ATLAS OF

NEURAL
THERAPY
 HISTORY OF NEURAL THERAPY Effects of Procaine
In what cases with
It begins is Neural Therapy it happened
a coincidence, It has a large
in 1925, when number of Ferdinand
the brothers benefits, some of which
not and indicated and what
Walter Huneke saw a headache that their sister suffered disappear, after
conditions can prevent are: it regulates circulation, is anti-allergic, calms
the administration of atophanil administered intravenously, the symptoms
successful treatment?
quickly disappeared. pain, reduces fever, stimulates diuresis,

Mental illnesses, neuroses, influences the production of hormones and
Atophanil was
neurasthenias, manufactured in two presentations: for intravenous injection and
nutritional
diseases, vitamin deficiency,
for intramuscular
enzymes and improves the general Whatcondition
use with a little procaine for painless injection (due to the
is Neuralof
hormone deficiency,
anesthetic of procaine), the
hereditary
properties vial they administered was Therapy?
the body. for
diseases, advanced infectious
intramuscular use.
diseases and cancer. Neural therapy is a
The brothers began an intense investigation, injecting procaine with caffeine,
method for
they deduced that procaine, in addition to having anesthetic effects, had
diagnosing and
curative properties for various diseases. They began the application with
segmental therapy, which is nothing more than the treatment of signs oftreating
the diseases
disease. at the same place of origin. caused by disorders
in the body's
electrical system,
called interference
What are Interference fields? fields, and they can
They are areas that have a lower electrical
be found anywhere
potential than the surrounding in the body, from
tissues. Current flows from areas of
high voltage travel to areas of lower
internal organs,
voltage, causing confusion in the ganglia, teeth, and
CNS , causing pain and/or illness.
scars on the skin.
How does Neural Therapy work?

It acts directly on the diseased organ, exerts
influence on the regulatory
mechanisms of the organism, and
directly attacks the interference
field.

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 What response can be expected when
treating an interference field?
You can expect the discomfort to disappear in a
matter of seconds for a period of 20 hours if the
injection is anywhere on the body and 8 hours if it
is in the teeth.

BASES OF NEURAL THERAPY

Life is not only tied to matter but also to energy. Each cell is equivalent to a tiny potassium
battery with a potential of 40-90 millivolts. Each stimulus causes the potential “depolarization”
to drop. Normally the cell recovers it immediately “repolarization”. The energy for this is
obtained from the metabolism of oxygen. If the irritating stimuli are very strong or there are
many and they add up (chemical, physical, traumatic, etc.), you will not be able to respond on
your own strength.
The cell goes into permanent depolarization; she is therefore weakened, sick; Its connection with
the information of the whole is no longer complete and it cannot correctly exercise its fusions.
But, it begins to radiate or transmit “interfering impulses” with rhythmic discharges, thus
creating the interfering field.

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The reactions of the basic system (the connective tissue cell + nerve + capillaries + extracellular
fluid) with the parenchymal cells, with the internal circulation and with the blood and lymphatic
system are presented schematically, as well as their location in the entire organism with the
connections to the known central poles.
The mother regulation system constitutes an energetic bioelectric system in which the main
thing is the oxidizing-reductive potential. The budget of oxygen and acids and bases depends on
this. Only in the background are the rest of the known functions carried out.
Each measure that is capable of introducing energy in some way into the mother system is
capable of setting in motion the vegetative functions that, using the aforementioned
communications, encompass the entire organism. Only if we start from this basis can the
ubiquitous effects of the so-called “impulse in the vegetative” be understood, no matter whether
the energy applied is thermal, electrical, chemical or mechanical.
Organs that are constitutionally weak due to past diseases have a diminished capacity to
separate and select impulses. They receive the interfering impulses and make them pathogenic,
resulting in problems in blood supply and other regulatory mechanisms.
Each human being has its weak point, its organ in reduced conditions and this will be the first to
get sick if the active effect of an interfering field occurs.
The local anesthetic placed in microdoses in the interfering field has a high own potential,
thereby repolarizing and stabilizing the potential of the membrane affected by the strong
irritative impulse or by the aggregation of many others. This recovers the interfered function in
all the circuits of the neurovegetative system (neural, humoral, cellular, hormonal, etc.) at least
temporarily with each repetition of the treatment the organism learns more and more to
depolarization and repolarization.

THE PHENOMENON IN SECONDS AND INTERFERENCE FIELDS

In 1940 the first “phenomenon in seconds” was observed, from there the important therapeutic
deduction was drawn that these neural irritants or “interference fields” can produce and
maintain the most diverse diseases beyond any segmental order. A way had been found to
disconnect pathogenic interference fields, thus curing diseases that until then had resisted all
therapy.

The conditions for a phenomenon in seconds are:

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When the neuraltherapeutic substance is injected into the culprit interference field, all remote
discomfort caused by it must disappear in the same second and 100%, as long as this is
anatomically feasible.
The total release of symptoms must last a minimum of 8 hours if the perturbation field injected
is in the teeth, and 20 hours if the neural therapeutic disinterference was done in any other part
of the body.
If the old symptoms appear again, the injection should be given at the same site. The duration of
the effect achieved at 100% should never be shorter than the repetition, it must be even longer
compared to that of the first application.
Interference fields can be considered: dead, infected, displaced teeth, etc. The tonsils, the
sinuses, every scar on the skin, deep in the periosteum or bone.
Also foreign bodies, chronically inflamed organs or residual states of old inflammations that on
previous occasions affected the liver, gallbladder, stomach, intestines, appendix, prostate,
uterus, ovaries and testicles.
If the injection into a suspected interference field does not provide the expected reaction, there
is no point in repeating injections at that site.
Have; We have to continue looking for another possible interference field.
The maximum dose for 2% procaine in adults and applied intravenously is applied for safety
reasons at 50 ml. For 1% lidocaine intramuscularly in 20 cc. The amounts that appear in this
booklet refer to the maximum limit, it being a fact that the experienced neural therapist doctor
can achieve his purposes with just a few millimeters.
CONTRAINDICATIONS: The application of procaine or lidocaine should be discontinued in
atrioventricular block (AV-BLOCK), in bradycardia in severe damage to the heart rhythm, in
persistent hypotension and in heart decompensation.

SEGMENTAL THERAPY IN HEART DISEASES

*STANDARD POINTS

*COMMON REACTION POINTS

As a basic treatment in all heart diseases that do not respond clearly to strophanthin and other
glycosides, we apply intravenous injections into the left cubital vein.

From 2 to 4 papules close to the sternum, in the intercostal spaces 1 to 3. A papule on; the angle
formed by the left edge and over the left side of the chest next to the sternum below the left
collarbone and over the left shoulder to the left side.

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SEGMENTAL THERAPY IN HEART DISEASES

The reflex zones of the heart on the back reach the last rib, passing between the scapulae. In this
area we find hyperalgesic points on palpation that can be disconnected by means of a papule and
even slightly deeper injections, some of which must eventually reach the periosteum.

All scars in the segment have to be treated according to the corresponding neural therapeutic
technique. The most powerful weapon of segmental heart therapy is the injection into the stellate
ganglion.

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SEGMENTAL THERAPY IN LUNG DISEASES

The basic therapy in all lung diseases is intravenous injection interspersed on the left and right.

4 to 6 papules next to the sternum, papules over the shoulder region and on both sides next to
the transverse processes of the thoracic vertebrae.

In Chinese acupuncture:

Point 1 of the lung meridian; located on the para-axillary line somewhat lateral to the mid-
clavicular line at the level of the 3rd intercostal space.

Point 2 of the lung meridian, one intercostal space above the second intercostal space.

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SEGMENTAL THERAPY IN LUNG DISEASES

Disconnecting, eliminating or neuraltherapeutically turning off any hyperalgesic point found in the
scars and in the segment, they have to be treated in the same session.

Injection into the stellate ganglion interspersed on the left and right has a strong regulatory effect
on the irritation or vegetative supply of the corresponding upper segment; segment that, of
course, covers the entire upper part of the body and also includes the head.

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SEGMENTAL THERAPY IN LIVER-GALLADBALL DISEASES

The following is the basic treatment for liver-gallbladder:

Intravenous injections of procaine or lidocaine, papules with deep injection in the epigastric fossa,
papules over the region of the gallbladder and pancreas, in the area of the head, back, and on the
shoulders, injection in the vicinity of the right supraorbital nerve, injections in Vogler's points to
the periosteum.

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SEGMENTAL THERAPY IN LIVER-GALLADBALL DISEASES

In biliary colic, paravertebral injections are recommended in the vicinity of the right intercostal
nerves of the 9th to 11th thoracic section.

For postoperative treatment of pain after upper abdominal surgeries, we perform paravertebral
injections in the thoracic intercostal nerves 5 to 11.

All hyperalgesic points and regions of muscle tension in the segment, as well as scars, must be
treated in the same session.

Injections into the abdominal sympathetic tract have always given the best results in diseases of
the upper abdomen.

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SEGMENTAL THERAPY IN STOMACH DISEASES

In basic treatment the following is applied:

Intravenous injections of procaine or lidocaine, injections in the epigastric fossa, in the vicinity of
the left supraorbital nerve.

In stomach cramps, gastralgias, etc. Paravertebral applications are made to the left thoracic
intercostal nerves 6 to 8.

Hyperalgesic points and scars in the segment, as well as painful gel spots, are treated in the same
session.

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SEGMENTAL THERAPY IN STOMACH DISEASES

Injection into the abdominal sympathetic troch associated with injection into the epigastric fossa,
Vogler's points and xiphoid process: they are an effective combination in diseases of the upper
abdomen and diseases of the stomach.

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IMPORTANT POINTS FOR NEURAL THERAPEUTIC INJECTIONS IN THE FOREHEAD

1.-Temporo-frontal bone
2.-Supraorbital nerve
3.-Eye papules
4.-Infraorbital nerve
5.-Ciliary ganglion
6.-Gasser's ganglion
7.-Inferior alveolar nerve (mental)

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Page
 5
4
6

MOST IMPORTANT INJECTION POINTS ON THE LATERAL HEAD

Points for headache:

1.- On the temples or parietal bone

2.- Supraorbital nerve
3.- Eye papules
4.- Sphenopalatine ganglion
5.- Ciliary ganglion
6.- Gasser's ganglion
7.- Infraorbital nerve
8.- Mastoid process

1
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 2

4 3

6 5
8
7

IMPORTANT INJECTION POINTS ON THE BACK OF THE HEAD, NECK AND SHOULDERS

THE SYMPATHETIC OR GREAT TRUNK CHAIN of the vegetative nervous system with its ganglia and
with its network of pathways that encompass everything, will come to be recognized as the lord of
life as the governor of the soul, of the will, of the artistic receptivity of the subconscious mind, as
the great regulator of the body's autonomous functions.

With the help of tonsils, adrenal glands, thymus, liver and spleen, it protects us from infectious
diseases. Hope, positive suggestion, faith, courage, tone and reorient it, the lack of hope and fear
of illness weaken it and thereby reduce the strength or immunological power of the body. Its
alterations lead to paralysis, cramps, psychopathies, asthma, ophthalmopathies, hearing
problems, growth inhibition as well as disproportionate growth and many other ailments. The
consequence of its wear is aging.

Through the sympathetic for a force directed and fed from the cosmos, it is a current that
according to the Prana enters through the Sacrum and exits through the top of the head, site of
the 3rd eye and the lotus flower with a thousand petals. . This is not a fantastic assumption but an
important manifestation that can be used at all times to achieve healing purposes.

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 HEAD – NECK

TEMPORAL ARTERY, INJECTION IN ITS IMMEDIATE AND INTRA-ARTERIAL VICINITY

INDICATIONS : temporal arteritis, migraine, temple headache.

INSTRUMENTAL : 18 gauge cannula

MATERIAL : 1cc amount of procaine or lidocaine.

TECHNIQUE : entry site: the temporal artery passes in front of the ear towards the temples, where
its pulse is visible and palpable.

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SUPERIOR CERVICAL GANGLION RETROSTYLOID REGION, PERIGANGLIONAR INJECTION

INDICATION : allergic diathesis.

INSTRUMENTAL : 6 to 8 cm cannula. Of length.

MATERIAL : amount of 5 cc of procaine or lidocaine

TECHNIQUE : entry site: the cutting point of 2 auxiliary lines, the vertical line goes down from the
anterior edge of the mastoid process, and the horizontal line crosses it one finger width above the
mandibular angle.

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INJECTION NEAR THE CILIARY GANGLION

INDICATION : All diseases and inflammations of the eyes: carotitis, iridocyclitis, glaucoma, certain
forms of headache.

INSTRUMENTS : 4 cm long cannula.

MATERIAL : amount of 2 ml of procaine or lidocaine

TECHNIQUE : the patient looks with his head supported, fixed and with his eyes open cranial-
medial, upward and to the center.

Entry site: in the right eye at 7 o'clock. And in the left eye at 5 o'clock clockwise.

Direction of penetration: while maintaining a small distance from the lower wall of the orbit, it is
gently penetrated backwards, upwards and inwards.

Penetration depth: after 3 cm and no more than 3.5, the proximity of the ciliary ganglion is
reached.

CAUTION : Before injection VACUUM!

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INJECTION NEAR THE MANDIBULAR NERVE AND NEAR THE GASSER'S GANGLION

INDICATIONS: Trigeminal neuralgia, lockjaw, in headaches of unidentified etiology, odors

produced by a tumor in the area of the corresponding innervation.

INSTRUMENTAL: cannula 6 cm long x 08 mm caliber.

MATERIAL: 1 to 2 ml of procaine or lidocaine.

TECHNIQUE:
Entry site: with the patient's mouth slightly open, the mandibular notch is palpated approximately
3 cm before the tragus, exactly below the zygomatic arch.
Direction: of penetration: in a transverse direction along the base of the skull towards the center
Depth of penetration: approximately 4 cm deep, the needle encounters the pterygoid process; It is
then stepped back to change direction and continue 0.5 to 1cm dorsally, reaching the immediate
vicinity of the oral foramen.
The correct location of the needle gives the patient a sudden pain reaction.

CAUTION: before injection VACUUM!

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INJECTION NEAR THE SPHENOPALATINE GANGLION AND NEAR THE MAXILLARY NERVE

INDICATION: Hay fever, vasomotor rhinitis, neuralgia of the second branch of the trigeminal
nerve, sinusitis, some forms of headache that do not respond to any other therapy, in jaw bone
pain without pathological findings by the dentist.

INSTRUMENTAL : 6 cm cannula. Length x 0.8 mm caliber.

MATERIAL : 1 to 2 ml of procaine or lidocaine.

TECHNIQUE:

Entry site: along the upper edge of the zygomatic arch halfway between the ear and the orbital
rim.

Direction of penetration: If it is penetrated at the correct angle, towards the zygomatic bone on
the other side of the skull (blunt angle forward and down).

Penetration depth: 5 to 6 cm. The pterygopalatine fossa is reached.

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INJECTION IN THE VICINITY OF THE STELLATE GANGLION

INDICATION:

1).- head: pre- and post-apoplexy syndrome, cerebral edema, intracranial vascular spasms,
traumatic concussive syndrome, traumatic epilepsy, facial paresis, posterisipela facial edema,
certain forms of headache, migraine.
2).- Eyes: glaucoma, herpes zoster ophthalmicus, claudication of the central retinal artery, thrombi
of the central vein, vascular wall diseases, degenerative problems of the macula.
3).- Ears: Meniere's disease, chronic otitis media, sudden hearing loss, zoster oticus, deafness of
the inner ear, ringing in the ear, cold injuries, allergies.
4).- Nose: Vasomotor rhinitis, chronic paranasal sinus infections
5).- neck: hyperthyroidism, cervical syndrome neuralgia, septic angina, cervical migraine,
6).- Shoulders: shoulder-arm syndrome, scalene syndrome, deforming osteoarthritis, capsular
arthritis, post-traumatic joint angilosing.
7).- Arm: brachial plexus neuralgia, phantom pain, Sudeck's dystrophy, epicondylitis,
tendinopathies, lymphatic edema, post-amputation of the hand, circulatory problems.
8).- Lung: bronchial asthma, pulmonary tuberculosis, pneumonia, pleuritis, herpes zoster,
hemiplegia, pulmonary edema.
9).- Heart: angina pectoris, infarction, ventricular fibrillation, paroxysmal tachycardia, cardiac
decompensation.
INSTRUMENTAL : 8 cm cannula. of length.
MATERIAL : 2 to 5 ml. of procaine or lidocaine.
TECHNIQUE : method according to Herget: the patient lies on his back and a cushion is placed
under the shoulders, which produces strong flexion of the head backwards and overextension of
the cervical spine.

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Entry site: in the transition area of the middle third of an auxiliary line that we draw between the
mastoid process and the sterno-clavicular joint along the vertical edge of the sternocleidomastoid
muscle. The entrance is approximately 2-3 cm away. of the midline.
Direction of penetration: perpendicular to the skin.
Penetration depth: after 6 to 7 cm. Touch the tip of the cannula to the head of the 1st rib, remove
the needle 2 cm. and place the therapeutic substance there.
CAUTION : Before injection VACUUM!
If the injection is placed correctly, the patient will present the following immediate symptoms:
miosis, enophthalmia, ptosis (symptomatic trio of Horner syndrome). Neck, cheek and face: they
are better irrigated, the conjunctiva and sclera show clear redness, anhidrosis of the face and neck,
tearing.

INJECTION IN THE VICINITY OF THE STELLATE GANGLION

Method developed and used by Leriche-Fontaine modified by P. Dosch.

INDICATION:

1) Head: pre- and post-poplexy syndrome, cerebral edema, intracranial vascular spasms, traumatic
concussive syndrome, traumatic epilepsy, facial paresis, postericipelal facial edema, certain forms
of headache, migraine.
2) Eyes: glaucoma, ophthalmic herpes zoster, claudication of the central retinal artery, thrombi in
the central vein, diseases in the vascular wall, degenerative problems of the macula.
3).- Ears: Meniere's disease, chronic otitis media, sudden hearing loss, Herpes Zoster, deafness of
the inner ear, ringing in the ears, cold injuries, allergies.
4).- Nose: vasomotor rhinitis, chronic paranasal sinus infections.
5).- neck: hyperthyroidism, neuralgia, cervical syndrome, septic angina, cervical migraine.
6).- Shoulders: shoulder-arm syndrome, scalene syndrome, deforming osteoarthritis, capsular
arthritis, post-traumatic joint angilosing.
7).- Arm: brachial plexus neuralgia, Sudeck dystrophy, epicondylitis, tendinopathies, post-hand
amputation lymphatic edema, circulatory problems.
8).- Lung: bronchial asthma, pulmonary tuberculosis, pneumonia, pleuritis, herpes zoster,
hemiplegia, pulmonary edema.
9).- Heart: angina pectoris, infarction, ventricular fibrillation, paroxysmal tachycardia, cardiac
decompensation.
INSTRUMENTAL: 4 cm cannula. of length.

MATERIAL: 4 to 5 ml. of procaine or lidocaine.

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TECHNIQUE: Leriche Fontaine method modified by P. Dosch.

Direction of penetration: towards the spinous processes of the 6th and 7th cervical vertebrae.

Depth of penetration: in cases where the head of the 1st rib is palpable, the lymph node is found
almost subcutaneously; In adipose patients it is sometimes up to 2 cm. deep.

Penetration site: the seated patient has his head flexed back and turned to the opposite side of
the injection site. With two fingers of the free hand, in the transitional area between the lower
third and the middle third of the sternocleidomastoid muscle, the vascular bundle is moved
towards the midline, the pleura towards the caudal and the head of the 1st rib is palpated
immediately above the probing side that serves as a guide and rail is penetrated with the cannula.

CAUTION: Before injection VACUUM!

If the injection is placed correctly, the patient will present the following immediate symptoms:
miosis, enophthalmia, ptosis (symptomatic trio of Horner syndrome). Neck, cheek and face: they
are better irrigated, the conjunctiva and sclera show clear redness, anhidrosis of the face and neck,
tearing .

INJECTION IN THE VICINITY OF THE STELLATE GANGLION

Method by Reischauer
INDICATION: 1) head: pre- and post-stroke syndrome, cerebral edema, intracranial vascular
spasms, traumatic concussion syndrome, traumatic epilepsy, facial paresis, posterisipela facial
edema, certain forms of headache, migraine.
2) eyes: glaucoma, herpes zoster ophthalmicus, claudication of the central artery of the queen,
thrombi in the central vein, diseases of the vascular wall, degenerative problems of the macula.
3) ears: Meniere's disease, chronic otitis media, sudden hearing loss, otic zoster, inner ear
deafness, ringing in the ears, retting lesions, allergies.
4) nose: vasomotor rhinitis, chronic sinus infections
5) neck: hypertrichosis, neuralgia, cervical syndrome, septic angina, cervical migraine
6) shoulders: shoulder-brachial syndrome, scalene syndrome, deforming osteoarthritis, capsular
arthritis, post-traumatic joint angilosation
7) arm: gill pain, cansalgia, brachial plexus neuralgia, phantom pain, sudeck dystrophy,
epicondylitis, tendinopathies, lymphatic edema due to breast amputation, circulatory problems
8) lung: bronchial asthma, pulmonary tuberculosis, pneumonia, pleuritis, herpes zoster, embolism,
pulmonary edema
9) heart: angina pectoris, infarction, ventricular fibrillation, paroxysmal tachycardia, cardiac
decompensation.
INSTRUMENTAL: 8-10 cm long cannula
MATERIAL: 10 ml of procaine or lidocaine
TECHNIQUE: method according to Reischauer
Penetration site: the patient is seated so that his forehead can rest on the patient's backrest, his
back free towards the doctor.
The patient can rest his forehead on his forearms by bending his head forward so that the spinous
process of the 7th cervical vertebra is clearly seen. At 4 cm from the midline between the 6th and
7th cervical, it is penetrated perpendicular to the surface of the skin parallel to the median plane.

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Depth of penetration: 3-3.5 cm, the lateral masses of the arches of the cervical vertebrae are
touched, the cannula is rotated 45° cranially and 45° laterally, penetrating forward without losing
bone contact. Abandoning bone contact, the cannula is pushed 1 cm more ventrally, injecting
there. The patient reports shoulder pain if the application is correct.
CAUTION: before injection VACUUM!

INJECTION UNDER THE SCALP

INDICATION: Headaches, dizziness, post-concussive symptom complexes, traumatic epilepsy,

spastic alterations of cerebral circulation, pre- and pro-apoplectic states, insomnia.

INSTRUMENTAL: Cannula no. 12.

MATERIAL: 0.5 to 1 cc of procaine or lidocaine.

TECHNIQUE:
Penetration site: On the temples or on the bone guiding at the level of the temples.

Direction of penetration: Perpendicular to the skin.

Penetration depth: To the periosteum.

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INJECTION IN THE MASTOID PROCESS

INDICATION: a) Segmental therapy: acute or chronic otitis media, external otitis, deafness
produced from the inner ear, ringing in the ears, dizziness, vestibular vertigo, facial paresthesia, tic
of the facial nerve.

INSTRUMENTAL: Cannula no. 12.

MATERIAL: 0.5 ml of procaine or lidocaine.

TECHNIQUE: Bending the ear upwards.

Site of penetration: On the anterior border of the mastoid process.

Depth of penetration: Once contact with the periosteum is achieved, leave a few millimeters of
procaine in a ventral and dorsal direction, so that the greater auricular nerve and the lesser
occipital nerve are reached.

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INJECTION IN THE IMMEDIATE VICINITY OF THE GLOSSOPHARYNGAL NERVE

INDICATION: In all diseases innervated by such nerve; glossopharyngeal neuralgia, atypical

trigeminal neuralgia, difficulty swallowing, tongue diseases.

INSTRUMENTAL: 6cm long cannula.

MATERIAL: 2 to 3 ml of procaine or lidocaine.

TECHNIQUE:
Site of penetration: Halfway between the tip of the mastoid and the mandibular angle.

Direction of penetration: Perpendicular to the skin.

Depth of penetration: Until contact with the bone, as well as with the mastoid process, 3 to 4 cm
deep, and then only the anterior face of the bone is infiltrated.

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INJECTION INTO THE SUPERIOR LARYNGEAL NERVE

INDICATION: Neuralgia, pain and discomfort when swallowing (laryngo-pharynx).

INSTRUMENTAL: 6 cm long cannula.

MATERIAL: 5 ml of procaine or lidocaine.

TECHNIQUE: At the level of the hyoid bone, the superior laryngeal nerve divides into an external
branch and an internal branch.

Site of penetration: Mid-center above the thyroid notch through a dermal papule.

Direction of penetration: Subcutaneous.

Depth of penetration: Remain subcutaneous until the patient reports paresthesia.

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INJECTION INTO THE MENTONIAN NERVE

INDICATION: Trigeminal neuralgia, facial pain, chin and lower lip pain.

INSTRUMENTAL: Cannula no. 12.

MATERIAL: Only 5 ml of procaine or lidocaine.

TECHNIQUE:
Site of penetration: Below the lower premolars on the alveolar edge and the lower edge of the
bone between the lower edge of the mandibular bone, the mental foramen can be palpated.

Direction of penetration: Perpendicular to the mental foramen and then a few millimeters towards
cranial-medial.

Depth of penetration: Until bone contact is achieved and the appearance of paresthesias.

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INJECTION INTO THE OCCIPITAL NERVES

INDICATION: Neuralgias in the back of the head, headaches, all discomfort in the area of
innervation, scalp to the top of the head, region of the temples and back of the ear.

INSTRUMENTAL: Cannula no. 12.

MATERIAL: 0.5 to 1 cc procaine or lidocaine.

TECHNIQUE:
Site of penetration: Immediately medial to the palpable occipital, approximately 2 to 4 cm from
the midline, between the bony insertions and semispinatus the nerve can be palpated.

Direction of penetration: Perpendicular until paresthesia is triggered.

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INJECTION INTO THE C3-C5 PHRENIC NERVE

INDICATION: Hiccups, pain caused by organic abdominal and thoracic diseases that radiate to the
shoulder, neck and neck area.

INSTRUMENTAL: 4 cm long cannula .

MATERIAL: 2 to 5 ml of procaine or lidocaine.

TECHNIQUE: The patient's head is turned towards the opposite side of the injection and tilted
slightly forward so that the sternocleidomastoid muscle is distended.

Site of penetration: Immediately above the clavicular insertion and along the lateral border of the
muscle.

Direction of penetration: Almost parallel to the clavicle in an oblique direction towards the middle
center.

Depth of penetration: After about 3 cm the needle enters the scalene space.

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CAUTION: VACUUM BEFORE INJECTION.

INJECTION INTO THE LATERAL SUPRAORBITARY NERVE

INDICATION: Trigeminal neuralgia of the first branch, herpes zoster, frontal headache, frontal
sinusitis.

INSTRUMENTAL: Cannula no. 12.

MATERIAL: 0.5 ml of procaine or lidocaine.

TECHNIQUE:
Site of penetration: somewhat medial to the middle of the orbital roof, the supraorbital notch is
palpated with the thumb.

Direction of penetration: Sliding in front of the thumbnail in a cranial direction

Depth of penetration: Until bone contact is achieved and the appearance of paresthesias.

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INJECTION INTO THE SUPERFICIAL CERVICAL PLEXUS

INDICATION: Pain in the neck and shoulder, torticollis, cervical syndrome.

INSTRUMENTAL: 4 cm long cannula.

MATERIAL: 2 cc of procaine or lidocaine.

TECHNIQUE: The patient lies on his back and with a pillow under the neck, his head is turned to
the opposite side of the injection.

Site of penetration: Halfway between the mastoid process and the clavicle on the posterior border
of the sternocleidomastoid muscle.
Direction of penetration: Perpendicular to the skin.

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Depth of penetration: From 2 to 3 cm deep, the transverse process of the body of the 2nd and 3rd
cervical vertebra is touched. The cannula is withdrawn 0.5 to 1 cm deep and an area of 1.5 to 3 cm
is infiltrated.

CAUTION: VACUUM BEFORE INJECTION!

INJECTION INTO THE DEEP CERVICAL PLEXUS C2-C4

INDICATION: Cervical syndrome, torticollis, pain in the neck.

INSTRUMENTAL: 4 cm long cannula.

MATERIAL: 2 cc of procaine or lidocaine.

TECHNIQUE: The patient lies on his back and with a pillow under the neck, his head is turned to
the opposite side of the injection and placed on a rolled pillow.

Site of penetration: With the fingers of the free hand, the sternocleidomastoid muscle is moved
ventrally and its posterior edge is penetrated at the level of the mandibular angle.

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Direction of penetration: Perpendicular to the skin.

Depth of penetration: At a maximum of 1 cm deep, bone contact is obtained with the tuberosity of
the 3rd transverse process. The cannula without deepening it further is carried just a few
millimeters in the dorsal-caudal direction.

CAUTION: VACUUM BEFORE INJECTION!

If it is in the correct location, the patient will have paresthesia in the shoulder region after the
injection.

INJECTION INTO THE THYROID

INDICATION: Hypo and hypertherosis, pressure in the throat, states of fear, palpitations,
alterations and problems of the menstrual cycle, habitual abortions, hair loss, tachycardia and
fever of unknown etiology, vegetative dystonia, gastrointestinal nervous discomfort, nervousness
and excessive hyperexcitability.

INSTRUMENTAL: Cannula no. 18.

MATERIAL: 0.5 to 1 cc of procaine or lidocaine in each glandular lobe.

TECHNIQUE:

Page 34
Site of penetration: Patient lying or sitting, palpating the location and size of the thyroid

Direction of penetration: Perpendicular to the skin.

Depth of penetration: From 2 to 3 cm deep, the transverse process of the body of the 2nd and 3rd
cervical vertebra is touched. The cannula is withdrawn 0.5 to 1 cm deep and an area of 1.5 to 3 cm
is infiltrated.

CAUTION: VACUUM BEFORE INJECTION. If blood is aspirated, change the location of the cannula.

INJECTION INTO THE TONSILLAR POLES

INDICATION:
a) Segmental therapy: Chronic tonsillitis, inflamed angina.
b) Search for interference fields: As a test injection in the anamnesis there are complaints of
repeated and frequent angina, scarlet fever, diphtheria and tonsillotomy.

INSTRUMENTAL: Cannula 8 cm long by 8 mm.

MATERIAL: 0.6 cc of procaine or lidocaine.

TECHNIQUE: The patient's head is kept fixed and the oral cavity wide open.

Page 35
Site of penetration: Above the tonsillar poles, taking the uvula as a reference one point on each
side.

Depth of penetration: Submucosa in tonsillotomy scars.

Penetration site: In the middle center of the scars.

Penetration depth: Always remain below the surface of scar tissue.

CAUTION: VACUUM BEFORE INJECTION. Due to the number of vessels that lead to the brain.

INJECTION INTO THE PHARYNGEAL TONSILLA AND THE PYPOPHYSIS OF THE ROOF OF THE
PALATE

INDICATION: Ganglion inflammation, lymphadenopathy, smell and taste disorders, bronchial

asthma, trigeminal neuralgia, rheumatism

INSTRUMENTAL: 8 cm x 0.8 mm cannula.

MATERIAL: 0.5 to 1 cc of procaine or lidocaine.

TECHNIQUE: According to Leger, it penetrates above the uvula into the limit or pit that remains
between the palate.

Page 36
We achieve the pituitary of the roof of the palate when we bend the tip of the cannula in such a
way that we penetrate cranially, reaching the anterior wall of the sphenoid sinus.
Upon establishing bone contact, the cannula is withdrawn 1 mm and after precathelative
aspiration, the neural medication is injected.

TEST OR TEST INJECTION OF THE TEETH

INDICATION:
a) Segmental therapy: in all inflammatory processes of the oral cavity. Alveolitis, post-extraction
pain, paradontopathy, delayed sensation of scars, etc.
b) Search for interference fields: In the dental area they can be: cavities, displaced apical remains,
dental pockets, extraction scars, apical resection scars or maxillary sinus operations scars, cysts,
paratodontosis, gingivitis and stomatitis.

INSTRUMENTAL: Inject dental cartridges or capsules.

Page 37
MATERIAL: 0.2 cc of procaine or lidocaine.

TECHNIQUE: On each apex to be tested, 0.2 to 0.3 cc of procaine or lidocaine is injected lingually
and buccally.

CHEST-BACK-ABDOMEN-PELVIS
INJECTION INTO THE INTERCOSTAL NERVES

INDICATION: Intercostal neuralgia, herpes zoster, for pain in rib fractures.

INSTRUMENTAL: Cannula No. 12.

MATERIAL: 2From 0.5 to 1 cc of procaine or lidocaine.

TECHNIQUE:

Page 38
Site of penetration: Depending on the location of the pains; in the posterior part towards the
middle of the intercostal space in the anterior part along the lower edge of the rib.

Direction of penetration: Until it touches the nerve.

Penetration depth: 0.5 to 1 cm, if the cannula is well placed there will be a painful reaction on the
part of the patient.

EPIDURAL ANESTHESIA

INDICATION: In all diseases of the innervation area of the sacral plexus; labor pain, menstruation
pain.

INSTRUMENTAL: 6 cm x 1 mm cannula.

MATERIAL: 0.5 cc of procaine or lidocaine, in obstetrics 20 cc.

Page 39
TECHNIQUE: The patient bends forward at a right angle supported on a high stretcher.

Site of penetration: 2 cm above the beginning of the gluteal groove, the bony protuberances of
the sacral horns are palpated and the membrane that closes the sacral opening is found between
them.
Depending on the adipose tissue, you should look for the entrance 4 or 5 cm above the tip of the
coccyx.

Direction of penetration: The cannula is produced by the semiperpendicular membrane (upwards)

then the syringe is tilted downwards.

Depth of penetration: Once in the canal, continue cranially for 4 to 6 cm. The dural sac ends 6 to 9
cm above the entry point.

INJECTION INTO THE POSTERIOR FORAMENS OF THE SACRULE

INDICATION: Sciatica, unilateral sacral pain, prostate and rectal conditions, lumbosciatic pain in
prostate carcinoma.

INSTRUMENTAL: 6 cm long cannula.

Page 40
MATERIAL: 2 to 5 cc of procaine or lidocaine.

TECHNIQUE:
Site of penetration: with the patient standing or lying face down, the union of both iliac crests or
bicrestal line is sought or it passes through the spinous process of the 4th lumbar vertebra. Two
spinous processes in the caudal direction are the 1st sacral vertebra. A space lateral to its lower
edge is the foramen.

Penetration depth: The cannula is inserted 1 to 2 cm.

CAUTION: VACUUM BEFORE INJECTION. Be careful with cerebrospinal fluid. Injections in the other
foramina are performed in an analogous manner.

INJECTION INTO THE ABDOMINAL SYMPATHETIC TRUNK ACCORDING TO WISCHNEWSKI

INDICATION:
a) Segmental therapy: diseases of the upper abdomen in the stomach, intestine, liver, gallbladder,
pancreas, kidney.

Page 41
b) Search for interference fields: as a trial injection or test when, after abdominal diseases, the
presence of an interfering field can be suspected.

INSTRUMENTAL: Cannula 12 cm long and 1 mm caliber.

MATERIAL: 2 to 5 cc of procaine or lidocaine.

TECHNIQUE:
Penetration site: The patient, bent slightly forward, rests on a stretcher or the top of an
examination table. Once the lower edge of the last palpable rib is located, follow it medially until
about 3 fingers along the line of the spinous processes, you can palate the edge of the muscle,
where the entry site is found. The patient is instructed to exhale extremely and not take in air so
that the lung limit is drawn upward.
Depth of penetration: From 8 to 10 cm deep, the resistance of muscles and facies is crossed. One
more centimeter brings you closer to the sympathetic trunk.

CAUTION: VACUUM before injection.

INJECTION INTO THE EPIGASTRIC FOSSA

INDICATION: All diseases of the upper abdomen. Gastritis, almost always in combination with
injection into the abdominal sympathetic trunk.

Page 42
INSTRUMENTAL: Cannula no. 12.

MATERIAL: 2 cc of procaine or lidocaine.

TECHNIQUE: With the patient lying down.

Site of penetration: In the midline 3 finger widths below the xiphoid process.

Penetration depth: Depending on the preperitoneal adipose tissue from 3 to 5 cm.

INJECTION IN THE VOGLER POINTS

INDICATION: Diseases of the stomach and gallbladder.

Page 43
INSTRUMENTAL: Cannula no. 12.

MATERIAL: 2 cc of procaine or lidocaine.

TECHNIQUE:

Site of penetration: On the periosteum of the costal arch, the painful point is palpated almost at
the mammillary line.

Direction and depth of penetration: Perpendicular to the skin to the periosteum.

INJECTION INTO THE LUMBAR SYMPATHETIC TRUNK

Page 44
INDICATION : Problems in the irrigation of the lower extremities, burns, cold injuries, cruris ulcer,
thrombosis, pain, Sudek's dystrophy, traumatic osteoporosis.

INSTRUMENTAL : Cannula 12 cm long and 1 mm caliber.

MATERIAL : 2 to 5 cc of procaine and lidocaine.

TECHNIQUE :

Site of penetration: the line of union of both iliac crests passes through the spinous process of the
4th lumbar vertebra. From here the indicated height level is selected, with the patient standing or
lying down, it is penetrated at 3 cun next to the spinous process of the 3rd lumbar vertebra.

Direction of penetration: 60 degrees towards the midline.

Depth of penetration: after approximately 3 cm the transverse process is touched, avoiding it, the
needle is raised upwards and outwards. Approximately 7 cm you reach the surface or lateral face
of the vertebral body, retreating slightly and continuing at the most open angle until you lose bone
contact.

CAUTION : before injection VACUUM!

INJECTION IN THE AREA OF THE ROOT OF THE SCIATIC NERVE L-3 L-5

Page 45
INDICATION : Sciatica, lumbar disc injuries, neuralgia, circulatory problems, paresthesias of the
lower extremities.

INSTRUMENTAL : Cannula 10 to 12 cm x 1 mm

MATERIAL : 2 to 5 cc of procaine or lidocaine.

TECHNIQUE : The patient must lean on a stretcher or examination table.

Site of penetration: palpating the edge of the iliac crest towards the vertebral column until
reaching the site where the iliac crest itself, transverse of the 5th lumbar vertebra and the body of
the 1st sacral vertebra form a palpable notch or fossa.

Direction of penetration: perpendicular to the skin.

Depth of penetration: at 5 or 8 cm the sciatic reflex is triggered.

INJECTION INTO THE SACRAL PLEXUS AND ITS NEAR

Page 46
INDICATION : diseases in the area of its innervation.

1.- Pudendal plexus with Pudendal nerve.

2.-Inferior crunio nerves.
3.-Posterior femoral cutaneous nerve.
4.-Sciatic nerve.
5.-S-1 S-4
6.-Lumbosacral trunk L-4 L-5

INSTRUMENTAL : Cannula 12 to 15 cm long x 1mm

MATERIAL : 5 cc of procaine or lidocaine.

TECHNIQUE :
Penetration site: at the crossing point of the two auxiliary lines.
1st. A horizontal line running from the upper gluteal groove to the upper edge of the greater
trochanter.
2nd. A perpendicular line descending from the posterior iliac spine to the outer edge of the
tuberosity of the sciatic bone.

Direction of penetration: Perpendicular to the skin.

Depth of penetration: until touching bone; The nerve lamina is approximately 3.5 cm wide and
must be infiltrated by penetrating upwards and outwards. The correct location of the cannula is
confirmed by the patient with paresthesias.

From the inside out: testicle, penis, perineum, thigh, buttocks, calf and foot.

PRESACRAL INFILTRATION ACCORDING TO PENDL .

Page 47
INDICATION : diseases of the sigmoid rectum, sphincter, perineum, urethra, bladder, anal and
vulvar itching. Prostate diseases, gynecological diseases, sciatica, circulatory problems, diseases of
the upper extremity.

INSTRUMENTAL : cannula no. 12 (from 12 to 15 cm x 1mm).

MATERIAL : 5 cc of procaine or lidocaine.

TECHNIQUE : the patient bends the trunk forward at a right angle and rests on the stretcher or
examination table.

Site of penetration: one cun lateral and below the tip of the coccyx.

Direction of penetration: next to the coccyx towards cranial along the ventral and anterior surface
of the sacral bone.

Depth of penetration: the upper sacral foramen is 10 or 12 cm, the next 8 or 9 cm from the site of
penetration.
Loose bone contact is proceeded.

CAUTION : Do not pierce the RECTUM!

INJECTION INTO THE SACROILIAC JOINT .

Page 48
INDICATION : sacral pain, lumbago, sciatica.

INSTRUMENTAL : cannula 6 to 8 cm long.

MATERIAL : 2 to 4 cc of procaine or lidocaine.

TECHNIQUE : The patient stands and leans forward on the stretcher.

Direction of penetration: at an angle of 45 degrees towards the skin in a lateral direction.

Penetration depth: approximately 3 to 5 cm.

INJECTION INTO THE FRANKENHÄUSER GANGLIA (UTEROVAGINAL PLEXUS)

Page 49
INDICATION:
a) Segmental therapy: dysmenorrhea, flow, problems and discomfort in endo-cohabitation and
parametritis, abnormalities in menstruation, pelvic floor neuritis, undefined discomfort of the
lower abdomen, frigidity, sterility, problems related to the menstrual cycle such as headache,
migraine, vegetative pelvipathy.
b) Search for interfering field: as a test when the anamnesis includes discharges, abortions,
difficult births, degradation, adnexitis, venereal diseases and operations on the genital tract.

CONTRAINDICATION : menstruation; During those days, the suprapubic technique is

recommended.

INSTRUMENTAL : 12 cm x 8 mm cannula.

MATERIAL : 2 to 4 cc of procaine or lidocaine.

TECHNIQUE : the patient must empty the bladder before the injection, then she is placed
comfortably with her legs properly supported on a gynecological chair. A mirror is used to search
for and locate the cervix.

Site of penetration: next to the “portio uterina” through the double mucosa of the lateral arch of
the vagina, approximately between 3 and 4 hours (left side of the patient); and at 8 and 9 o'clock
(on the right side).

Direction of penetration: somewhat oblique towards lateral and dorsal.

Penetration depth: 1 to 2 cm.

CAUTION : do not exceed the indicated depth! And if it does not enter parallel to the cervix, it
would be possible to puncture the ureter or uterine artery.

INJECTION IN THE GYNECOLOGICAL FIELD

Page 50
INDICATION:
a) Segmental therapy: dysmenorrhea, menorrhagia, metrorrhagia, leukorrhea, pelvic pain and
sacral pain, diseases related to the menstrual cycle, sterility, frigidity.
b).- Search for interference field: as a test or test injection when genital diseases are recorded in
the clinical history.

INSTRUMENTAL: Cannula 6 to 8 cm long.

MATERIAL : 2 cc of procaine or lidocaine on each side.

TECHNIQUE : the patient lies on her back, having previously emptied her bladder.

Site of penetration: 4 cun lateral to the symphysis corresponding to 2 cun medial to the palpable
femoral artery in the area bordering the pubic hair. With 2 fingers of the free hand we look for the
upper edge of the pubic bone.

Direction of penetration: perpendicular between the fingers towards the bone, (29 acupuncture
stomach); The needle is withdrawn a little and then passing it along the edge of the bone,
continuing towards the middle caudal (direction projected towards the anus).

Penetration depth: 4 to 6 cm.

LOCATION : the pubic symphysis, an imaginary midline is drawn 2 cun lateral where the pubic hair
begins.

PUDENNAL NERVE INJECTION

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INDICATION : Pudendal neuralgia, anal and vulvar pruritus, diseases of the scrotum, penis, vulva
and perineum. In obstetrics to combat pain during the various phases of childbirth, for episiotomy
and suturing of the perineum.

INSTRUMENTAL : 12 cm x 1 mm cannula, or cannula with launcher.

MATERIAL : 5 to 10 cc of procaine or lidocaine.

TECHNIQUE :
a).- The patient placed forward.
Site of penetration: 3 to 4 cun below the site of entry to the sacral plexus.

Direction and depth of penetration: the cannula is advanced in the direction of the symphysis until
paresthesia occurs in the genital region.

b).- perineal route: the patient sits on a gynecological chair; From the vagina or rectum the ischial
spine is palpated and located.

Penetration site: next to the vagina or rectum.

Direction and depth of penetration: under the control of the finger that we have placed in the
rectum or the fingers inserted into the vagina, the needle is directed to the ischiadic spine.

c) Transvaginal technique: the patient is positioned as for the technique.

d) for this technique a cannula with a launcher (Wölm) is required. Under this control of the gloved
hand the thrower is directed directly at the spine.

INJECTION INTO THE XIPHOOD .

Page 52
INDICATION : Stomach discomfort, as a complement to the sympathetic trunk and the injection of
the epigastric fossa.

INSTRUMENTAL : Cannula no. 12.

MATERIAL : 1 cc of procaine lidocaine.

TECHNIQUE:
Site of penetration: immediately below the tip of the xiphoid.

Direction of penetration: perpendicular to the skin.

Penetration depth: depending on the adipose tissue up to 1 cm deep.

INJECTION INTO THE PROSTATE .

Page 53
NOTE :
a).- Segmental therapy: acute and chronic prostatitis, prostatic hypertrophy, urination problems
and impotence.
b).- foreign prostatitis, nonspecific urethritis, nocturia.

INSTRUMENTAL : 8 cm long cannula.

MATERIAL : 1 cc of procaine or lidocaine.

TECHNIQUE : the patient is placed on a gynecological examination chair; he himself holds his
scrotum up; The gloved index finger of the free hand palpates the prostate through the rectum.

Penetration site: almost 1 cm. Next to the midline.

Direction of penetration: under the control of the finger that is in the rectum, the cannula is
introduced to the prostate.

CAUTION : Be careful NOT to pierce the RECTUM!

Warn the patient that urine and ejaculate may be bloody after injection into the prostate.

LIMBS – ARM – LEG

INJECTION INTO THE PERI AND INTRA-ARTERIAL BRACHIAL ARTERY.

Page 54
INDICATION : Circulatory problems, sudek dystrophy of the upper extremity.

INSTRUMENTAL : Cannula No. 12.

MATERIAL : 1 cc of procaine or lidocaine.

TECHNIQUE :

Penetration site:

a) the artery is located by palpation above the elbow and punctured there.

b) In the armpit, palpation of the artery is easy; the artery emerges from below the pectoralis
major muscle and runs through the median groove of the biceps.

INJECTION INTO THE SUBCLAVIAN, PERIARTERIAL ARTERY.

INDICATION : circulatory problems, abscesses, paresthesias, burns of the upper extremity.

Page 55
INSTRUMENTAL : 4 cm cannula. Length.

MATERIAL : 1 cc of procaine or lidocaine.

TECHNIQUE :

Penetration site: 1 cm. Below the middle of the clavicle you can feel the pulsation of the artery.

CAUTION : do not penetrate more than 1.5 cm. Deep, due to the proximity of the pleural dome.

INJECTION IN THE ELBOW JOINT .

INDICATION : all diseases in the joint area.

INSTRUMENTAL : cannula no. 12

Page 56
MATERIAL : 1 cc of procaine or lidocaine.

TECHNIQUE : the patient places his arm on a table in such a way that the arm and forearm form a
right angle.

Site of penetration: halfway between the olecranon and the lateral epicondyle.

Direction of penetration: as if pointing towards the center of the joint, ventral side.

Penetration depth: 1 to 2 cm.

INJECTION INTO THE JOINT OF THE HAND.

INDICATION : osteoarthritis, arthritis, post-traumatic joint discomfort.

INSTRUMENTAL : Cannula No. 12

Page 57
MATERIAL : 1 cc of procaine or lidocaine.

TECHNIQUE :
Site of penetration: at the midpoint between the distal end of the ulnar bone and the ulnar styloid
process.

Direction of penetration: perpendicular to the skin.

Penetration depth: 0.5 to 1 mm.

INJECTION IN THE SHOULDER JOINT .

INDICATION : deforming osteoarthritis, humerus-scapularis periarthritis, bursitis, post-traumatic

state of the shoulder.

MATERIAL : 1cc of procaine or lidocaine.

Page 58
TECHNIQUE :
Site of penetration: with the arm dropped and turned outward, it can be palpated towards the
medial part of the head of the humerus in the joint space.
Entry below the clavicle.

Direction of penetration: below the acromion outwards.

Depth of penetration: once the cannula passes through the resistance of the band apparatus, it
gently slides over the joint.

MEDIAN NERVE INJECTION

INDICATION : hand diseases in the area of innervation of the median nerve, in carpal tunnel
syndrome.

INSTRUMENTAL : cannula no. 12

Page 59
TECHNIQUE :
a) in the elbow we find the nerve on the ulnar side of the palpable brachial artery.

b) site of penetration: About 3 cun above the groove of the hand joint, we find the nerve on the
radial side of the facia of the palmar muscle, when we flex the hand dorsally.

Direction of penetration: perpendicular to the skin.

Depth of penetration: until the patient reports paresthesia in the area of innervation of the
median nerve.

INJECTION INTO THE RADIAL NERVE.

INDICATION : hand diseases in the area of innervation of the radial nerve.

INSTRUMENTAL : cannula no. 12

MATERIAL : 1 to 2 cc of procaine or lidocaine.

Page 60
TECHNIQUE :
a).- in the elbow area we find the radial nerve.

Site of penetration: 4 cun above the lateral epicondyle.

Direction of penetration perpendicular to the skin.

Depth of penetration: if the cannula is in the correct place, the patient reports electrifying pains in
the thumb and the back of the hand.

b).- in the area of the hand joint the nerve is located about 3 cun above the groove of the wrist
joint.

Site of penetration: through the radial finger of the radial artery.

C).- radial nerve, we can reach it in the snuff box in the dorso-radial area of the hand.

Direction of penetration: perpendicular to the skin.

Penetration depth: Subcutaneous.

INJECTION INTO THE ULNAR NERVE

INDICATION: diseases of the hand in the area of its alveolar innervation, for example vasospastic
pain.

INSTRUMENTAL: cannula No. 12

Page 61
MATERIAL: 2 cc of procaine or lidocaine

TECHNIQUE:
a) site of penetration: between the middle epicondyle of the humerus and the olecranon, the
ulnar groove is palpated.
Penetration direction: perpendicular to the skin

Depth of penetration: 1-2 cm depending on the complexion, the nerve is located before its
bifurcation into the alveolar and dorsal branches.

b) about 3 finger widths above the wrist joint between the ulnar artery and the fascia of the flexor
carpiulnaris thigh, which is towards the ulnar side of the artery, we find the alveolar branch of the
ulnar nerve.

OBERST ANESTHESIA FOR FINGERS AND TOES

INDICATION: joint and other diseases of fingers and toes, whitlows.

INSTRUMENTAL: cannula No. 2

MATERIAL: 2 cc of procaine or lidocaine

Page 62
TECHNIQUE:
Penetration site: on both lateral edges of the base of the fingers

Direction of penetration: 1 cc of procaine or lidocaine is placed on the flexor side and also on the
extensor side.
The procedure for the feet is completely analogous.

INJECTION IN THE BRACHIAL PLEXUS C-5=TH-1

INDICATION: neuralgia of the plexus, brachialis, paresthesias in the arm, circulation problems,
sudeck, frostbite and burns, for the replacement maneuver of shoulder dislocations

INSTRUMENTAL: 4 cm long cannula

Page 63
MATERIAL: 2 cc of procaine or lidocaine

TECHNIQUE:
a) supraclavicular anesthesia of the brachial plexus
The nape of the neck is fixed while sitting, the head is turned towards the opposite side of the
injection and tilted slightly forward, warning the patient of possible paresthesia so that he can
control defensive movements.

Penetration site: 1 cm above the middle of the clavicle, immediately lateral to the pulsating
subclavian artery.

Direction of penetration: as if pointing towards the spinous process of the 3rd dorsal vertebra.

Depth of penetration: 1 cm from reaching the plexus, on the first rib, the correct location of the
needle is made known by the patient himself through paresthesias in the corresponding
innervation area

CAUTION: be careful with the pleura!

Anesthesia of the brachial plexus through the axillary route: The brachial artery is palpated in the
arm in the same cavity or axillary fossa, where the pulse tends to disappear. This site is entered
with the cannula in depth until the patient experiences paresthesia in the area of innervation.

INJECTION INTO THE FEMORAL, PERI AND INTRA-ARTERIAL ARTERY

INDICATION: leg irrigation problems of all types and kinds including obstructive arterial diseases
and cruris ulcer, phlebitis, post-thrombotic status, angiospastic dysphasia.

INSTRUMENTAL: cannula No. 12

Page 64
MATERIAL: 2-3 cc of procaine or lidocaine

TECHNIQUE:
site of penetration: below the inguinal band in the fossa ovalis, the femoral artery is palpated, the
vein is medial and the nerve is lateral.

a) The artery with good palpation is located between the index finger and the middle finger, where
it is punctured.

b) in fatty patients, the artery can be found better when you look for its trajectory with the index
and middle fingers and then enter between the two with the cannula in a perpendicular direction.
As soon as the syringe penetrates the pulsating arterial blood, 2 c of procaine or lidocaine is
rapidly injected. After the injection it is good to compress the penetration site for a few minutes.

INJECTION INTO THE POSTERIOR TIBIAL ARTERY, PERI AND INTRA-ARTERIAL

INDICATION: circulatory problems. Chinese acupuncture recommends the injection for the
treatment of hip and knee joint diseases of the urogenital system and in menstrual conditions.

INSTRUMENTAL: cannula No. 12

MATERIAL: 1 cc of procaine or lidocaine

Page 65
TECHNIQUE:
Penetration site: below the calf and on the inner surface of the tibia. When the needle is correctly
positioned the patient reports a dull pain.

INJECTION INTO THE HIP JOINT

INDICATION: coxarthrosis, arthritis, ankylosed joint pain.

INSTRUMENTAL: 8-10 cm long cannula

MATERIAL: 2-3 cc of procaine or lidocaine

TECHNIQUE:

Page 66
a) according to Kibler: with the patient lying on his side above the greater trochanter, entering
above its superior border.

Direction of penetration: until contact with bone

b) injection from the front: with the patient lying on his back

Site of penetration: 2 cun lateral to the pulsating femoral artery, on the auxiliary line that goes
from the greater trochanter to the superior border of the symphysis.

Direction of penetration: until contact with the bone

INJECTION INTO THE KNEE JOINT

INDICATION: osteoarthritis, arthritis, post-traumatic discomfort in the knee area

INSTRUMENTAL: 4 cm long cannula

MATERIAL: 2 cc of procaine or lidocaine

TECHNIQUE: the patient lies on his back and flexes the knee a little

Page 67
Site of penetration: along the medial or lateral edge of the lower third of the patella

Penetration direction: 1-2 cm

INJECTION INTO THE FOOT JOINT

INDICATION: osteoarthritis, arthritis, sports accidents, etc.

INSTRUMENTAL: cannula No. 12

MATERIAL: 1-2 cc of procaine or lidocaine

TECHNIQUE:

Page 68
a) dorsally: on the fibular surface in the upper joint of the foot

Site of penetration: approximately posterior to the ventral malleolus

Penetration depth: 1cm

b) ventrally: site of penetration: approximately on an auxiliary line that joins both malleoli, medial
to the fascia of the extensor longus muscle.

Penetration direction: slightly inward and downward

Penetration depth: about 1cm

INJECTION INTO THE JOINTS OF THE FINGERS AND TOES

INDICATION: all painful diseases of the joints of the fingers of the hands

INSTRUMENTAL: cannula = dental carpula injector with short needle

MATERIAL: 0.5 cc of procaine or lidocaine

TECHNIQUE:

Page 69
Penetration site: you must hold the finger in question with your free hand, since the injection into
these joints is very painful.
The slightly flexed joint is punctured dorsally, rarely laterally. It is entered dorsally immediately
next to the extensor fascia.

Direction of penetration: the tip of the cannula forward and down on the joint head.

INJECTION INTO THE CUTANEUS FEMORIS LATERAIS NERVE

INDICATION: diseases of the peri- and intraneural femoral nerve

INSTRUMENTAL: cannula No. 12

MATERIAL: 2-5 cc of procaine or lidocaine

TECHNIQUE:
Penetration site: 1-2.5 cm medial and caudal to the anterior superior iliac spine

Page 70
Direction of penetration: infiltrating in the direction of the spine until bone contact and triggering
of pain in the area of innervation.

INJECTION INTO THE PERI AND INTRANEURAL FEMORAL NERVE

INDICATION: diseases in the area of innervation, neuralgia, vascular diseases, circulatory

problems.

INSTRUMENTAL: cannula No. 12

MATERIAL: 2-5 cc of procaine or lidocaine

TECHNIQUE:

Page 71
Site of penetration: below the inguinal canal or band approximately 1 or 2 cm lateral to the
femoral artery.

Penetration direction: perpendicular to the skin

Depth of penetration: if the needle was correctly placed, the patient will experience paresthesia
on the anterior surface of the thigh.

INJECTION INTO THE FIBULAR NERVE

INDICATION: post-sciaticoid pain in the leg, circulatory problems.

INSTRUMENTAL: cannula No. 12

MATERIAL: 2-5 cc of procaine or lidocaine

TECHNIQUE:
Site of penetration: The easiest way to find the nerve immediately below the fibular head.

Page 72
Penetration direction: perpendicular to the skin

Depth of penetration: infiltrating deep until the patient announces painful reactions.

INJECTION INTO THE OBTURATOR NERVE

INDICATION: adductor spasms, grancilis syndrome, hip and knee osteoarthritis.

INSTRUMENTAL: 8 cm long cannula

MATERIAL: 5 cc of procaine or lidocaine

TECHNIQUE:

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Site of penetration: the patient lies on his back, separates the muscle outwards, somewhat lateral
to the symphysis, the tuberculum pubicum of the pubic bone is palpated. One thumb caudal from
there is the entry site.

Direction of penetration: first perpendicular to the skin until contact is made with the horizontal
branch of the pubic bone.

Depth of penetration: the cannula is withdrawn a little and introduced in a caudal lateral direction
along the edge of the branch of the pubic bone, reaching along the foramen obturatum.
Paresthesia in the area of innervation shows the correct location of the needle.

INJECTION INTO THE TIBIAL NERVE

INDICATION: paresthesias, pain, circulatory problems, pruritus, eczema, consequences of wounds

and trauma in the area of innervation

INSTRUMENTAL: cannula No. 12

MATERIAL: 1-5 cc of procaine or lidocaine

TECHNIQUE: with the patient lying face down

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Site of penetration: at the level of the cranial part of the internal malleolus, the posterior tibial
artery is palpated next to the Achilles tendon.

Direction of penetration: through a papule, it is penetrated perpendicular to the skin in such a way
that the tip of the cannula is correct, the patient will report painful reactions.

INJECTION INTO THE GREATER TROCHANER

INDICATION: senile malum coxae, coxitis, spondylitis, bechterew

INSTRUMENTAL: cannula No. 12

MATERIAL: 2 cc of procaine or lidocaine

TECHNIQUE: with the patient lying or standing the trochanter is easy to see and palpate

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Penetration direction: perpendicular to the skin

Penetration depth: up to touching periosteum

PAPULES IN THE AREA OF THE KNEE JOINT

INITATION: osteoarthritis and arthritis of the knee joint, post-traumatic discomfort.

INSTRUMENTAL: cannula No. 20

MATERIAL : 0.5 cc of procaine or lidocaine for each papule

TECHNIQUE:
Site of penetration: external surface, a papule at the level of the joint space.

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Internal surface: one papule on the head of the tibia, on the joint space and on the head of the
femur in a triangle and one on the popliteal fossa.

THERAPY WITH PAPULES

INDICATION: intracutaneous papule is a very frequently used injection in neural therapy. This only
makes sense when it is carried out on altered tissue which can be found by patient data, by
inspection and by palpation. The mechanism of action works through cutivisceral reflex pathways.
Any application of papules that is not carried out with a selective criterion will have nothing to do
with neural therapy.

INSTRUMENTAL: cannula No. 20

MATERIAL: 2-4 cc of procaine or lidocaine

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TECHNIQUE: the papule must be placed strictly intracutaneously
For children and fearful patients, the “dermo jet” has been very helpful. With this device, papules
are placed on the skin at ultrasonic speeds.

INTRAMUSCULAR INFILTRATION

INDICATION: myalgia, gel pain, tense areas such as pimples, cervical syndrome, muscle
contractions, muscle tears, bruises or blows, all reflex muscle signs.

INSTRUMENTAL: cannula depending on the depth at which the injecting, infiltrating and
disinterfering process is carried out.

MATERIAL: according to the size of the tissue alteration, speaking of cubic centimeters only.

TECHNIQUE:
penetration site: placing a papule over the area that is painful or tender to palpation.

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Direction of penetration: through the papule it goes to depth, infiltrating and probing.

Depth of penetration: even in the gels and painful tissue, up to the periosteum, in the periosteum
itself, in bands and in facia insertions.

INTRAVENOUS INJECTION

INDICATION: as a basic treatment in all diseases located in the head, neck and thorax, procaine or
lidocaine acts by calming pain, dilating vessels, permeabilizing capillaries, lowering fever,
regulating circulation, anti-allergic, anti-inflammatory, diuretic. The same injection applied into a
vein has an effect similar to sparteine and perinidine on the heart.
Experimentally produced circulatory collapse (bezold-jarish reflex) can be suppressed or controlled
with procaine or lidocaine as well as anaphylactic shock and necrosis formation in the
schwartzman-sanarelli phenomenon.

INSTRUMENTAL: cannula No. 12

METERIAL: 1 cc of procaine or lidocaine! NEVER MORE

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TECHNIQUE: in the usual way, before removing the cannula, half a cubic centimeter is left in the
paravenous area.

INJECTION IN SCARS

INDICATION:
A) segmental therapy: all scars in the diseased segment have to be properly injected. In all
discomforts caused or coming from scars, in keloid scars and in postoperative problems.
B) search for the interference field: scars of all types and kinds, size and age, can be an
interference field.

INSTRUMENTAL: cannula No. 12

MATERIAL: quantity according to scar size

TECHNIQUE: as superficial as possible in the scar so that the skin is raised and the papules
converge. In long scars, papules 1 or 2 cm apart. In deep scars inject deep.

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