Abstract
Dear Editor:
We read the article entitled “Battlefield Acupuncture in the U.S. Military: A Pain-Reduction Model for NATO,” 1 published in your journal, with great interest and would like to highlight two important contributions.
First, in this article, the length of the ASP needles used in the Battlefield Acupuncture is described as being 2-mm long. However, the average thickness of the skin overlaying the cartilage in some acupuncture points, such as Shen Men and Point Zero, is ∼0.8 mm. 2 While an insignificant insertion of the needles into the cartilage is acceptable and safe, inserting the needles >1.5-mm deep, particularly in these points, however, is useless because the needles would reach the cartilage, which is an avascular and aneural tissue and, therefore, cannot produce any stimulation.
Second, but not least, the article notes that the needles may remain in the ears for up to 3–4 days or longer. While an interaction between the metal needles and ionic solution produces a chemical reaction and induces the subsequent physiologic effects, keeping the needles for prolonged duration is controversial and may not be necessary, because the chemical reaction is temporary and will cease after the neutralization of the ionic solution. 3 In addition, although the authors have stated that no side-effects with this practice were reported in the past decade, the majority of auricular acupuncture–related complications, such as irritation and infection, were reported in patients treated with permanent needles. 4
Limiting the depth of insertion to a maximum of 1.5 mm and removing the needles after ∼20–40 minutes will probably produce similar effects, with lower complication rates.
Footnotes
Author Disclosure Statement
The authors declare that they have no conflicts of interest.