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Thirty-seven years of practice in electrodermal screening (EAV).

As an original student of Dr. Reinhold Voll beginning in 1979, 2016 marks 37 years commitment to EAV. Electroacupuncture according to Voll (or EAV) is a modern technique first introduced to America in 1979 at the Jack Tar Hotel, San Francisco. Those were exciting times as we all suffered from the nebulous concepts of TCM, yin/yang, five elements, and little of it making Western medical sense.

Reinhold's system, beginning in 1952, was the first medical approach to acupuncture of substance, an electrodermal method to measure "energy" at the topical acupuncture points as anatomical references and to evaluate ailments from a state of hypertonia or hypotonia measured electronically. Armchair observers have often stated that there is no credible evidence of diagnostic capability of EAV. I beg to differ as such oversight represents a fundamental lack of knowledge in neurology in tandem with the helpless expositor having probably little to no clinical experiences nor medical education of substance.

Electrical skin tests form the basis of a wide variety of systems, including the electrocardiogram, electroencephalogram, the infamous 'lie detector,' as well as the Hubbard E-meter, and other systems. The skin conductance response, also known as the electrodermal response, is the phenomenon that the skin increases conduction of small currents of direct current electricity when either external or internal stimuli occur that are physiologically arousing. Arousal is a broad term referring to overall systemic activation and is widely considered to be one of the two main dimensions of an emotional response. However, it is also linked to sympathetic nerve tone generated from the internal organs, projected upon the body's dermatomes. Measuring sympathetic tone at small diameter skin spots outside of the arousal state, i.e. the acupuncture point, is therefore not the same as measuring elicited emotions with large patch electrodes--two entirely different approaches, and different instrumentation as well. Arousal has been found to be a strong predictor of attention and memory. Sympathetic skin tone at small dermal spots, however, are modulated by the internal organs and bowels and vary in conductance based on sympathetic nerve tone and, thus, skin moisture and electrolyte content. The measurements should take place without the arousal state, just as we would measure blood pressure and pulse. The electrodermal measurement, in competent hands, is a strong predictor of health status and disease status.

Critics often site that double-blind trials lead to no conclusive evidence of the electrodermal phenomena: In tests, double-blind trials, "A wide variability of the measurements was found in most patients irrespective of their allergy status and of the substance tested. Allergic patients showed more negative skin electrical response at the second trial, compared to normal controls, independent of the tested substance. No significant difference in skin electrical response between allergens and negative controls could be detected." (Semizzi)

Having taught and observed so-called "acupuncturists" and Voll practitioners down through the years, I have scarcely found few so skilled and competent to conduct proper measurements, as originally taught to me personally by Reinhold Voll. One must be physically shown the measurement on a number of subjects and then proceed to a detailed study of topographical anatomy and point location. EAV instruments are not 'plug and play' devices. Just as a wiggle or a warble of a 'sleight of hand' can skew a proper ultrasound image from a diagnostic sound head, the same can be said for the electrodermal stylus positioning in relation to anatomical surfaces, skin thickness, skin moisture, and ambient temperature, not to mention an accurate location as fundamental to the entire procedure itself. I state this with all seriousness. Considering that the topical points of EAV are 2 mm in diameter, and the skin surface of adults about 18,000 cm2 (men) or 16,000 [cm.sup.2] (women), it is quite an imposing task and learning curve to become specialist in topographic anatomy and skilled in EAV measurement. The same can be said for diagnostic ultrasonography, radiology, and electrocardiography.

Criteria for Measurement

Dr. Voll determined from school children the approximate skin conductance in the healthy state, that being around 1.25 volts at fifty microamperes. Were the human body in a perfect state of health, no points on the skin surface would be 'active', that is, exhibit a deviation from this measurement of the normotonic state, just as no deviation is found on a lie detector when a person speaks the "truth." That actually is a blessing, meaning only active points are detectable and remarkable, which certainly narrows down the field of inspection to a least amount of points and surface zones required for evaluation.

For example, in the face of suspected case of glycosuria in an out-of-control diabetic, I use the very tip of the thumb, an old 'family point' for diabetes. I have researched for the last five years. More than one hundred cases of frank glycosuria, confirmed by laboratory, have shown this point to exhibit meter indicator deviations upon measurement. It is a point that can be readily relied upon in lieu of urine sticks.

This Voll method, of time-consuming measurements upon remarkable presentation, is the original method of research. The author, to his knowledge, is the only such person on planet Earth that continues this research method on a weekly, clinical basis. There are three basic levels of conductance at the topical points by a properly calibrated instrument:

1. Normotonic: This reads "50" on a meter scale of zero to one hundred.

2. Hypertonia: These points exhibit conductance above 70 (to 100) on the meter scale.

3. Hypotonia: These points exhibit conductance below 40 (to zero) on the meter scale.

However, these are called 'stable' measurements, meaning, upon placement of the electrode upon the skin, the meter swings upward to a peak conductance value and rests stable in a steady state, relatively indefinitely. Clinically, these measurements are generally considered 'unremarkable'; they lead to no clinical findings generally. Dr. Voll insisted aptly that the only meter measurement of any import is the unstable measurement. Just as the ECG shows atrial fibrillation as a heartbeat that is 'irregularly irregular,' so to the EAV 'indicator drop' points to the pathologic state from the point so measured.

The indicator drop means that the needle on the meter reaches a maximum value on skin contact, and precipitously drops to a lower value within seconds. This drop cannot be fudged by sleight of hand, and occurs even with advancing pressure exerted on the measurement stylus in an effort to force increased conductance. Thus, the 'indicator drop' is the pathological measurement exclusively.

Diagnostic Criteria

EAV does not 'diagnose'--i.e., "to determine the identity of a disease, illness, etc." For example, an indicator drop on the measurement point "descendingcolon" could mean anything from a bleeding polyp, to irritable bowel, to threadworm parasitosis, to frank obstipation. The diagnosis is made by the doctor and confirmed with signs, symptoms, laboratory and, if necessary, radiology.

A rule or principle for evaluating measurements in EAV is to always take reference to the presenting history, signs and symptoms. As a general rule, the larger the indicator drop, the more grave the complaint. Slight indicator drops of the needle, say, 5 or 10 points from maximum value, usually means some incipient problem, but does not objectify the chief complaint as a rule. Dramatic drops of the needle, 20 points or more are remarkable and lead to the summating criteria, i.e. the clinical impression.

From Plethora to Efficiency

In my book, Points 2016, I catalog more than 2,000 acupuncture points. Obviously, all are not active on any one individual. Generally, from the case history, we should be able to surmise a number of dysfunctions in light of vital signs and presentation. Thus, we have our old standby points on the order of about fifty that are commonly used and committed to memory after a certain amount of practice time and dedication to this great art.

I often use such points as thyroxin, central and autonomic nervous systems, white blood cells, descending colon, stomach fundus, insulin, estrogen, testosterone, dysbosis, SIBO (ileum), prostate/uterus, allergy, lymphatic (hydration status), and assortment of others. The traditional EAV practitioner may find these points surprising and new, and they are.

Dr. Voll taught EAV at its rudiments, to first learn and evaluate the "control measurement points," based on so-called meridian anatomy. I abandoned control points long ago; they scarcely exist and are not relevant. Acupuncture meridian theory also serves no relevance as the EAV point is strictly transdermal, located in the dermatome. The electrical path of conductance is limited to the dermal papillary boundary layer and no more. Were the Voll device actually measuring 'meridians' then our meter needle would be jumping with each and every sinoatrial discharge (aka heartbeat). That is a good thing!

Dr. Voll's schema of preliminary evaluation with 'control points' is thus not relevant nor accurate. For example, if one were to rely on CMP. Large Intestine, you will miss looming constipation each and every time. If one were to rely on CMP Bladder (meridian) for prostate scanning, you will miss elevated PSA's and hypertrophy each and every time. You are better off with a history and a latex glove. With all due respect to my mentor Reinhold, I believe the presentation of these control points in 1978 was premature and in need of more evaluation.

Conclusions to Date

Reinhold Voll bequeathed us with a fabulous system of timely, cheap, and effective bedside evaluation. To this day, in my primary care practice, it is above all the fastest and most expedient method to quickly assess health status. No longer do I sacrifice a patient's paycheck with thyroid profiles, PSA's, hair analysis, allergy tests, etc. unless absolutely critical. Signs and symptoms, EAV measurements, and a noodle of common sense suffices in 80% of primary care cases. The device I use has sat on my desktop for nearly twenty years with never any need of repair. I have even built a portable device with a solar cell that drives a gel cell for field use that I have taken to many parts of the world for missionary service.

I have personally added dozens of new points that serve as great utility in practice. Such points as gallstones (fundus, cholelithiasis), glycosuria, lactose intolerance, gluten intolerance, renal failure (elevated BUN), prostate (hypertrophy), dysbiosis (colon), SIBO (small intestine bacterial overgrowth), stomach HCI (parietal cells), thyroxin, TSH, cortisol, GABA (epilepsy), dopamine, and many others.

Once these points are mastered, evaluation is generally less than five minutes and is woven into the patient interview. That being said, four to six patients per hour presents no difficulties. My latest foci are the various food allergies including shellfish, nightshades, peanut allergy, soya, MSG, and others. Of course, research is limited to frank presentations with known histories. For example, to evaluate shellfish, latex, or peanut allergy, one needs a patient with a known history of angioneurotic edema. Once a trend of indicator drops evidence on an unknown point on several known cases, then I become comfortable from the findings but continue to track the point for years with desktop notes. At present status, when a patient complains of a migraine coming on after eating a rare bag of peanuts, and the peanut point drops, no harm done telling the patient not to eat any more peanuts (until proven otherwise)!

The Nature of the Beast

For the simple minded, it may be easy to scoff at the notion of discrete points, hardwired in the dermatomes of the skin on the plane of humanity. Fact remains, most of us have two eyeballs, ten fingers and toes, two ears, left and right hemispheres (at best), and a navel. Science and neurology to this day cannot explain the sudden emergence of the frontal lobes of a deviant race suddenly drifting away from primates and becoming bipedal.

In diagrams or maps, the boundaries of dermatomes are usually sharply defined, as are acupuncture points. However, in practice there is some overlap of innervation between adjacent dermatomes on patients, and acupuncture points may deviate slightly from known anatomical landmarks. This is why it is essential to use an electrical conductance meter to locate active points and measure accordingly. However, the author has found down through the years on thousands of patients, these deviations are minuscule and not topical (pardon the pun). Such anatomical landmarks as cranial sutures, osseous angles and edges, muscle origins and insertions, and obvious landmarks as the tip of nose, apex of the auricle, palpebral junctions, ungual corners, dermal boundary layers, etc. make point location fairly consistent in all groups both young and old.

One can only imagine when man first observed with his new found frontal lobes the twinkling of stars, only to realize centuries later that they are relatively stationary, fixed in the sky, and do not move. And in fact, their locations in relation to planetary orbs actually portend future events, the growth of crops, the movement of ocean tides, storms, fortunes, and calamities. And in fact, that is what some ancient observers did long ago, giving us acupuncture, the medicine of the sun, moon and stars. Have we come full circle?

Focal Point VB73

Medical Indications: edema, swollen kidney, discomfort of the abdomen and the sides of the body [loins]; glycosuria.

* EDS Point: This point is specific for glycosuria (sugar in the urine) and thus out-of-control diabetes.

From: Points 2016--Volume XVIII revised issue no. 6. Treatise of Acupuncture Series--Compendium of the Topographical Points of Energy Medicine both Ancient and Modern [As an aid to acupuncturists, electroacupuncturists, and research electrodermologists] by Hon. Prof. (Dr. of Med.) Charles McWilliams

References

McWilliams, C. POINTS 2016. Nevis Island: PanAmerican School; 2016.

Schuldt, H. Bioenergetics in Acupuncture and Electroacupuncture According to Voll. American Journal of Acupuncture. 1978; 6(1): 17-22.

Semizzi M, Senna G, Crivellaro M, et al. A double-blind, placebo-controlled study on the diagnostic accuracy of an electrodermal test in allergic subjects. Clin. Exp. Allergy. June 2002;32 (6): 928-32. doi:10.1046/j.

Voll, R. Topographic Positions of the Measurement Points in Electroacupuncture. (Four volumes and 1st Supplement), ML1-Verlag GmbH, D-311: Uelzen, West Germany; 1978.

Voll, R. Twenty Years of Electroacupuncture Diagnosis in Germany: A Progress Report. American Journal of Acupuncture. 1975;3 (1): 7-17.

by Professor [Dr. of Medicine] Charles McWilliams

PanAmerican School & Clinic, Nevis Island; www.privyinfo.org

Prof. Charles McWilliams maintains a primary care practice on Nevis Island, having resided there for 27 years. EAV is his primary diagnostic tool, yet he also maintains his own laboratory for blood and urinalysis. He has taught extensively on EAV, having introduced the system in Ecuador, Brazil, Curacao, Mexico, Hong Kong, Sri Lanka, Colombia, and the Philippines. He has published extensively on the subject and continues to hold an annual seminar on Nevis Island for dedicated practitioners. He will be conducting a one week seminar on EAV, pathophysiology, and bedside diagnosis on Nevis Island, March 7-11, 2017 (see marketplace ad for details). He can be reached at panamint@sisterisles.kn.

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