In cosmetics, aesthetics, daily medicine, N°2, the treatment ignores the AP_

 In cosmetics, aesthetics, daily medicine, N°2, the treatment ignores the AP_ Acupuncture Point.

Advantages of the professional stimulation.                                      

Publication in two parts: Part Two
                                                            

Two new events were at origin of the rebirth of Mesopuncture, fallen into oblivion in the West, facilitating the realization of Mesopuncture Acupuncture:

·                    The BMN, disposable device that allows, once its needle inserted in the AP, performing, without any change, Acupuncture and Mesopuncture and also Mesotherapy around the AP.

·                    The emergence of Mesotherapy and the ease for performing Mesotherapy in the same therapeutic Act than Mesopuncture-acupuncture: Same insertion needle, same needle, same drug.

·                    The virtual Mesotherapy apparatus that allows the Therapist performing without needles by iontophoresis, Mesopuncture and Mesotherapy into and around the AP already stimulated for the acupuncture effect by a non-invasive method.

They are two kinds of drugs used in Mesopuncture,

·                    The drugs are chosen, in most cases, in the Western Pharmacopoeia, by the Therapist according to his therapeutic action on the condition he wish or want to treat: Allopathy, trace elements, herbal medicine, homeopathy, saline, vitamins, distilled water, vitamins, antiaging etc.

·                    The drug without therapeutic effect or minimal therapeutic effect: The drug has an intrinsic  action of stimulation of the AP producing the Acupuncture Effect, either by AP distension or mechanical action due to its volume or its physicochemical action on the AP anatomical structures.

·                    The drug with therapeutic action, producing the pharmacological effect, which is added to its acupuncture effect. The pharmacological effect,   effect recognized in the Western or Eastern pharmacopoeia, also depends on the physicochemical structure of the drug.

It is useful to remind us are two kinds of methods of stimulation

In Acupuncture

n    Either by non-invasive method, by external stimulation at the surface of the skin (massage, laser, pulsed light, etc.), the AP beginning in the epidermis and ending in the subcutaneous tissue.

n     Either by invasive method, by internal stimulation, in the thickness of the skin. A compact metal needle is inserted into the AP.

In Mesopuncture

Mesopuncture is characterized by various modes of stimulation. 

n    Noninvasive mode

The iontophoresis process which allows the liquid drug deposited on the skin covering the AP, crossing the skin to reach the AP. 

Minimally invasive method

By a specific and disposable device, the BMN, performing Mesopuncture, once is inserted the needle into the AP. The supine position is possible. 

Another way

An injection needle deposits at any level of the AP, micro-doses of a liquid drug.

Mesotherapy

Mesotherapy is another way to administer, by injection or passive deposit without needle, in any part of the dermis or superficial hypodermis around the AP, some drops of a liquid drug with therapeutic effect.

In practical terms
*** Professionals qualified to inject.

 The needle, classical acupuncture needle or the hypodermic acupuncture needle or BMN, is inserted into the AP, selected and identified through appropriate training.

The needle will remain, in situ, 20 minutes (Acupuncture effect).

With the same/another needle, is injected the drug, with or without pharmacological effect, into the AP (Mesopuncture).

Around the AP, in the dermis, the Mesotherapy Points_ MPs are created by micro-injections of a liquid drug into the dermis (Mesotherapy), it is necessary that the liquid drug has a pharmacological effect to be selected for Mesotherapy.

It exists in the market of disposable medical devices, a disposable device, the BMN, which performs the MAM, once its needle was inserted, only once, into the skin.

***Professionals not qualified to inject, using or not, Acupuncture needles. 

 The Mesopuncture effect is reached by iontophoresis provided by an electric apparatus applied in the epidermal part of the AP to allow the drug disposed on this PA, crossing the skin for reaching the dermal part of the AP.

By moving on the epidermis, the iontophoresis apparatus around the AP, the Mesotherapy Points_ MPs may be created.

Confusion between the Acupuncture Points_ APs and Mesotherapy Points_ MPs

Confusion between the Acupuncture Points_ APs and Mesotherapy Points_ MPs
Note: The drug injected / deposited in any part of the dermis creates the MP, injected into the AP it creates Mesopuncture by liquid drug stimulus of the AP.

It is difficult when MPs are created into the skin of concluding that the drug has not been injected into the APs or Mesopuncture and that the result is only referred to the Mesotherapy without participation of the APs.

We already know that the PMs are of random location in the dermis or superficial hypodermis and without anatomical or histological structure.

Indeed, in the skin area, selected by the Therapist as close as possible of the altered region of the body to create MPs, preexist APs as in all other part of the skin.

They are PAs, of localized action, described as active, on the same health or aesthetic disturbance that the Therapist in Mesotherapy wishes to treat by multiple skin injections, of drug.
PAs et PMs are so close, one of the other, that often are adjacent and that, the same needle remaining inserted in the PA, can reach them, avoiding to the patient a double insertion pain, knowing that in addition in each acupuncture session, several APs are targeted, rarely a single AP.

·         Acupuncture considers that the health or aesthetic disturbance is due to an imbalance of the body’s energy.  To relieve or cure this aesthetic or health disturbance, it is necessary to recover the energy balance.

 The cure of the energy imbalance is made through the APs: Each AP occupies a precise and systematized skin location, with specific therapeutic properties to each AP.  Online Learning at various websites, for example in our internet space 'mesopuncture.com', allows their use in daily practice.

For the therapeutic action of AP be effective and produces the Acupuncture effect it is necessary to stimulate the AP:

·         Or by inserting a metal needle remaining inserted about twenty minutes, without preventing the decubitus or continuation of the session.

·         Or, since the end of the last century, by injection / deposit of some drops of a drug chosen by its action on the disturbance of health or aesthetic. The drug acts in two ways:
on the one hand it produces an acupuncture effect by its volume or its physicochemical structure and
on the other hand keeping their therapeutic properties by its pharmacological effect.

It can be concluded:

We already know that the AP has a skin surface of 5 mm. It is described as a well going from the skin surface to the connective tissue, through the skin thickness. The APs are of known location since thousands of years.

In all the dermal area of the skin surrounding the AP to the neighboring AP, can be created the MPs of random location.

Knowing the skin location of APs, result of Internet learning, for example, it belongs to the Therapist to decide if he wants to include them in his Mesotherapy treatment, without great technical change in the Mesotherapy session: Same treatment by injection, same drug, and same skin area but with hypodermic needle instead of compact needle.

In fact and in theory, two needles are necessary: Compact acupuncture needle and hypodermic injection needle. For each AP is will be a double needle insertion pain.

 ----The solution is the hypodermic needle recognized as acupuncture needle.

According to the ' Food and Drug Administration' or FDA, to be used as acupuncture needle the hypodermic needle must have a handle for facilitating its use by the Therapist without preventing the decubitus ventral and dorsal of the Patient, also remaining ones twenty minutes inserted in the skin, without danger.

This disposable device, the BMN, exists, in accordance with these obligations: A needle of 0.30 mm in diameter, hollow at the same time hypodermic and acupuncture, according to the FDA, crowned by a reservoir in polymer resilient, without piston:

The BMN we produce is a needle as fine as the acupuncture needle, 0mm3 external diameter and 13mm long, surmounted by a reservoir of 12 mm long and half centimeter of width, without piston; the reservoir is filled out and emptied with two fingers.

In addition to allowing performing for the musculoskeletal pain, the trigger points treatment by wet and dry needling, the BMN, in its main role, inserted into the AP, allows, the Therapist in Mesotherapy, performing when the needle is inserted
--- into the AP, a dual stimulus, needle stimulus (acupuncture) and liquid drug stimulus (Mesopuncture), and
--- around the AP, the needle remaining inserted into the AP, the Therapist may create Mesotherapy points into the dermis around the AP through the dermal part of the AP

·         For the Therapist in Mesotherapy, in the skin area chosen to create the MPs, it is useful, of locating the APs, thanks to precise anatomical details. The MPs will be created in the dermis around the AP.

If the Therapist chooses to perform only Mesotherapy:

APs are located in first.
MPs can be, then, created in all part of the dermis around each AP even adjacent to the AP until the neighboring AP.

If the Therapist chooses to include APs in creating the MPs:

The Therapist inserts a hollow hypodermic needle as the needle of the BMN into the AP, it remains inserted some twenty minutes for performing the acupuncture effect.

The Therapist injects with this hollow needle, some drops of the drug he has elected, into the AP to perform Mesopuncture and the pharmacological effect.

With the same needle remaining into the PA, the Therapist injects some drops of the same drug, according to star shape, through the thickness of the dermis surrounding the AP, creating then the MPs.

The liquid drug in Acupuncture or Mesopuncture. Notes & definitions.

The liquid drug in Acupuncture or Mesopuncture. Acupuncture & Pharmacological Effects. Some notes & definitions.

Definitions

Acupuncture Effect: Effect resulting from the Acupuncture Point stimulus  by the metallic acupuncture needle or classical acupuncture.

Pharmacological effect some drops of a liquid drug, injected or passively deposited without needles, in the AP:

 For Acupuncture, disease is the result of the body’s energy imbalance. 

Acupuncture helps to restore the balance of the body’s energy by using needles inserted in the body.

In effect,

• To benefit of the Acupuncture therapeutic effect or ‘Acupuncture Effect’, it is necessary to stimulate the Acupuncture Points _ APs, after having carefully located them.

For centuries, stimulation of the APs was achieved by compact needles inserted into APs.

Since the end of the last century, for painful, acute, chronic or persistent or rebellious cases, Chinese medicine proposed and started the liquid drug injection, into the APs already selected and stimulated by the acupuncture needle it is, sometimes expedient and useful, to associate, to classical stimulus by metallic needle of the AP or classical acupuncture, few drops of a liquid drug injected or passively deposited without needle in the AP.

Using, in Mesopuncture liquid drugs of the pharmacopoeia, as PA stimulus on the one hand helps to restore the body's energy balance on the other hand allows the Patient to benefit from the own preserved pharmacological drugs properties or Pharmacological Effect'.        

The Acupuncture Point fluid stimulus or Mesopuncture generally accompanies the Acupuncture Point_ AP compact acupuncture needle stimulus or classical Acupuncture. 

This fluid stimulus of AP or Mesopuncture added to the classical stimulus can "enhance" or ‘potentiate’ it.

It is advisable to use the same needle double-acting, at the same time for of the AP stimulus through metal needle stimulus or classical acupuncture and drug injection into the PA or Mesopuntura.

This association, ‘Pharmacologic Effect’ and ‘Acupuncture Effect’, of the liquid drug is the fundamental property of liquid drugs administered by intravenous or intramuscular injection and listed, for the most part, in the western pharmacopoeia of daily use, in conventional medical treatment of localized or generalized disturbance, in aesthetic or health.

The Mesopuncture, made by hollow acupuncture needle, allows a triple treatment:

Double stimulation of PA, by needle and liquid drug producing a double Acupuncture Effect.

The drug keeping its pharmacological properties produces a Pharmacological Effect.

The liquid drug in Mesopuncture, N°1:‘Acupuncture Effect’.

The liquid drug in Mesopuncture, N°1:‘Acupuncture Effect’.

Mesopuncture or Acupuncture Point_ AP fluid stimulus was started by Chinese medicine, at the end of the past century

Since recent decades, in case of acute, chronic or persistent and rebellious pain, Chinese medicine has proposed and initiated, a liquid drug, injected/deposited into the selected APs or Mesopuncture already stimulated by acupuncture needles or Classical Acupuncture producing an Acupuncture Effect by needle.

The ‘Acupuncture Effect’ in Mesopuncture

Injected or deposited in the AP, the liquid drug, stimulates the therapeutic properties attributed to this AP, by Chinese medicine, through its action on the human body energy:

·         This ‘Acupuncture Effect’ by fluid stimulus like the acupuncture needle stimulus, in the human body causes in Acupuncture, a therapeutic effect thanks to rebalancing the altered energy, it is the Acupuncture Effect of variable duration depending on the stimulus duration and covering, in the human body, an area local, regional and more rarely, general.

·         This Acupuncture Effect is the therapeutic and energetic action, resulting of the AP stimulus either by needle or by liquid drug. This therapeutic effect, this energetic effect, described by the Chinese medicine since millennia, by which Acupuncture treats the health disorders, is the Acupuncture Effect produced in this case, by a fluid stimulus.

·         This 'Acupuncture Effect ' of fluid origin is used to add or enhance by a liquid stimulus the classic metal stimulation or classical acupuncture; it is superimposed to the ‘Acupuncture Effect’ created by acupuncture needle including the needle used to inject the liquid drug or by external stimulus applied at the skin surface.

The Acupuncture Point_ AP

·         This liquid drug creates by fluid stimulus the ‘Acupuncture Effect’, specific of the AP stimulated whatever the stimulus. It should be remembered that the 'Acupuncture Effect' obtained by the AP stimulus is independent of the stimulus (liquid or metal or another), but dependent from the AP selected, from the therapeutic properties attributed to this AP, by Chinese medicine, in the treatment of the energy imbalance, origin of all diseases in Acupuncture.

'Acupuncture Effect', fundamental property of all liquid drugs selected for Mesopuncture, could be perhaps, due to the:

-* Physicochemical structure of the liquid drug used or more precisely, due to

-*Mechanical action produced into the AP by the volume of liquid drug injected or deposited, for example, by distension or irritation of connective tissue composing the AP.

The liquid drugs

·         All liquid drugs of the Pharmacopoeia, selected by the Therapist for use in Mesopuncture, with/without known pharmacological effect are stimuli of the APs either when they are directly injected into the AP located in the connective tissue or deposited at the skin surface on the level of the AP and reaching the AP already located.

In the latter case, the liquid drug crosses the skin by iontophoresis to reach the connective tissue where APs are located (knowing that the path from the epidermis to the connective tissue belongs to the AP, also). 

·         Stimulus duration of the AP depends on the liquid drug and particularly on its physicochemical structure.

In this group of AP stimulus with/without needles, it may be mentioned other therapeutic techniques used in Acupuncture and active, it seems, by physical action: Catgut burial in APs, titanium implants or permanent needle for Auriculotherapy; Distilled water injection in Auricular points.

The liquid drug in Mesopuncture, N°2:‘Pharmacological effect’.

The liquid drug in Mesopuncture, N°2:‘Pharmacological effect’.

 Mesopuncture, fluid Stimulus of the Acupuncture Point_ AP: The Pharmacologic Effect.                                     

Started by Chinese medicine, at the end of the last century:

 ‘Pharmacological effect’ of the liquid drug in Mesopuncture- 

The Acupuncture Point _ AP is stimulated by liquid drugs of the Pharmacopoeia, liquid drugs without or with pharmacological properties producing the Pharmacologic Effect added to the property of producing the Acupuncture Effect by this AP stimulus.

In effect, generally, the liquid drug used in Mesopuncture, is selected according to its ‘Pharmacological Effect’; it completes the Acupuncture Effect from both the metal needle stimulus and its own Acupuncture Effect.

It is possible to describe, among all liquid drugs, two categories of liquid drugs according to their Pharmacological Effect:

**-* Some liquid drugs, injected/ deposited, among those used in Mesopuncture for their Acupuncture Effect, are neutral, ‘without’ obvious pharmacologic effect known or described in the Western pharmacopoeia, but with a physical or mechanical action of filling, irritation, which stimulates the AP and produces the Acupuncture Effect only.

A particular mention concerns Hyaluronic Acid, used for long-term stimulus of the AP, without pharmacological action.  

 In this group of liquids drugs, at origin of AP fluid stimulus only, without obvious or very low pharmacological action known, we may find: Distilled water or saline… trace elements, homeopathy etc.

·         Using only liquid drugs without pharmacological properties to stimulate the APs is the goal often sought by the Therapist, in the initial period of integration of Mesopuncture, in his daily treatment. These liquid drugs are inactive in Mesotherapy.

**-* The majority, of these liquid drugs, has its own pharmacologic properties, due to the physicochemical structure of its molecule.

These pharmacological properties preserved when the liquid drug is used in Mesopuncture, produced the Pharmacological Effect.

By using liquid drugs of the pharmacopoeia for restoring the body's energy balance (the Acupuncture Effect) which, additionally, act by their own pharmacologic properties preserved (the Pharmacologic Effect in Mesopuncture), the Patient can, thus, benefit of the therapeutic virtues of liquid drugs of our pharmacopeia.

The liquid drugs with pharmacological effect are eligible for Mesotherapy.

These pharmacological properties preserved when the liquid drug is used in Mesopuncture, constitute the Pharmacological Effect.

By using liquid drugs of the pharmacopoeia for restoring the body's energy balance which, additionally, act by their own pharmacologic properties preserved (the Pharmacologic Effect in Mesopuncture), the Patient can, thus, benefit of the therapeutic virtues of liquid drugs of our pharmacopeia.

The liquid drugs with pharmacological effect are eligible for Mesotherapy.

This liquid drug with pharmacologic properties stimulates the AP and creates, the ‘Acupuncture Effect’, by fluid stimulus due to mechanical action or physicochemical structure of its molecule. This ‘Acupuncture Effect’ of fluid origin, is superimposed to the ‘Acupuncture Effect’ created by acupuncture needle or by external stimulus applied at the skin surface.

This selection of liquid drugs by the Therapist may also take into account, two criteria both depending on the physicochemical structure of the liquid drug. 

1-First criterion, Synergy or lack of synergy

Synergy of action between the western therapeutic effect of the liquid drug producing the Pharmacologic Effect and the Acupuncture Effect produced either when this liquid drug stimulates the AP or when the needle stimulates this same AP.

This drug is precisely chosen for being the pharmacological treatment of the same health or aesthetic disorder, in western medicine.

·         This liquid drug produces also, the therapeutic/energetic effect or ‘Acupuncture Effect’ when, keeping its therapeutic/pharmacological properties it is injected into this AP.  

·         This same ‘Acupuncture Effect’ is produced when the needle is inserted into this AP as stimuli of the AP

After both the metal needle insertion and liquid drug injection into the AP, we can note:

·          ‘Acupuncture Effect’ of the AP stimulated both by metallic needle and liquid drug, Acupuncture Effect described and known since millennia on health or aesthetic disturbances, which is the goal of this treatment.  

·         ’Pharmacological Effect ‘of this liquid drug, injected into the AP.

These three Effects:  ‘Acupuncture Effect’ by needle, ‘Acupuncture Effect‘ by liquid drug, ‘Pharmacological Effect’ by liquid drug are synergistic and are a complete treatment of the health or aesthetics disorder both by acupuncture and western medicine.

But, if the ‘Acupuncture Effect' created by the liquid drug injected into the AP is, often, synergistic with the pharmacological properties of the liquid drug injected into, this is not the rule because the choice of the liquid drug obeys a second criterion: the duration of action of the AP stimulation (Acupuncture Effect) which is also the duration of pharmacological action (pharmacological Effect) of the liquid drug used.

It should be remembered that

·         The 'Acupuncture Effect' obtained by the AP stimulus is independent of the stimulus (liquid or metal or another), but dependent from the AP selected, from the therapeutic property attributed to this PA, by Chinese medicine, in the treatment of the energy imbalance, at origin of diseases in Acupuncture.

·         Acupuncture Effect and Pharmacological Effect are of same duration, both depending on the physicochemical structure of the liquid drug injected/deposited into the AP, this duration of its pharmacological action is mentioned in the pharmacopoeia.

Duration of both effects of this liquid drug is often greater than the stimulus duration from the acupuncture needle and often much higher.

In Western pharmacy, we possess long acting drugs for several weeks but with a specific pharmacological effect, in rheumatology, for example. The duration of action of this injectable medication is 3-4 weeks.

In the AP, selected for its anti-inflammatory action, injection of few drops of this drug will produce two effects, of same duration, both dependent on the physicochemical structure of this medication:

·                    On the one hand, the liquid stimulus of AP producing the ‘Acupuncture Effect’ is of 3-4 weeks of duration.

·                    On the other hand, the preserved Pharmacological Effect is of identical duration, 3-4 weeks.

It is not ethically possible to use this long acting medication, outside rheumatologic indications, for long lasting stimulation, for long lasting Acupuncture Effect, because of possible side effects, deontologically inexcusable because this liquid drug is unjustified in this indication.

Indeed, ethically, it cannot be used for long lasting Acupuncture Effect for a Patient not having a formal rheumatologic indication for this product.

A particular mention concerns Hyaluronic Acid, used for long-term stimulus of the AP, without pharmacological action. Also, Hyaluronic acid can be used for patients pusillanimous, pressed and active.

The duration of action of Hyaluronic acid is of few months, it has no pharmacological action targeted outside of a physical action of filling. It can be used for stimulation of long-term or even of very long duration, as are employed catguts or ear implants in titanium...

Side effect of Mesotherapy or how to ensure that it is not Mesopuncture

    Side effect of Mesotherapy or how to ensure that it is not Mesopuncture.

Collateral but beneficial effect of Mesotherapy... or is difficult to confirm that the liquid drug was not deposited/injected into an Acupuncture Point_AP.

Mesotherapy is defined by Mesotherapy Points _ MPs, which are micro-reservoirs, without any histological or anatomical structure of a liquid drug, active on the condition in treatment, injected on the superficial hypodermis/dermis or  deposited at the epidermis, of random location but facing the altered region of the body.

The points of Mesoterapia_ PMs, are created not preexist, therapist, on the entire surface of the skin covering the altered region of the body. Mesotherapy Points MPs are created not pre-exist, by the therapist, on the entire skin surface covering the altered body region.

In the COATING (nappage) version of a given skin área, no free skin space is found without PMs: PMs cover the entire skin surface of the given area. But whatever the way the MPs are created, on the same skin surface, are located, Acupuncture Points_ APs, systematized of local action.

In fact, in the same skin area, we can find three types of Acupuncture Points _ APs, of systematized location described for millennia: APs of local, regional or general action.

Only APs of local action, can be stimulated, simply, without having to resort to the foundations of Chinese medicine.

In this way, it will be easier to attribute to Mesotherapy the eventual improvement of the health/aesthetic disorder, noticed in the patient, if the PAs have not been requested: The side effect, beneficial for the patient, of Mesotherapy, to not being able or not knowing how to locate the APs, is to add to his own pharmacological treatment of Mesotherapy, an energy dimension due to the activation of APs by the liquid drug injected/deposited involuntarily into the PAs, of local action.

 The Mesopuncture

the introduction of a drug into the AP acts at the same time, as in Mesotherapy, by its pharmacological effect, and, unlike Mesotherapy, by its stimulating effect of the PA or Acupuncture Effect, two effects due to its physicochemical structure; Moreover, this acupuncture effect of the drug will last so long that the pharmacological effect of the drug described in the pharmacopoeia lasts. This acupuncture effect is added to the preserved own pharmacological effect of the drug.66

Note

For the western Pharmacopoeia, injecting a liquid drug into a cutaneous point is equivalent to a local liquid drug administration of with a particular metabolism.

 Conclusion

To give the patient the possibility during the same treatment session to take advantage of both a current treatment of Mesotherapy, and a much older treatment of Acupuncture, it is necessary to provide to the therapists on the one hand reliable documentation and on the other hand a specific vector for this treatment

Training, online, allows recognizing

·       On the one hand, the location in the skin of the APs in order to use the skin space between two APs for creation of Mesotherapy Points _MPs

·        On the other hand, the treatment the PMs either only or

in addition to this PMs treatment, the APs treatment  to which can be applied Acupuncture and Mesopuncture, without impeding prone or supine decubitus.