Electroacupuncture Quality Issues Revisited
In a previous editorial and article,1,2 I addressed concerns about quality issues involving commercial electroacupuncture stimulators on the market. In my own clinic, I am now calibrating the output of various electrostimulators by using a combination of a frequency meter and an oscilloscope (Figure 1). I can "tune" to the exact frequency output of the electro-stimulator and observe its waveform characteristics. Regrettably, the waveform cannot be modified on many of these devices. One may also observe that as the frequency is increased or when the battery weakens, there is a degradation of the waveform. Consequently, I do not treat the patient under these conditions. Even more, I would like to soften or harden the square wave by changing its slope or even have the option to switch to a sinusoidal wave. A sinusoidal wave has no harmonics, but a square wave does. What will be the effects of stimulating acupuncture points with a sinusoidal output? Sounds like another project brewing. And, as you might suspect, I have already started it. How many of you check your electrostimulators for accuracy and waveform outputs?
On January 27, 2003, I gave a lecture to the Defense Advanced Research Projects Agency3 on a concept that I term "battlefield acupuncture." Dr Terry Oleson, Dr Z.H. Cho, and TSgt Steve Smith assisted in the lecture material. Dr Cho was present and discussed neurophysiologic mechanisms that may substantiate our clinical data.
The United States Armed Forces does not employ acupuncture on the battlefield. Many Asian countries do incorporate acupuncture by virtue of their own traditional practice of medicine. Noteworthy is that traditional Chinese acupuncture being practiced on the Asian battlefield today may now incorporate the use of Western narcotic and non-narcotic analgesics.
Perhaps the most substantial complaint from American military physicians is that prescribing narcotics for severe pain on the battlefield is a reason to temporarily remove the soldier from duty, which severely handicaps, if not terminates, a critical military mission. I proposed in my lecture that ear acupuncture (auriculotherapy) be utilized individually or by the buddy system in a combat situation. Small semi-permanent gold needles may be injected in both ears in the areas of the cingulate gyrus and thalamus points. The anatomic landmarks are very evident, and the technique may be taught in less than 1 hour to combat troops. Although other ear points exist and are useful for pain relief, it is not the purpose to train these troops in the art of auriculotherapy. Based on our clinical data, the attenuation of pain from these small needles injected into the cingulate gyrus and thalamus points may at times equal or surpass that of narcotics without the side effects of mental deprivation. Thus, a military mission may be continued without major compromise.
Several of my colleagues have used this "battlefield acupuncture" technique with a maximum total of 2 needles in each ear achieving outstanding clinical results in their private practice. I urge you to try this technique in the clinic employing the cingulate gyrus and thalamus points especially on patients with fibromyalgia.
I express my gratitude to Roz Royal, Stacy Christiansen-Krol, Deb Odell of The Odell Group, and the Editorial Board in the preparation of this edition of Medical Acupuncture.
— Richard C. Niemtzow, MD, PhD, MPH
- Niemtzow RC. Quality issues of electroacupuncture stimulators. Medical Acupuncture. 2002;14(1):3-4.
- Niemtzow RC, Clydesdale D, Cho Z-H, Oleson T, Son Y-D, Johnstone PAS. Are frequency outputs of commercial electroacupuncture stimulators accurate? (pilot project). Medical Acupuncture. 2002;14(1):41-44.
- The Defense Advanced Research Projects Agency (DARPA) is the central research and development organization for the United States of America, Department of Defense (DoD). It manages and directs selected basic and applied research and development projects for DoD, and pursues research and technology where risk and payoff are both very high, and where success may provide dramatic advances for traditional military roles and missions.
Dr Richard C. Niemtzow is a Radiation Oncologist and a Colonel in the United States Air Force. He is the Chief Medical Consultant for Alternative Medicine for the Air Force Surgeon General. In addition to his research activities, Dr Niemtzow practices Medical Acupuncture full-time at Malcolm Grow Medical Center, Andrews Air Force Base, Maryland. He is President of the Medical Acupuncture Research Foundation (MARF).
Richard C. Niemtzow, MD, PhD, MPH
9800 Cherry Hill Rd
College Park, MD 2074089
Phone: 301-937-7424 • Fax: 301-937-3205
Colonel (Dr) Richard C. Niemtzow
Medical Group (AMC)
Malcolm Grow Medical Center
Andrews AFB, MD 20762