SCIENTIFIC THEORY FOR ACUPUNCTURE PAIN CONTROL, which has eluded scientists for centuries by the little guy Dr. Scott D Neff MPS MSOM DC DABCO DACFE FACFE CFE FFABS FFAAJTS Doctor of Medicine.

  In 1978 this examiner wrote on subjects, which were not yet correlated in physiology textbooks of the day.  I still have my 1978 additions and my articles with comment from many of the most famous physicians, investigators, and various governments and their agencies.  Up until my articles and similar works in various physiology labs around the nation beginning around the same time, muscle neurophysiology was based on the Sartorius Muscle of the Frog.  Sartorius Muscle Frog physiology was taught as human physiology relative to anaerobic and aerobic energy mechanisms in the exercising muscle.  Thus, this young student chiropractor postulated in the Los Angeles College of Chiropractic library, that because Humans were not spooned as tadpoles and could not live under water nor rely on anaerobic glycolysis and its primary energy production metabolism, human neurophysiology was quite different. This examiner wrote two articles which for the first time in history validated Chiropractic Medicine Scientifically, based on Neuroanatomy, Neurology, Clinical Neurology, Physiology, Pathology and the like.  These two articles created a scientific movement within that profession.  Rene Cailliet, MD University of Southern California School of Medicine, Department of Rehabilitative Medicine, 1982 writes to the President of the California Council Against Health Fraud, Inc, “His articles are extremely well written, well documented and substantial in their neurophysiologic concepts.  I seriously congratulate the California Council Against Health Fraud, Inc., and I compliment Dr. Scott David Neff and his intent.  I encourage you both to go further.”

  Early in 1984 Dr. Cailliet wrote, "Dear Dr. Neff:  I read with a great deal of interest your paper, "The Walking Time Bomb": and the copies of the articles, the Journals and references you appended.  I feel that occlusion of vertebral arteries has been well documented in all of your references, or at least the references stated in the journal, you appended... There are also evidence of studies in which cerebral infarcts followed manipulation of the cervical spine...To do research, of justifying that rotation, the "Neff Test" occludes or diminished the vertebral artery flow, would only be reproducing what has already been shown.  My advice, therefore, would be to discuss this with the chief of a neurological service in one of the major medical schools, UC Davis, UCLA, USC or UCFF and become a co-author to an article in one of the major medical journals.  This would, in many ways, justify the care exerted in a diagnostic procedures proceeding cervical manipulation; also, give more credence to the scientific interest of the chiropractic profession and in their continuing medical education.  I will be more than happy to discuss this with you further if you wish, by phone... 

  From this I wrote an additional article inclusive of Dr. Cailliet's advances and analysis and contributions from the inventor of the Space Shuttle fuel injector, the patent bought by Nasa Control, the honorable Nasa Rocket Scientist, holder of over 300 additional US military patents, co-founder and second President of the American Academy For Justice Through Science and the InfoJustice Journal, the honorable Samuel Stein. That published article via assistance from DC magazine, the article "Cervical Manipulation the Death Threat Connection" presented the first Statistical evidence of 1 in 1 million adverse events, which was less then established pharmaceutical standards and much in the way of clinical and intensive scientific discussion.  

  Antithetically it proved that absent the "Neff Tests" (Which this editor had named "The Global Sustained Rotation Test", and then apply the same test with a little extension called appropriately "The Global Sustained Extension Rotational Test.") and often times MRI of the vertebral circulation and circle of Willis, some forms of Cervical Manipulation could be contraindicated for some patients. This author then lectured for Dr. Cailliet at the American Back Society in 1984 for medical physicians who received their yearly continuing medical education (e.g., I was advised by the Medical Accrediting Body that your editor was the first DC in history to do this...two others followed that day.) I would opine that my concepts have of course been incorporated within research and science pursuant to scientific progress.   In fact if one looks at the literature today, my groundbreaking articles, the "Walking Time Bomb" and "Cervical Manipulation the Death Threat Connection" have been copied universally absent being referenced.  Perhaps it was that these were published in the Chiropractic Literature of the early 1980's.  Also the new research demonstrates the ratio maybe higher then 1 in 1 million as there are many more cases then the 184 this researcher had found in world literature back in the day.  And thus it is prudent to help bring out all that is good through early research such as this.

  However after being exposed to Acupuncture and Herbology ( the Following 1982 Original Hypothesis postulated and theory was presented for the National Council Against Health Fraud by this examiner), I could not understand why these Oriental Medical Arts and their practitioners, had not discovered how, or even why acupuncture therapy may have worked for pain control!  I researched and found the known articles, which in truth still had abandoned any comprehension of the brain and its nerve branch function from a researchers prospective.  Once the scientist studies this section, your “a ha” or that part of the human consciousness which recognizes subsets of information and organizes these subsets into the whole immediately or intuitively, will re-correlate today's Scientific Oriental Medicine.  This article has nothing to do with claims other then some pain management.  And from this article and the Book this editor wrote for my Oriental Medical School, I received a scholarship to attend, and subsequently graduated with the degree, Masters of Oriental Medicine and was presented at my graduation "The Oriental Medicine Pioneer's Award".

THE SCIENCE BEHIND ACUPUNCTURE PAIN CONTROL

  The human conscious brain has the ability to direct it’s attention to different segments of sensory formation such as sensory information from the eyes, the ears, the taste receptors, and all somatic receptors.  This is due to the fact that all sensory afferents save the olfactory nerve have connections through the thalamic relay.  This achieves the functions of facilitation or inhibition of cortical receptive areas.  Thus, built within the great human brain, are complex yet easily dissected control mechanisms, which allow for harmony in a vast amount of differing and simultaneous situational sensations and experiences. Much like computer, once a form of access is acquired, (keyboard, modem, fax, microwave and so forth) than, modulation or attenuation or increases and decreases in pain at the level of the brain can be controlled.  This is not to eliminate any other scientific manners of keying in or controlling the brain, or Master Controller of the human body (e.g., Through medical anesthetics/pharmaceuticals via the anesthesiologist or CIA Psychiatrist..).

  This examiner opines, that the Ancients, through trial and error experimentation on actual human test subjects, categorized neurological, sclerotomal, myotomal and to a lesser degree, vascular and lymphatic channels as acupuncture meridians and accidentally gained threshold control over those who have a low threshold to pain or those of greater sensitivity to pain when injured or ill.  This control of the patient is through needling.

  Much like Herbology, nonsense, egotism, and often times power persons have denied acupuncture pain control, which does not work on all folks as you will discover if you study this article, scientific scrutiny for political reasons.  Further, as I indicated in the Forward, of my book, once available here at the Journal, each culture, especially one which had been attacked since its birth by westerners, protects its social mores if possible.  And in the case of Oriental Medicine, this protectionist attitude has been the demise of scientific progress in the profession since the invention and approval of the small acupuncture needles by USFDA used in the United States today, as opposed to the large bore needles used in the Orient.  As a scientist I have no personal gain, nor political, ideological or philosophical barriers.  Yet this research is only that, and does validate or advocate any care, which must be left up to the Licensed practitioner or physician.  In fact, because of what this researcher calls the "invisible injuries", such as any damage to cervical arteries or those in the Circle of Willis, or skeletal anomalies appropriate special study (MRI, CT Scan, Angiography and even X-ray and nerve studies) is then deemed immediately appropriate by this researcher akin to medical scientific review for Acupuncture pain control.

Therefore to review the science thus far:

(1) Corticofugal control equates to the fact that as the pathway begins in the cortex, this is the site where the sensory pathway that controls terminates.  In other words, this feedback loop exists to alter, when necessary, the threshold for different sensory signals.  This equates to the brains ability to focus attention on specific types of information unconsciously and then take the appropriate action. 

(2) The human conscious brain has the ability to direct it’s attention to different segments of sensory formation such as sensory information from the eyes, the ears, the taste receptors, and all somatic receptors.  This is due to the fact that all sensory afferents save the olfactory nerve have connections through the thalamic relay.  This achieves the functions of facilitation or inhibition of cortical receptive areas.  Thus, built within the great human brain, are control mechanism, which allow for harmony in a vast amount of differing and simultaneous situational sensations and experiences

(3)  The human brain can be likened to a advanced computer which is understood by those that have published original concepts in neuroscience, and that the brain can be keyed relative to sensory threshold through the use of microdamage to tissue via acupuncture because the puncture is a microcosm of a large injury or disease with very direct and specific nerve stimulation as in damaged tissue, the release of bradykininn and lysyl-bradykinin because the needle makes a small puncture and tissue ruptures, pain, and healing about the microhole made from the needle.

  However and again, understanding specificity relative to the variables in the human brain gives us a complete understanding of the processes involved.  Thus, to continue, contralateral hemi-anesthesia of the head, trunk and limbs is noted with pathology of the thalamocortical fibers on route to the sensory cortex.  This is seen in stroke patients with vascular lesions in the posterior limb of the internal capsule.  Hemianesthesia, hemianopsia and hemihypacusis occurs with lesions in the posterior third of the posterior limb. (Carpenter: Human Neuroanatomy, 7th edition, Williams and Williams Company, 1977,p.464)

  Thalamocortical and Corticofugal fibers are within the internal capsule.  Remember lesions in this area produce more widespread disability than lesions in an other region of the nervous system.  Such as thrombosis or hemorrhage of the anterior choroidal, striate or capsular branches of the middle cerebral arteries (represents most injuries to the internal capsule).

  The posterior limb of the internal capsule contains corticospinal fibers, frontopontine fibers, the superior thalamic radiation and relatively smaller numbers of corticotectal, coticorubral and coticoreticular fibers.  The corticospinal fibers are organized in a specific manner so that those closest to the genu are concerned with cervical portions of the body, while succeeding, more caudal region are related to the upper extremity, trunk and lower extremity, respectively.  Thus the internal capsule is composed of all the fibers, afferent and efferent, which to, or come from, the cerebral cortex.  A large portion is dedicated to the thalamic radiations.  The remaining is composed of Corticofugal fiber systems (efferent cortical fibers), which descend to lower portions of the brain stem and to the spinal cord. These include the corticospinal, corticobulbar, corticoreticular and corticopontine tracts, as well as number of smaller bundles.  Thus with these tracts involved, acupuncture application anywhere around the body becomes centralized through the ascending sensory fibers and is acknowledged by the cortex as sensation.

  And because the central reticular core must be recognized as a common system of neurons with multiple relays, which are discharged, equivalently by all sensory systems projecting collateral to it, this system is the modulator for recognition of the acupuncture stimulation as a micro tolerable pain which should cause the threshold to be raised.  Such a common system would not be involved in the conscious perception of any one sensory modality, but utility would be afferent functions common to all types of sensory experience, namely, altering and attracting attention.  Thus, it has been noted that the nonspecific sensory impulses ascending in the reticular activating system would appear to function by sharpening the attentive state of the cortex and creating optimal conditions for the conscious perception of sensory impulses mediated by the classical pathways. (Carpenter: Human Neuroanatomy, 7th edition, Williams and Williams Company, 1977 page 392).   And thus, anesthesia and the anesthetic state produced by depressant drugs are due to these two systems differential susceptibility as illustrated above.  Anesthetic states (due to ether and certain barbiturates) are due to impairment or blockage of synaptic transmission in the multi-neuronal reticular activating system.  For example a diminished persistence of impulses in the lemniscal systems and the blocking of impulses in the ascending reticular core (Carpenter: Human Neuroanatomy, 7th edition, Williams and Williams Company, 1977 page 393). Pain sensibility to somatic sensory area II are via key cells in the cortical area responsible to noxious peripheral stimuli.  This somatic sensory area II is connected primarily to the spinothalamic system (or ascending sensory pathways which conduct impulses in the antero-lateral position of the spinal cord) for communication of the sensibility of painful noxious stimulation.  Of course these complex reciprocal connections are relayed through the primary somesthetic area (Carpenter: Human Neuroanatomy, 7th edition, Williams and Williams Company, 1977 p. 566) of the cortex.

  Obviously sophisticates in the neurosciences understand that which I have delineated thus far and of course research demonstrates that Physicians offer reduction in pain in the following procedures based on the above; cordotomy to relieve pain from spinal trauma which has the side effect of Contralateral loss of pain sensation below the level.  Other surgical procedures which alleviate intolerable pain but often are not helpful in chronic pain are nerve section, sympathectomy (for visceral pain), myelotomy to section spinothalamic fibers in anterior white commissure, posterior rhizotomy, anterolateral cordotomy, medullary tractotomy, mesencephalic tractotomy, thalamotomy, gyrectomy and of course prefrontal lobotomy.  These are the surgical anti-pain procedures.  Medicinally, prostaglandin inhibitors such as Aspirin and other non-steroidal anti-inflammatory drugs inhibit the action of prostaglandins and relieve pain; hypalgesia or analgesia.  Prostaglandin’s lower the threshold of perception of peripheral nociceptors and thereby increase the sensibility to pain (hyperalgesia).  Other medicinal mechanisms are the artificial introduction of Enkephalin-like substitutes such as Bayer’s Heroin, Morphine, Demerol, Deladid, Laudanum and Codeine.

  Even with today’s scientific knowledge, these types of pain control are offered by Licensed physicians and surgeons or Doctors of Chiropractic in New Mexico.  Yet it has been this examiners experience that some folks opt away from Orthodox care.  Thus licensed Acupuncturists or Doctors of Chiropractic licensed in Acupuncture use these methods and is clear why the ancients tried acupuncture, Herb’s and manipulation.

  To review this second section, the specific nociceptors described previously as primary affects of a total system ending in the brain.  These are free nerve endings of peripheral and cranial nerves.  Pain fibers in their periphery are of a small diameter and are readily affected by local anesthetic.  Poorly myelinated and unmyelinated fibers make up the A fibers (convey discrete, sharp, short-lasting pain) and the C fibers which transmit chronic, burning, and often unbearable pain.  From  the activation of these fibers central ascending pathways for sensation consist of the spinothalamic tract and spinoreticulothalmic systems.  When we discussed the laminar organization to begin this discussion, realize that this extends to the spinal cord in the way of gray matter cells of laminas I and II and some cells in lamina V respond to noxious stimuli by way of the small diameter afferent fibers.  Laminas III, IV, and VI demonstrate a narrow range of response to non-noxious stimuli via large-diameter afferents; lamina V has a broad range of response.  The large-diameter fibers prevent the lamina V afferents from transmitting signals.  “Stimulating (rubbing) these fibers helps to suppress the sensation of pain, especially sharp pain.  Mothers from all generations even those of the Ancients knew that small children seem to know this instinctively and rub the injured spot, thus activating the large-diameter fibers (Carpenter: Human Neuroanatomy, 7th edition, Williams and Williams Company, 1977 p272).  Thus mothers often rub their children who feel the relief.  Obviously, then Acupuncture would be the most direct way in stimulating the fibers when the point of contact are tissues with the activation site.  Further, now with knowledge in focus, apply this to spinal or back pain and the sudden relief associated with spinal manipulation (e.g., Not to mention the sudden release of spasticity due to the traction of the muscle attachments, realigning joint facets and weight bearing portions of the spinal vertebra as well as a sudden release of local endorphins...).  Indeed. 

  Finally, Western medicine according to Carpenter, formerly attempted to permanently implant electrodes to electrically stimulate the dorsal columns to alleviated sharp pain.  Again, however, Chronic pain, and emotionally burdensome, deep, “burning” pain was not relieved.  Thus the knowledge was missing relative to pain control from acupuncture or spinal manipulative medicine for that matter, until today’s discussion (e.g., Worth very little in this world where a lack of understanding science generates volumes of money!).

  Peripheral tissue acupuncture and subsequent nerve stimulation can activate the periaqueductal gray matter of the midbrain (Of course a nerve is never needled for the lay folks who may read this article.).  This is the Enkephalin or endorphin receptor region which contains opiate receptors, membrane bound proteins that specifically bind opiate agonists (morphine, diladid etc.) or antagonists (e.g., naloxone).  The endogenous opiate like compounds within the human body are enkephalin, beta-endorphins (beta-endorphin is a fragment of the pituitary hormone beta-lipotropin) and others.  Peptides bind to opiate receptors in the brain and nervous system as does external morphine introduction.  These are chronic pain relief.  This does not cause sharp severe pain abatement.  Endogenous endorphin production is aided by a diet rich in tryptophan (serotonin) which was made illegal in the United States to receive absent prescription from a licensed physician.  Typtophan is the active ingredient in milk which when warmed rotates the molecule into the L or Levo-rotatory aspect which causes drowsiness.  Again, something every mother in the United States used to give children prior to the 1980’s medical revolution or Business revolution (profit made on illness vs. care giving because, deny access to preventative care by alleging smoking did not kill, damage the lungs, create a predisposition to other disease and so forth making the cigarette manufacturing industry much money world wide.)    

  These morphine-like substances or endorphins have a profound and long-lasting analgesic effect.  “Several lines of evidence suggest  that analgesia afforded by acupuncture may depend upon stimulation of the release of these substances, perhaps by the pituitary gland (Marx, 1977 BT8-148).  “There is a reversal of the acupuncture analgesia with administration of naloxone, both in humans and in animals.  Removal of the pituitary in mice prevents decreased response of the spinal pain pathways which otherwise occurs with acupuncture stimulation.” (BT8-148).