:12.300 --> 57:15.533 align:left position:27.5% line:5% size:62.5% And I hope that you learned something 57:15.533 --> 57:20.733 align:left position:15% line:5% size:75% and are open to talking about acupuncture in the future. 57:20.733 --> 57:22.066 align:left position:27.5% line:5% size:62.5% Thank you so much.