Sunday, May 11, 2008
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There are twelve energy pathways, or meridians, in the human body that connect to specific organs in the body. Chinese medicine believes that each organ has a two hour time period when the Qi is at its peak in that meridian. The Qi flows cyclically in a clockwise rotation like a wave through the meridians.
Up to 25% of babies at some point in a pregnancy are in a breech position, but by 34 weeks most fetuses turn into a head-down, or vertex, position on their own. This is the normal and safest fetal position for birth. Delivering a baby in a breech position involves several risks to the infant. Most obstetricians in todays world therefore will opt to perform a caesarean section if the fetus has not turned on its own.
Moxibustion, the burning of the herb mugwort over an acupuncture point, in this case Bl-67 on the little toe, has been shown to be very effective to turn the fetus. Here is an excellent video where Dr. Lorne Brown, an acupuncturist from Vancouver Canada, demonstrates the procedure. I had the pleasure of meeting Dr. Brown at a seminar in Toronto last year where Jane Lyttleton lectured on Traditional Chinese Medicine in the treatment of infertility.
I was recently asked by one of my patients whether or not I thought acupuncture treatments would benefit their sister who was told she had a bladder prolapse. Since most of my patients seek help for painful conditions, it reminded me that many people are not yet aware that Chinese medicine is also very beneficial for other types of disorders.
Yes! Unless the condition has progressed to the point of requiring immediate surgical repair, acupuncture may help prevent organ prolapse conditions from deteriorating, if not completely rectify the problem.
Here is a demonstration of Chinese medicine cupping to treat low back pain - performed by the author of “Traditional Chinese Medicine Cupping Therapy”, Ilkay Zihni Chirali. In this video, he is using cups made of glass. Glass cups are probably the most commonly used in this country because they are easy to sterilize and it is easy to see the strength of the suction when applied to the patients skin. In China, bamboo cups are very common because they are inexpensive, but they have some disadvantages. They have sharp edges, break down easily and can be a greater risk for cross-infection.
In both cases, the technique of obtaining suction is the same. A cotton ball is soaked in alcohol and lit. This is used to heat the inside of the cup which removes the oxygen and creates a vacuum. When the cup is placed on the patient, the skin is drawn up into the cup. By placing the cup over an injured area, stagnant blood and toxins are brought to the surface allowing fresh blood to nourish the injured site. Often the skin will be left with circular bruises that may last up to two weeks.
Cupping Therapy has been an integral part of Chinese medicine for thousands of years and continues to be incorporated into treatments today. This book by Ilkay Zihni Chitali is an excellent resource for the practitioner of Chinese medicine. Mr. Chitali provides details for ten different cupping methods. For each method he explains the technique itself in detail along with valuable illustrations.
Examples are given for conditions that may benefit from that particular technique. Half of the book (almost 100 pages) is devoted to specific treatment protocols for common ailments. Cupping instructions are given along with acupuncture points, moxibustion and herbal remedies. Case studies accompany each section.
Several techniques may be used with children and he specifically notes the difference in cupping duration and technique that should be applied for each age group.
There are many Master Tung points that I personally have found to be more effective than traditional meridian acupuncture points and Wu Hu (Five Tigers) is in that category. Wu Hu is a set of five acupuncture points located on the radial aspect of the proximal segment of the thumb on the border of the red and white skin. The points are numbered sequentially, one thru five, with Wu Hu 1 being the most distal point and Wu Hu 5 the most proximal.
Wu Hu 1 is selected for finger pain, palmer pain and tenosynovitis. Wu Hu 3 is selected for toe pain. Wu Hu 2 is added to strengthen the effect of Wu Hu 1 or 3. Wu Hu 4 is needled for instep or dorsal foot pain and Wu Hu 5 is very effective for heel pain (in combination with points on the heel of the palm and PC 7 on the pericardium meridian). As with most Master Tung points used to treat painful conditions, points are needled contralaterally to the pain and the patient is asked to move the affected part of the body while the needles are stimulated.
Master Tung passed away in 1975 leaving behind only one book documenting his acupuncture points. Today there are only three direct disciples of Master Tung living in the US. Dr. Wei-Chieh Young is one of them. I am extremely grateful to Dr. Young for sharing his experience with Master Tung’s points via his lectures, seminars and recently published books.
Xiaojie is a point that Dr. Young discovered based on Master Tung’s holographic imaging of the body and contralateral needling technique. This point is located at the base of the ball of the thumb and needled for an inch and a half thru the thenar eminance of the palm. This acupuncture point alone is amazingly effective for sprained or strained ankle and I have had occasion to use it several times in my clinic.
Here it is - my debut on www.youtube.com! My sister convinced me that I could make an instructional video on acupressure, so we gave it a whirl. Considering we had several takes due to one or both of us bursting out laughing, it didn't come out too bad, if I do say so myself.
I chose to demonstrate this Master Tung acupuncture point because I have used it myself and I know it is effective. As I say in the video, the translated name of the point is "Intestine Gate". Intestine Gate has a powerful effect on calming the intestinal tract. Acupressure can be used in an acute situation. Acupuncture to this point along with others based on the Chinese medical differential diagnosis can be used to treat chronic diarrhea.
This two-point unit is located on the ulnar aspect of the proximal segment of the dorsal side of the thumb. This acupuncture point is very effective to treat almost any kind of gynecological disease including irregular menses, dysmenorrhea, menorrhagia, amenorrhea, endometriosis, fallopian tube blockage, uterine pain or fibroids, frequent miscarriage and infertility.
This point is needled on one hand and often coupled with a different point on the opposite hand called Return to Nest (Nest being a reference to the uterus). The first time Fu Ke will be needled on the left and Return to Nest on the Right. The next time, Fu Ke will be needled on the right and Return to Nest on the left. Continue alternating the points with each treatment.
Last weekend I attended a NIA workshop at the Kripalu Yoga Institute in Lenox, Massachusetts. Carlos Rosas, co-founder of the technique, led our “Dancing Through Life” workshop. NIA, an acronym for Neuromuscular Integrative Action, is an amazing mind, body and spirit approach to fitness.
You may think that a website devoted to acupuncture and Traditional Chinese Medicine (TCM) is an odd place to be discussing a fitness technique, but if you consider that TCM also focuses on keeping the body in balance to maintain health by addressing the mind, body and spirit of each individual, you will see that there is a definite correlation.
I often give my patients homework to do between acupuncture treatments. This homework commonly involves acupressure. Sometimes small seeds are applied to the ear to stimulate corresponding parts of the body to relieve pain. Sometimes points are stimulated on the hand corresponding to Korean Hand acupuncture points. And sometimes pressure is applied directly to the meridian acupuncture points.
Acupressure can address acute symptoms between the acupuncture treatments which in turn focus on addressing the underlying imbalance in the body that is causing the pain, symptom or disease.
Here is a short video clip I found on YouTube demonstrating the use of acupressure to relief constipation. The narrator explains that this technique can be helpful for those incidences of constipation that many people experience while travelling.
If I had to pick one event in the last six years that had the most impact on my career as an acupuncturist, I would have to say that it was in 2003 when I listened to a taped lecture by Susan Johnson on Master Tung’s Top Ten Points.
At the time, my training in Traditional Chinese Medicine (TCM) had focused on the 365 points of the Fourteen Meridian System, a system that has been standardized in the People’s Republic of China. This is the system that is most often taught in the acupuncture schools of the U.S. It is the system upon which the national (NCCAOM) acupuncture board exam is based.
With the new year, come New Year’s resolutions, and several people have been asking me about using Chinese medicine to help them to quit smoking. Acupuncture has been used successfully to overcome addictions in this country for decades.
The National Acupuncture Detoxification Association (NADA) was formed in 1988 and promotes the use of a specific ear acupuncture protocol to help with the anxiety and stress associated with hardcore drug addiction withdrawal. This protocol has been applied to smoking cessation. Four or five points are selected on the ear and stimulated either by hand or with electrical stimulation.
There are many good books on the market for auricular acupuncture and I have several in my reference library, but there is one that is special to me – “Modern Chinese Ear Acupuncture” by Ping Chen. Dr. Chen (though she always insisted that we call her Ping) was one of my professors at the International Institute of Chinese Medicine in Albuquerque, New Mexico. She is a dedicated teacher and compassionate doctor and I am very grateful to have had her as a mentor.
Ping’s book is thorough in point location and indications with detailed diagrams and case studies. She speaks of many ways to stimulate the auricular points including seed acupressure, needle implantation, plum blossom needling, ear moxibustion, ear massage, medicated plasters, electroacupuncture, magnet therapy, medicine injection and bloodletting.
A local support group for heart and stroke patients asked me recently to give a talk about acupuncture and Chinese medicine at one of their monthly meetings. One gentleman approached me afterwards and said that he had not slept well since his heart bypass surgery, which had been about three years earlier. This did not surprise me, as the Heart in Chinese medicine is said to house the spirit and has a lot to do with the body’s ability to sleep peacefully. Since the problem was becoming really worrisome (he only slept two hours a night), and he did not want to add another medication to his long list of prescriptions, he decided he had nothing to lose by trying acupuncture treatments.
We started weekly treatments. I used points that are well known to calm the mind and nourish the heart to help sleep. For a couple of weeks, he would sleep better for a night or two only to return to the same pattern of two hours a night. After four treatments he was getting discouraged, and even though I did not expect to turn around a three year-old habit overnight, I was searching all of my materials for the best protocol for his constitution.
by Dr. Chen Decheng
I have written before about the power of a single point being able to resolve pain in the body, but here is a book from my library that documents 100 diseases that can be treated with a single point!
Many of the points that Dr. Decheng writes about are well known points either on the regular meridians or extra points that are commonly taught in acupuncture schools around the country. For example, a point on the leg on the stomach meridian (ST38) is commonly used to treat frozen shoulder. The master point of the Du meridian, which runs through the spine, (SI3) is commonly used to treat stiff neck. Moxa (an herb) is burned over the point BL67 (next to the nail on the little toe) to correct a transverse or breech fetal position. And the extra point Er Bai, on the palmer aspect of the forearm, is specifically used to treat hemorrhoids.
In March of 2006, I attended an excellent weekend seminar at Memorial Sloan-Kettering Cancer Center in NYC entitled Acupuncture for the Cancer Patient. They offer this seminar to licensed acupuncturists and other health care professionals twice a year. This seminar, sponsored by the Integrative Medicine Service, is so popular, I had been on a waiting list for a year.
The Integrative Medicine Service at Sloan-Kettering was established in 1999 and has grown exponentially. They offer many complementary therapies, including acupuncture and massage, on both an inpatient and outpatient basis. They conduct research studies on the effectiveness of acupuncture. And they offer their expertise to other health care facilities around the country on the best way to integrate this adjunctive care into the mainstream protocols.
I often tell my patients that there are many styles of acupuncture and many theories of how to select the points for a treatment. A person could go to three different acupuncturists and potentially have three completely different treatments that all could very well be effective. As a practitioner, I want to have as many tools of the trade at my disposal as possible. Some techniques may be better suited for children or needle phobic patients. Some systems may be better suited to those who are physically unable to lie on a treatment table for any length of time. Sometimes, a patient just doesn’t respond to a particular approach and it is always nice to have a plan ‘B’.
Wrist-Ankle Acupuncture (WAA) is a relatively new branch of the acupuncture field. Dr. Xinshu Zhang brought the system into being in Shanghai, China in the 1970’s. It differs considerably from meridian style acupuncture in both theory and needle technique. The best English text on the subject that I am aware of is “Wrist-Ankle Acupuncture, Methods and Applications” written by He Hon Lao, MD. It is an excellent instructional and reference resource. Enough pictures and diagrams are provided of point location and needling considerations, so that with a little practice any acupuncture practitioner could become proficient in the technique.
Treating Pediatric Bed-Wetting with Acupuncture & Chinese Medicine
By Robert Helmer
A Book Review
Bed-Wetting, or Primary Nocturnal Enuresis (PNE), is a very common pediatric problem, though one that most families do not like to discuss openly. It is estimated that as many as 20% of five year-olds, 10% of six year-olds and even 1% of 15 year-olds experience an inability to control night time urination. While there may be a medical condition that is causing the problem, and every child should be tested to rule out such conditions, only 1-3% of enuresis cases have an organic cause that is identifiable by Western medical tests.
During my training in Traditional Chinese Medicine (TCM), we were taught that acupuncture and Chinese herbal formulas were often used in China to treat herpes zoster – more commonly known as shingles. But as luck would have it, I never encountered a case in the student clinic. Two weeks ago my 78 year-old diabetic mother complained of back pain that was excruciating during the night and subsided during the day. She did not remember straining her back. Then on the third day, she noticed a cluster of blisters on her right side. She called her doctor and was told that she had shingles and that there was very little that they could do for her other than prescribe a pain medication (which has been quite ineffective to treat her pain).
I immediately dragged out all of my notes from school and rummaged through all of my reference materials. I learned that my mother is in the age group with the highest incidence of shingles and with the greatest risk of developing postherpatic neuralgia – pain that may last years after the blisters have healed! Luckily, I found many protocols in TCM that can be very effective in reducing the severity and duration of the pain.
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