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Bonica's Management of Pain

Adam Ward

Acupunct Med 2002 20: 207-208

doi: 10.1136/aim.20.4.207-a

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6017/37 BMAS vol 20(4) 12/2002 28/11/02 10:30 AM Page 206

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Book Reviews


Acupuncture in the treatment of depression: A controlled study evaluating acupuncture as a

manual for practice and research. treatment for depression. The authors’ perspective
Rosa N Schnyer & John JB Allen of acupuncture is that of traditional Chinese
medicine. Clearly, the target audience are
Hardback, Pages: 240, Price: £30.99 acupuncturists of the traditional Chinese medicine
Churchill Livingstone, 2001 paradigm.
ISBN 0-443-07131-4 In chapter 7, the authors take the reader through
research methodology and problems unique to
Depressive disorder is a common chronic investigation of acupuncture. They go onto present
condition. It results in a greater burden than cancer, their findings from their study. The authors also
diabetes or heart disease in terms of disability present some interesting case reports from their
adjusted life years according to a pivotal study by study.
the World Health Organisation and World Bank. In the assessment of depressive disorder,
Conventional treatments for depressive disorder general practitioners will screen for organic
can be broadly categorised into pharmacological causes of depression, such as anaemia. It is not
and psychological. Antidepressant treatment is the clear whether the authors’ intake protocol takes
mainstay of treatment. Although the response to this into account. The authors have covered
antidepressants is good, there is a significant suicide assessment thoroughly. They have also
number of patients who either do not respond to included a caution about acupuncture in treating
treatment or do not develop full remission with depressive disorder in pregnancy. One important
treatment. Psychological treatments range from omission from this book is the risk benefit
counselling using problem solving to cognitive assessment of acupuncture. There is no mention of
therapy and interpersonal therapy. All have been any of the adverse effects of acupuncture. The
shown to be efficacious. The outcome of combined safety concerns of acupuncture should be
pharmacological and psychological treatments is mentioned. Most adverse effects can be avoided
better than either alone. Electroconvulsive therapy by proper training of the practitioner.
remains an important treatment for severe Any attempt to scientifically evaluate a
depressive disorder. Novel treatments showing treatment for depressive disorder is important. I
promise include transcranial magnetic stimulation. think that the authors must be congratulated on
Professor Thase from University of Pittsburgh their work in this field. Hopefully others will be
School of Medicine has written an excellent stimulated to embark on further research to
chapter on depression, its symptoms, epidemiology, evaluate the role of acupuncture in mild to
aetiology and treatment. Schnyer & Allen state moderate depressive disorder.
that the book is based on their pilot randomised Hagen Rampes

Color Atlas of Acupuncture half inches by four and three quarter inches. It is
Body Points, Ear Points, Trigger Points therefore extremely portable and will fit into any
H-U Hecker, A Steveling, E Peuker, J Kastner, large pocket. Nevertheless, contained within its
K Liebchen covers is an immense amount of information of
clinical and practical significance, all the authors
Paperback, Pages: 268, Price: £22 being physicians with a special interest in
Thieme, Stuttgart 2001 acupuncture.
ISBN 3 13 125221 9 After a brief introduction describing the
This small paperback measures just seven and a generalities of point location the book is divided

ACUPUNCTURE IN MEDICINE 2002;20(4):206-210.

6017/37 BMAS vol 20(4) 12/2002 28/11/02 10:30 AM Page 207

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Book Reviews

into three sections. Part one includes body Part Two covers the ear acupuncture points
acupuncture points encompassing the 12 paired (Chinese and Nogier) located on very clear close-
meridians together with the Conception vessel, up colour photographs with amplification in the
Governor vessel and Extra Points. Each meridian text, which includes specific indications and
is traced on a photograph of a model with all the general comments.
points indicated, however, only selected points are Part three includes 19 muscles and their
described in the text. All the most important commonly occurring trigger points illustrated by
points are included and broadly conform to the simple and very clear, coloured anatomical
selection of points used in the foundation courses drawings. The Trigger Points are shown together
of the BMAS. Each selected point is compre- with their referral patterns and, most interestingly,
hensively described together with its location, important acupuncture points occurring close to
depth of needling, indications and action in TCM trigger points are also shown. The text includes a
terms. In addition, highlighted paragraphs include description of each muscle, and includes its
immensely useful comments relating to safety and origin, insertion, innovation and action, as well as
anatomical location. There are also clear anatomical preliminary background, examination techniques
drawings as well as illustrations of the practitioner’s and therapeutic comments. The book is well
hand placements used to locate selected points. referenced and indexed.

The Seirin Pictorial Atlas of Acupuncture descriptions of the location, needle insertion,
An illustrated manual of acupuncture points action, indications and special comments that
Yu-Lin Lian, Chun-Yang Chen, Michael Hammes, include safety aspects. The 12 paired principal
Bernard C Kolster channels are included together with the pathways
Edited by Hanhs P Ogal & Wolfram Stor of the Du Mai and the Ren Mai, and there is a
comprehensive selection of extra points. The
Hardback, Pages 351, Price: £25 introduction includes basic principles of
Konemann, Cologne 2000 measurement, needling techniques and a brief
ISBN 3 8290 2996 9 summary of channels and points. All points are
located numerically as well as being named in
The Seirin atlas is a large A4 sized book devoted Chinese together with the English translation.
to 409 selected Chinese acupuncture body points. There is also an index and list of reference texts.
Each is clearly indicated with three different This is obviously not a book that can be easily
illustrations (two photographs and one anatomical be carried in a pocket but the quality and clarity of
3D colour drawing). The text includes brief the illustrations more than compensate.

Each of these Acupuncture atlases are quite started studying acupuncture. Any student of
exceptional in their own way and I would acupuncture, at any level, will find them of
thoroughly recommend obtaining a copy of each. immense value.
I only wish they had been available when I first Adam Ward

Bonica’s Management of Pain Anyone involved in acupuncture / dry needling

Editor: John D Loeser becomes something of a pain expert if only
Associate Editors: Stephen H Butler, C Richard through the day-to-day experience of treating
Chapman, Dennis C Turk patients. This was exemplified by a recent survey
of NHS hospital pain clinics in the UK that
Hardback, Pages: 2178, Price: £181 revealed that it is now unusual for acupuncture /
Lippincott Williams & Wilkins, Philadelphia 2001 dry needling not to be offered as part of the
ISBN 0 683 30462 3 therapeutic repertoire.

ACUPUNCTURE IN MEDICINE 2002;20(4):206-210. 207
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Book Reviews

Bonica’s Management of Pain has become a brief chapter giving an overview of acupuncture.
something of a classic in pain management texts But this book’s strength is in its broad coverage and
and provides a comprehensive and practical practical approach. It discusses psychology, ways of
approach to all areas of pain control. The late John measuring disability, physiology, specific diseases
J Bonica’s first edition was published in 1953 and and a wide range of therapeutic interventions.
rapidly established itself as a leader in the field. Those of us who regularly use acupuncture /
This third edition is now very much a multi-author dry needling know that helping patients who come
textbook and has grown into standard reference to us with pain and disability is much more than
work with no less than 132 contributors. inserting needles in a technically proficient way.
The book is made up of five parts. These are I thoroughly commend this book as a first class
devoted to a general introduction, patient evaluation, reference source for developing a rounded,
generalised pain syndromes, regional pains and knowledgeable and, in the end, more satisfying
methods of symptom control. This comprehensive and effective approach to the care and treatment of
approach covers all areas of pain management and pain and suffering.
includes a contribution from Chan Gunn as well as Adam Ward

Pediatric Acupuncture The book is full of interesting ideas. Attention

May Loo deficit hyperactivity disorder (ADHD) is a
challenging condition to treat in the West. The
Hardback, Pages: 372, Price £45 author claims to have had success in treating 7-9
Churchill Livingstone, Edinburgh 2002 year olds incorporating five-element developmental
ISBN 0 443 07032 6 theory. A number of recipes for this condition are
given, for example, Sishencong and Yintang for
A handsome new textbook written by an Assistant general treatment.
Clinical Professor in paediatrics at Stanford The author manages to ‘integrate western
University should be a good setting for a knowledge and technology with ancient Chinese
comprehensive account of paediatric acupuncture. medicine’ and a good example is seen in treating
With 25 years experience of working with children, acute otitis media where ‘Acupuncture treatment can
as a western paediatrician and then in combination be given concomitantly with antibiotics, as Chinese
with traditional Chinese acupuncture (TCA), the medicine’s goal in expelling the pathogen and
author has a wealth of experience in paediatrics. tonifying the immune system complements the
22 common conditions are detailed, both as western regimen’. However, the author gives very
western description and treatment, and then using little guidance on when not to use acupuncture, and
traditional Chinese concepts; this is very alarmingly suggests that most western diagnoses
comprehensive and has 804 references. The author can by treated by traditional Chinese acupuncture,
explains the pros and cons of immunisation for the which may give the wrong impression to lay
western and Chinese approaches, and I am glad to acupuncturists. This approach is not medical
observe that she broadly supports vaccination. In acupuncture, but simply western medical education
practice she allows the parents to make an informed for those practitioners without medical training,
decision about whether to vaccinate or not. and not always informative for doctors.
Disappointingly, there are no scientific or There are pictures of happy children having
medical acupuncture principles, and nothing about acupuncture and clear graphics showing
segmental innervation, or neuro-hormones. It is all acupuncture points and meridians. The book is
heavy TCA – but very well described. The only the most comprehensive text on paediatric
common ground is in some of the methods of acupuncture that I have come across, but I do hope
acupuncture technique, and the fact that electro- that the author will incorporate scientific and
acupuncture, laser, and non-invasive techniques medical acupuncture principles in the next edition.
may have a part to play in treatment. Colin Lewis

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Software Review

Anatomy of the locomotor apparatus over the action ‘hot spots’ would cause the program
Francesco Bettinzoli, Bio Media to freeze, requiring a Ctrl-Alt-Del sequence to end
the program task. In fact, the same technique was
On 3 CD-ROMs – Upper extremity, useful to close the program rather than go through
Lower extremity, and Trunk and Head an endless scroll of credits. I would like to see a
Price: ^47 per CD facility to be able to minimise the program screen,
Bio Media, Switzerland 2002 so that I could return to the program easily rather than closing it down, and then waiting for the
entire opening credits before using it again. The
Content: anatomical content is reasonably comprehensive,
One of my fond memories as a medical student but what happened to the missing quadratus
was getting to grips with anatomy. Many an evening lumborum muscle?
was spent with Gray’s in one hand and the bones The software is written using Macromedia
of my half skeleton in the other. Reams of notes Director (the Rolls Royce of interactive multimedia)
were made describing the origin and insertion of and uses QuickTime movie control. There is a
each muscle, with annotations showing the muscle choice of four languages, and the package gives a
in action. good feel of professionalism to the presentation,
How easy anatomy would have been using this and no doubt forthcoming medical students may
software! Set up installs the QuickTime playback well learn their basic anatomy from a package like
program, and inserts information into the computer this. For medical acupuncturists, it is a painless
registry, but the program runs directly from the way to become re-acquainted with the knowledge
CD-ROM. The first CD of the series shows the of anatomy that may have slipped away during the
bones, joints and muscles of the upper extremity clinical years. At about £30 per CD, it represents
in glorious multimedia. A series of menus allows good value for medical software. Don’t throw
you to focus down on the particular aspect of away your Gray’s anatomy just yet, as the extra
anatomy that you wish to study. So, I chose bones, detail in the book makes anatomy come alive in a
selected scapula, and the screen showed a virtual way that no animation by itself can possibly achieve.
scapula bone in fine detail, with a written The Biomedia website (address above) gives a
description. By allowing the mouse pointer to very useful hands-on feel for the program, and is
hover over an anatomical term, the scapula picture well worth a visit.
revolves round and zooms in, to show me the
highlighted detail. In virtual reality mode I am Rating:
able to rotate the scapula about a vertical axis. Presentation 10/10
Well, now I know all the anatomical landmarks, Medical content 9/10
written my own notes with the inbuilt notemaker, Ease of use 9/10
I can now proceed to discover how the shoulder
joint works. I choose the glenohumeral articulation, System requirements:
and a short movie accompanied by the narration PC: 486, 66MHz, 16mB RAM, Win 95, 640x480
of an Italian, speaking very good English, shows graphics resolution, CD-ROM x 4 speed, SB
me just how mobile the joint is. The muscle menus compatible sound card.
take me down to the individual muscles where MAC: OS 7,8, or 9
their origin, insertion, innervation and function
are described as text. The movie option again gives Reviewed:
a narrated action sequence of the muscle in action. 29th September 2002
I found that moving the mouse too quickly Colin Lewis

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Software Review

The Journal of Chinese Medicine (1979-2002) You will need to have Internet Explorer and
4th Edition Adobe Acrobat reader installed on the computer
before you can use the disc. Copies of this
CD-ROM (279MB), Price: £120 + VAT software are provided (albeit old editions).
Navigation will be familiar to anyone who uses a
Increasingly, I find it very convenient to have web browser, and allows the reader to zoom in on
resource material stored as digital media – just a final article, which is in a Portable Document
look at the success of Microsoft’s Encarta. The Format (.pdf) file, and read using Acrobat reader.
CD-ROM takes up so little room compared to a The search facility configuration is complicated
book, and the search facility should better any and instructions are given for version 4 of Acrobat
index. reader. I use a more up-to-date version of the
However, the CD-ROM must obey some basic software, and I was unable to configure it so that I
rules. First, it must not install files on my could search the whole CD rather than just the
computer without my knowledge. Secondly it article I was looking at. This deficiency needs to
must be fast and intuitive to use, and thirdly, the be sorted out before the next release.
search facility must be able to find a keyword, There was a fascinating selection of
title, or author for the whole content. This CD acupuncture topics on this CD-ROM despite the
scores well on the first two rules, but the third heavy emphasis on TCM. It is time that a CD of
could be better. Acupuncture in Medicine articles is put together!
The JCM CD-ROM contains a varied mix of
articles and reviews from its paper journal – 454 Rating:
full articles, 527 abstracts and 157 book reviews Presentation 8/10
and plenty of news features, spanning the last 23 Content (Traditional Chinese Acupuncture) 10/10
years. Acupuncture is the main topic, but there is Content (Medical acupuncture) 4/10
some reference to herbal medicine and massage. Ease of use 8/10
Under the heading contents by subject, the
submenu lists Acupuncture points (very System requirements:
descriptive – not an anatomical catalogue), CD-ROM drive, Internet Explorer, Adobe Acrobat
Techniques (from cupping to propagated needle reader
sensations), Case histories, Diseases, General
discussion and General theory. The emphasis is For more details:
very much on Traditional Chinese Medicine, but I Contact Journal of Chinese Medicine
was pleased to see in the News sections, that there Internet:
was reference to the BMJ and Acupuncture in Email:
Medicine. The abstracts are taken from the Journal
of Traditional Chinese Medicine, and the book Reviewed:
reviews are very thorough – even including 10th November 2002
medical acupuncture books. Colin Lewis

ACUPUNCTURE IN MEDICINE 2002;20(4):206-210.