Gallbladder Meridian Research Articles

Different Patterns of Dynamic Variations on Electrical Conductances of Acupoints Between Qi Vacuity and Qi Non-Vacuity After Glucose Ingestion

In Traditional Chinese Medicine (TCM), Qi maintains the physiologic function and indicates physiologic energy. Glucose provides energy to humans, thereby playing a role analogous to "nutritive Qi." This study aims to identify the correlations among blood glucose, Qi Vacuity (QV), and the electrical conductances of acupoints. Twenty (20) subjects who had ingested a glucose solution after a 10-hour overnight fast were divided into two groups based on QV score. Then their acupoint conductances were measured sequentially using a Ryodoraku instrument during the following 120 minutes. Data were analyzed using generalized estimating equations as a time-series model. Eight (8) subjects were categorized into a Qi Vacuous group for QV score >6, and the other 12 subjects were categorized into a Qi non-Vacuous group for QV score ≤6. During the first 30 minutes, the acupoint conductances decreased on the left Pericardium, left Heart, right Liver, Kidney, and Gallbladder meridians in the Qi Vacuous group, and increased on the right Pericardium meridian and decreased on the right Gallbladder meridian in the Qi non-Vacuous group. From 30 to 60 and 60 to 90 minutes, the acupoint conductances decreased on the Gallbladder, Heart, left Pericardium, left Kidney, right Liver, and right Stomach meridians in the Qi Vacuous group, and increased on the Pericardium, Heart, left Small Intestine, and left Lung meridians in the Qi non-Vacuous group. During the last 30 minutes, more of the acupoint conductances were increased in the Qi non-Vacuous group, whereas only the acupoint conductance on the liver meridian was increased and that on the left gallbladder meridian was decreased in the Qi Vacuous group. The findings suggest that the energy distribution and transformation in meridian vessels present different patterns in QV and non-QV groups after glucose consumption.

Using Ryodoraku Measurement to Evaluate the Impact of Environmental Noise on Human Physiological Response

According to relevant studies on the influence of indoor sound environment on human responses, long-term exposure to excessive indoor noise can have a significant effect on human physiological responses, such as heart rate variability, electroencephalography and blood pressure. Moreover, it may cause tinnitus, palpitation and headache. In order to find out the impact of noise environment on human physiological response changes, this study undertook experiments in a Lab with a precise control of environmental factors and based on the viewpoint of meridian of traditional Chinese medicine, the changes in human autonomic nervous response and the degree of effect on corresponding meridians after 45 min stimulation of white noise environment at 40 dB (A), 50 dB (A), 60 dB (A) and 70 dB (A) sound pressure levels, were evaluated. The analysis of the experimental results found that, the human Heart Constrictor meridians, Heart meridians and Triple Heater meridians were related to pericardium, blood vessel and blood circulation system; and are likely to be influenced by the noise environment stimulation. When the noise sound pressure level exceeded 60 dB (A), the human Bladder meridians and Gall Bladder meridians related to ears, eyes, shoulder joints, digestive system and endocrine system could be influenced significantly.

Shōnishin para el tratamiento de las asimetrías

Background The treatment of a baby suffering from asymmetry with a craniocervical blockage was documented on video. Treatment with the Japanese Acupuncture method Shonishin lead to a release of the blockage. Aim To demonstrate a simple method of treating asymmetry. Methods A baby with asymmetry has not been able to develop a sense of symmetry yet. In order to facilitate this, one has to convey a sense of “center”. Therefore, the meridians of the frontal cycle (stomach, large intestine, spleen, lung) have to get activated. Having gained a sense of the “middle”, a rotary motion – as is necessary for the release of the articular blockage - can be performed. This is achieved by activation of the Gall Bladder meridian and a stimulation of the Bladder meridian. Results Recent findings suggest that in some cases of babies suffering from craniocervical blockage, these can be released without employing manual therapy. Conclusion The body follows the energetic flow, which in turn determines motion direction and physical structure.

Shōnishin bei Asymmetrie

Background The treatment of a baby suffering from asymmetry with a craniocervical blockage was document ed on video. Treatment with the Japanese Acupuncture method Shonishin lead to a release of the blockage. Aim To demonstrate a simple method of treating asymmetry without the use of manual therapy. Methods A baby with asymmetry has not been able to develop a sense of symmetry yet. In order to facilitate this, one has to convey a sense of “center”. Therefore, the meridians of the frontal cycle (Stomach, Large Intestine, Spleen, Lung) have to get activated. Having gained a sense of the “middle”, a rotary motion – as is necessary for the release of the articular blockage - can be performed. This is achieved by activation of the Gall Bladder meridian and a stimulation of the Bladder meridian. Results Recent findings suggest that in some cases of babies suffering from craniocervical blockage, these can be released without employing manual therapy. Conclusion The body follows the energetic flow, which in turn determines motion direction and physical structure.

Acupuncture as a treatment for functional dyspepsia: design and methods of a randomized controlled trial

BackgroundAcupuncture is widely used in China to treat functional dyspepsia (FD). However, its effectiveness in the treatment of FD, and whether FD-specific acupoints exist, are controversial. So this study aims to determine if acupuncture is an effective treatment for FD and if acupoint specificity exists according to traditional acupuncture meridians and acupoint theories.DesignThis multicenter randomized controlled trial will include four acupoint treatment groups, one non-acupoint control group and one drug (positive control) group. The four acupoint treatment groups will focus on: (1) specific acupoints of the stomach meridian; (2) non-specific acupoints of the stomach meridian; (3) specific acupoints of alarm and transport points; and (4) acupoints of the gallbladder meridian. These four groups of acupoints are thought to differ in terms of clinical efficacy, according to traditional acupuncture meridians and acupoint theories. A total of 120 FD patients will be included in each group. Each patient will receive 20 sessions of acupuncture treatment over 4 weeks. The trial will be conducted in eight hospitals located in three centers of China. The primary outcomes in this trial will include differences in Nepean Dyspepsia Index scores and differences in the Symptom Index of Dyspepsia before randomization, 2 weeks and 4 weeks after randomization, and 1 month and 3 months after completing treatment.DiscussionThe important features of this trial include the randomization procedures (controlled by a central randomization system), a standardized protocol of acupuncture manipulation, and the fact that this is the first multicenter randomized trial of FD and acupuncture to be performed in China. The results of this trial will determine whether acupuncture is an effective treatment for FD and whether using different acupoints or different meridians leads to differences in clinical efficacy.Trial registration numberClinical Trials.gov Identifier: NCT00599677.

Clinical observation of Tuina therapy in treating 47 cases of vertigo

In order to observe the clinical effect of Tuina therapy for vertigo, 47 cases of the patients with vertigo were treated by massaging Triple Energizer Meridian and Gallbladder Meridian on the head, and the results showed cure in 36 cases, improvement in 11 cases and the total effective rate was 100%.

Clinical observation of acupuncture, stone scraping plus cupping therapy for neck-type cervical spondylosis

观察砭石、 拔罐、 电针及红外线综合疗法治疗颈型颈椎病的疗效及安全性。 70 例患者随机分为综合组(35 例)和对照组(35 例)。 综合组重用耿氏多功能砭板沿督脉实施推法和刮法, 闪罐留罐法, 并用常规电针疗法及红外线照射治疗; 对照组采用常规电针疗法及红外线照射治疗。 两组均隔日施治1 次, 治疗6 次为1 个疗程。 观察两组治疗后即刻与1 个疗程结束后的临床疗效以及不良反应。 综合组治疗后即刻总有效率为88.6%, 对照组为80.0%, 综合组即刻疗效好于对照组(P<0.05)。 综合组1 个疗程结束后总有效率为97.1%, 对照组为94.3%, 综合组1 个疗程后疗效也好于对照组(P<0.05)。 针砭罐综合疗法治疗颈型颈椎病安全有效且见效较快。 To investigate the efficacy and safety of a composite treatment with stone scraping, cupping, electroacupuncture and infrared irradiation for neck-type cervical spondylosis. Seventy subjects were randomly allocated into composite treatment group (35 cases) and control group (35 cases). The composite treatment group was treated by scraping along the Governor Meridian, the Gallbladder Meridian and the Bladder Meridian with Geng’s multifunctional stone plate, quick cupping with subsequent retention of cups, routine electroacupuncture, and infrared irradiation. The control group was treated by routine electroacupuncture and infrared irradiation. Both groups were treated once very other day, 6 times as a course. The clinical curative effects and adverse responses were evaluated immediately after each treatment and at the completion of one course of treatment in both groups. The total immediate effective rate was 88.6% in the composite treatment group and 80.0% in the control group. The immediate effect was significantly better in the composite treatment group than in the control group (P<0.05). The total effective rate at the completion of one course of treatment was 97.1% in the composite treatment group and 94.3% in the control group. The curative effect after one course of treatment was also significantly better in the composite treatment group than in the control group (P<0.05). Composite treatment with acupuncture, stone scraping and cupping is safe and effective in treating neck-type cervical spondylosis

Expressions of epidermal growth factor receptor signaling substances in gastric mucosal cells influenced by serum derived from rats treated with electroacupuncture at stomach meridian acupoints

To study the effects of serum derived from rats treated with electroacupuncture at stomach meridian acupoints on the expressions of epidermal growth factor receptor (EGFR) signaling substances phospholipase C gamma-1 (PLC gamma-1), protein kinase C (PKC) and c-myc in gastric mucosal cells. Sixty rats were randomly divided into normal group, stomach meridian group, gallbladder meridian group, stomach meridian plus PD153035 group and gallbladder meridian plus PD153035 group. Water-immersion and restrained stress methods were adopted for inducing gastric mucosal injury in the rats. Gastric mucosal cells were separated by using pronase digestion method, and incubated by PD153035, a EGFR inhibitor, and 100 ml/L serum. The expression of PLC gamma-1 in the gastric mucosal cells was tested by enzyme linked-immunosorbent assay (ELISA), while the expression of PKC by isotope incorporate assay and the expression of c-myc by reverse transcription polymerase chain reaction assay (RT-PCR). In gastric mucosal cells, weak expressions of PLC gamma-1, PKC and c-myc were seen in the normal group, and relatively strong expressions of PLC gamma-1, PKC and c-myc were seen in the stomach meridian group and the gallbladder meridian group, among which, the expressions of PLC gamma-1, PKC and c-myc in the stomach meridian group were the strongest, and there was a significant difference between the stomach meridian group and the gallbladder meridian group (P<0.01). Relative weak expressions of PLC gamma-1, PKC and c-myc were seen in the stomach meridian plus PD153035 group and the gallbladder meridian plus PD153035 group, and there was a significant difference between the stomach meridian group and the stomach meridian plus PD153035 group (P<0.01). The serum derived from the rats treated with electroacupuncture at stomach meridian acupoints can activate the EGFR singling pathway, and this provides an evidence for the theory of "relative particularity between meridians and viscera" in traditional Chinese medicine.

Neuronal Specificity of Needling Acupoints at Same Meridian: A Control Functional Magnetic Resonance Imaging Study with Electroacupuncture

The purpose of this study was to investigate the neuronal specificity of needling acupoints at same meridian by functional Magnetic Resonance Imaging (fMRI). The selected acupoints GB34 (Yanglinquan) and GB39 (Xuanzhong) were at the same gallbladder meridian based on traditional Chinese medicine. In our study we devise three distinct EA (electroacupuncture) manipulations: real EA (deep needling at acupoints), sham EA (deep needling at no-meridian points) and shallow EA (subcutaneous needling at acupoints). Twelve healthy volunteers with right-handiness were enrolled and received three different EA manipulations in counter-balanced orders. DeQi scores were used to evaluate the degree of needling sensation. We found real EA can induce significant stronger needling sensation than sham EA and shallow EA. Multisubjects group mean analysis showed that pain-related cortex including primary and secondary somatosensory cortex (SI and S II), anterior cingulated cortex (ACC), insula were involved in three EA stimulation. Bilateral activation of prefrontal gyrus and occipital cortex were exclusively found in real EA. Deactivation over the rostral segment of ACC was also shown in real and shallow EA. Further paired two difference analysis indicated that real EA induced higher activation than sham EA over bilateral prefrontal gyrus, right-side occipital gyrus and deactivation over the rostral segment of ACC. In the comparing with real EA versus shallow EA, there was right-side activation over the SI, S II, motor cortex, ACC, insula, thalamus, hippocampus, occipital cortex, and cerebellum; also activation over bilateral prefrontal gyrus, caudate and pons. Although no significant activation was found over periaqueductal gray (PAG), further analysis showed the mean and maximal signal changes were different under three EA manipulations. We concluded that EA at analgesic acupoints of same meridian maybe involved the pain-related neuromatrix especially the hypothalamus-limbic system; deep EA at meridian points could elicit stronger needling sensation and modulate the pain-related neuromatrix more effectively than EA at nonmeridian points or shallow EA at meridian points.

The Effect of EA on the Gastric Mucosal Histology and ITF mRNA Expression in Stress-Induced Rats

This study focuses on the effect of electroacupuncture (EA) on the gastric mucosal histology and ITF (intestinal trefoil factor) mRNA in stress-related rat, and the relationship between the gastric protective mechanism of EA at acupoints of Stomach Meridian of Foot-Yangming (SMFY) group and Gallbladder Meridian of Foot-Shaoyang (GMFS) group. Forty rats were randomly divided into 4 groups: blank control group (BCG), model control group (MCG), SMFY group (EA at acupoints of SMFY for 7 days before model inducing), and GMFS group (EA at acupoints of GMFS for 7 days before model inducing). All rats (except normal group) were made model by water immersion and restriction (WRS) on day 7, then the gastric mucosal lesion index (GUI) was accessed, ITF mRNA expression of the tissue was detected by reverse- transcriptase-polymerase chain reaction (RT-PCR) method, and the histological change under light microscope was observed. As a result, the GUI value in SMFY/GMFS groups decreased significantly (p < 0.05 or 0.01). The level of ITF mRNA expression in SMFY group was significantly higher than that in MCG (p < 0.01), while that in GMFS group was higher than MCG but there was no statistical difference (p < 0.05). This result may be due to the intrinsic mechanism of EA's gastric mucosal protection by the upregulation of ITF mRNA expression in gastric mucosal tissue, and the expression variance indicated the classical traditional Chinese medicine (TCM) theory "Relative Particularity between SMFY and Stomach.".

Effect of electroacupunture on gastric mucosal intestinal trefoil factor gene expression of stress-induced gastric mucosal injury in rats

To investigate electroacupuncture(EA) at the acupoints of Stomach Meridian of Foot-Yangming (SMFY), Gallbladder Meridian of Foot-Yangming (SMFY) on gastric mucosal intestinal trefoil factor (ITF) gene expression detection in stress-induced rats with gastric mucosal lesion, and to explore the regulatory mechanism and significance of EA-related gastric mucosal protective effect. Forty rats were randomly divided into 4 groups: Blank group, Model group, Model group+EA at acupoints of SMFY group ("SMFY group"), and Model group+EA at acupoints of GMFY group(GMFY group). All rats (except blank group) were made model by water immersion and restraint stress (WRS). Then the gastric mucosa tissue in each rat was taken off after assessment of gastric mucosal lesion index(GUI), and the expression of ITF mRNA of the tissues was detected by reverse transcription-polymerase chain reaction (RT-PCR) method. Compared with Model group(54.3+/- 1.34), the GUI value in SMFY group (31+/- 2.21) decreased significantly(P< 0.01), so did that in GMFY group (39.8+/- 1.62, P< 0.05), meanwhile GUI value in SMFY group was significantly lower than in GMFY group(P< 0.01). Compared with Model group (0.65+/- 0.01), EA had a tendency to improve the expression of gastric mucosal ITFmRNA gene: such tendency existed in GMFY group (0.66+/- 0.01) but with no significant difference(P>0.05), in SMFY group(0.76+/- 0.01) with an extremely obvious difference (P< 0.01), furthermore the expression in SMFY group was significantly higher than in GMFY group (P< 0.01). The gastric mucosal protective effect by EA at the acupoints of SMFY and GMFY was related to the expression variance of ITF, indicating certain meridian specificity exists. It could be one proof for the TCM theory "Relative particularity between SMFY and stomach".

Short needling and herniation of lumbar intervertebral disc: A report of 100 cases

Altogether 100 cases of lumbar intervertebral disc herniation were treated by needling major points including Yaotu (Extra point), Yinlingquan (SP 9) and Zusanli (ST 36) with heat-reinforcing manipulation, adjunct points including Weizhong (BL 40) and Sugu (BL 65) in the case of pain radiating to the Bladder Meridian or Yanglingquan (GB 34) and Zulinqi (GB 41) in the case of pain radiating to the Gallbladder Meridian with even reinforcing and reducing manipulation. The result showed that 49 cases got recovery, 37 cases got marked effect, 11 cases got certain effect, 3 cases got no effect and the total effective rate was 97.0%.

Modulation of cardiovascular excitatory responses in rats by transcutaneous magnetic stimulation: role of the spinal cord

This study investigated the efficacy of magnetic stimulation on the reflex cardiovascular responses induced by gastric distension in anesthetized rats and compared these responses to those influenced by electroacupuncture (EA). Unilateral magnetic stimulation (30% intensity, 2 Hz) at the Jianshi-Neiguan acupoints (pericardial meridian, P 5-6) overlying the median nerve on the forelimb for 24 min significantly decreased the reflex pressor response by 32%. This effect was noticeable by 20 min of magnetic stimulation and continued for 24 min. Median nerve denervation abolished the inhibitory effect of magnetic stimulation, indicating the importance of somatic afferent input. Unilateral EA (0.3-0.5 mA, 2 Hz) at P 5-6 using similar durations of stimulation similarly inhibited the response (35%). The inhibitory effects of EA occurred earlier and were marginally longer (20 min) than magnetic stimulation. Magnetic stimulation at Guangming-Xuanzhong acupoints (gallbladder meridian, GB 37-39) overlying the superficial peroneal nerve on the hindlimb did not attenuate the reflex. Intravenous naloxone immediately after termination of magnetic stimulation reversed inhibition of the cardiovascular reflex, suggesting involvement of the opioid system. Also, intrathecal injection of delta- and kappa-opioid receptors antagonists, ICI174,864 (n=7) and nor-binaltorphimine (n=6) immediately after termination of magnetic stimulation reversed inhibition of the cardiovascular reflex. In contrast, the mu-opioid antagonist CTOP (n=7) failed to alter the cardiovascular reflex. The endogenous neurotransmitters for delta- and kappa-opioid receptors, enkephalins and dynorphin but not beta-endorphin, therefore appear to play significant roles in the spinal cord in mediating magnetic stimulation-induced modulation of cardiovascular reflex responses.

LP – „Der vergessene Akupunkturpunkt” – Seine klinische Bedeutung

In the examination of patients suffering from osteoarthritis of the hip, a painful point was regularly observed situated one hands breadth beneath the trochanter major femoris. This point on the Gallbladder Meridian was first named „Lower Point” (LP) of the hip; at a later period it was referred to as „Liertzer Punkt”. This point has not only a certain diagnostic significance but can also be used therapeutically in the treatment of osteoarthritis of the hip as well as for lower back pain. The localisation of this point correlates with the point „LI 14” on the upper extremity.

Characteristics of treating Bi condition with acupuncture

The information concerning the treatment of Bi condition in 93 ancient medical books has been statistically analyzed through computer. The results showed that there were a total of 149 items of literature and 102 acupoints (276 times in frequency) in association with Bi condition. The common acupoints are Hegu (LI4), Zusanli (ST36), Fengshi (GB31), diseased foci, Quchi (LI11), Weizhong (BL40), Yanglingquan (GB34), Yangfu (GB 38), et al. The common meridians are Gallbladder Meridian, Bladder Meridian, Large Intestine Meridian, Stomach Meridian, Lung Meridian, Liver Meridian and Triple Energizer Meridian. The common parts are the lateral aspect of leg, arm, and foot, the medial aspect of foot, the lateral aspect of hand, the medial aspect of arm, and head. The common acupuncture techniques and their frequencies are moxibustion (54), needling (9), blood-letting (9), fire needling (2), ironing (2) and compression (1). Statistical analysis on the above information showed in the ancient times in treating Bi condition with acupuncture, selecting acupoints are according to meridian distribution, the body parts and syndrome differentiation.

Tuina therapy for prolapsed lumbar intervertebral disc

Recurrent low back pain and reflex sciatica of lower limbs are the two leading symptoms of prolapsed lumbar intervertebral disc, which can be confirmed in the history, symptoms, signs and imaging examination such as CT scan and MRI. It should be differentiated from those conditions characterized by lumbago and/or possible sciatica. Tuina was performed mostly on the Bladder Meridian, Gallbladder Meridian and Governor Vessel, as well as their acupoints such as Jiaji (Ex-B 2) points, Shenshu (BL 23), Dachangshu (BL 25), Yaoyangguan (GV 3), Huantiao (GB 30), Weizhong (BL 40), Chengshan (BL 57), Yanglingquan (GB 34) and Ashi points. Thumb-massaging manipulation, rolling manipulation, pulling manipulation, pressing manipulation, kneading manipulation and grasping manipulation are often performed.

Treatment of dormant papule with acupuncture in ancient times

The information concerning dormant papule in 93 ancient medical books is statistically computerized and shows that there are totally 29 items of information and 25 acupoints (55 times in frequency) in connection with dormant papule. The commonly used acupoints, are Quchi (LI 11), Jianyu (LI 15), Tianjing, (TE 10), etc, which are around joints, on the upper body, on, the lateral aspect or on the ends of the limbs. The commonly used meridians are Large Intestine Meridian, Pericardium Meridian, Triple Energizer Meridian, and Gallbladder Meridian. The commonly used parts are the lateral aspect of arm, the dorsum of hand, the external aspect of leg, the medial aspect of arm, and the palm.

Perivascular space: possible anatomical substrate for the meridian.

Despite the meridian system being an important concept in Traditional Chinese Medicine (TCM), modern biology and Western medical systems have failed to find an anatomic substrate. Since the 1960s, a variety of phenomena along meridians have been reported, among which quite a few suggest that along meridians there is a fluid pathway (but not blood vessels or lymphatics). On the other hand, perivascular space (PVS) has been demonstrated to be a body fluid pathway in addition to blood vessels and lymphatics in some mammalian tissues, such as brain, thymus, and lung. The present study was designed to examine the relationship between PVS and the meridian. We studied characteristics of the tissues around the blood vessels along the Stomach Meridian of Foot-Yangming and the Gallbladder Meridian of Foot-shaoyang, with the goal of identifying anatomical structure corresponding to the meridian described in TCM. Through perivascular dye injection and frozen section histology, we found that there is PVS around the blood vessels along the meridians, and it is a fluid pathway. Subsequent physiologic studies revealed that the PVS shows significantly greater electrical conductivity and significantly higher partial oxygen pressure (pO(2)) compared to medial and lateral tissues. The PVS along the meridians has properties offering good explanation for the meridian phenomena. The work sheds new light on the studies of meridians and may contribute to research on the mechanism of Chinese acupuncture.

Ancient acupuncture literature on apoplexy

This paper reviews twenty-eight Chinese medicine books with complete prescriptions prior to the Qing Dynasty, and analyzes the characteristics of acupoint selection and needling manipulations from the perspective of apoplectic symptoms. It is concluded that, in ancient times, apoplexy is often treated on the basis of its symptoms and a great number of acupoints are employed; hemiplegia is mainly treated by the acupoints of the Large Intestine Meridian and Gallbladder Meridian, with two key acupoints; coma is mainly treated by first-aid acupoints and qi-supplementing acupoints, with seven key acupoints; wry mouth and convulsion are mainly treated by the local acupoints; as for needling manipulations, moxibustion with moxa cones is principally used, while needling is less used.

Effect of electroacupuncture on pressor reflex during gastric distension.

The effect of electroacupuncture (EA) on the reflex cardiovascular response induced by mechanical distension of the stomach was studied in ventilated male Sprague-Dawley rats anesthetized by ketamine and alpha-chloralose. Repeated balloon inflation of the stomach to produce 20 mmHg tension on the gastric wall induced a consistent rise in mean arterial pressure, while heart rate (372 +/- 22 beats/min) was unchanged. This response was reversed by transection of the splanchnic nerves. Bilateral application of EA (1-2 mA, 2 Hz) at Neiguan-Jianshi acupoints (pericardial meridian, Pe 5-6) over the median nerve for 30 min significantly decreased the pressor response from 33 +/- 6 to 18 +/- 4 mmHg (n = 7, P < 0.05). This effect began after 10 min of EA and continued for 40 min after termination of EA. EA at Zusanli-Shangquxu acupoints (stomach meridian, St 36-37) over the deep peroneal nerve similarly inhibited the pressor response. The effect lasted for 10 min after EA was stopped (n = 6, P < 0.05), while EA at Guangming-Xuanzhong acupoints (gallbladder meridian, GB 37-39) over the superficial peroneal nerve did not inhibit the pressor response. Naloxone injected intravenously (n = 6) immediately after termination of EA or administered by microinjection into the rostral ventrolateral medulla (rVLM) 25 min after initiation of EA (n = 6) reversed the inhibition by EA, suggesting an opiate mechanism, including the rVLM, was involved.