Acupuncture Services of Central NY

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.

Once Western medicine rules out a physical problem, treatment options consist of counseling, motivational therapy, behavioral therapy such as using alarm devices to wake the child, and drug therapy. Several medications are available to attempt to increase bladder capacity or to reduce the amount of urine produced by the body. None of the medications are a cure for enuresis and most of these medications have potential major side effects. Most doctors will not prescribe medications for children until the age of seven. Unfortunately, the social stigma that we associate with bed-wetting may have already had a huge negative impact on the self-esteem of these children.

Traditional Chinese Medicine (TCM), views enuresis as a disorder of water metabolism. In TCM, the three organs that control water metabolism are the Lungs, the Spleen and the Kidneys. Enuresis is usually explained in TCM as a deficiency of the energy of one or more of these organs. The Heart and the Liver may also play a part. Mr. Helmer does a good job of explaining pattern differentiation that would be easily understood by trained acupuncturists.

The majority of Mr. Helmer’s book is devoted to documenting scores of research protocols that have been conducted in China. He provides dozens of case histories. He also provides a sample in-take form that would be helpful to conclude the TCM pattern differentiation.

The good news is that the majority of these protocols have very high success rates in curing or improving enuresis. Many TCM treatment modalities have proven to be effective. Body acupuncture, auricular acupuncture or acupressure, moxibustion, tuina (TCM massage), internally administered herbal medicine or externally applied herbal medicine, magnetotherapy and cupping have all proven to be effective either alone or in combination.

The study that most impressed me, consisted of applying an herbal paste of scallions and sulfur to the navel area at night-time. All 132 patients in the study were completely cured in 2-4 days and there was no reoccurrence of enuresis two years later. Simple, non-invasive, and effective. How wonderful for these children!

Like most TCM research, treatment was given more frequently than is practical or affordable in this country. Usually treatment was given daily, or every other day, for a week. If necessary, the patient was given a day off, and then the course was repeated. But many of the techniques could easily be taught to parents by compassionate practitioners of TCM. Auricular acupressure, moxibustion and tuina could easily be administered by trained parents and could be the answer for many of these children.

Hats off to Mr. Helmer for providing a host of TCM options to treat enuresis!

About the Author:
Joyce Marley is a licensed acupuncturist that provides acupuncture therapy in New Hartford, NY. She writes alternative health articles about acupuncture and Oriental medicine.

Posted by Joyce Marley at 02:16 PM | Treating Pediatric Bed-Wetting with Acupuncture & Chinese Medicine

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.

I found an article in the 1996 September issue of the Journal of Chinese Medicine entitled “The Clinical Effectiveness of Bloodletting Therapy in the Treatment of Herpes Zoster”. The article discussed a study involving 38 patients suffering an acute case of shingles. Each patient had a few drops of blood taken out of the tip of the ear on the affected side of the body. If the herpes was above the waist, a few drops of blood were taken out of the acupuncture point LU-11 near the thumb fingernail. If the herpes was below the waist, a few drops were taken out of SP-1 near the toenail of the big toe. Additionally, the top of the leading herpes blister and the red streaks around it were pricked and cups were placed over the area to encourage bleeding from the local area. All 38 cases in this study were cured (the lesions faded and there was no pain) after one to three daily treatments.

In the May 1994 issue of the Journal of Chinese Medicine, another article entitled “Treatment by Acupuncture – Herpes Zoster”, the author talks about some empirical points that can be alternatively bled to treat shingles. One of the points is called Longyan (Dragon’s Eyes) and is located on the ulnar side of the little finger. Another set of points is called Sheyan (Snake’s Eyes) and they are located on the thumb. In ancient China this disease was likened to a creeping snake because the eruption of blisters creeped along the body in a line. The first patches of lesions to appear were called the head of the snake and the last were called the tail of the snake. So it is logical that the points to treat this disease would be named after a snake!

Bleeding one or two of these points can be combined with each acupuncture treatment in the acute phase of the disease. Of course, bleeding therapy would be contraindicated for any patient taking a blood thinning medication such as Coumadin. And bleeding should be done sparingly, if at all, on people with extremely weak constitutions.

About the Author:
Joyce Marley is a licensed acupuncturist with a practice in New Hartford, NY. She writes alternative health articles about acupuncture and Chinese medicine.

Posted by Joyce Marley at 07:52 AM | Treating Herpes Zoster (Shingles) with Bloodletting Therapy

In China, acupuncture is recognized as the most effective of all therapies for the treatment of herpes zoster (shingles). Traditional Chinese Medicine (TCM) usually attributes shingles to a combination of excess and deficiency in the body. Therefore, shingles usually affects older patients whose constitutional energy is deficient or younger patients who are suffering from exhaustion. The more pronounced the weakness of the patient, the more likelihood of complications and the more prolonged the course of the disease is likely to be.

Shingles is explained in TCM by the presence of pathogenic damp, heat and wind in the body. TCM acupuncture treatment of shingles is based on pattern differentiation according to the pathogenic factor and the energy channels involved. If damp is predominant, the lesions are more likely to be in the lower part of the body with more fluid discharge from the blisters. If heat predominates, blisters show more heat and redness and the pain is more severe. If wind predominates, the lesions are more likely to be in the upper part of the body with greater itching sensation.

Location of the lesions will indicate the channels that are affected. Lesions on the flanks and intercostal areas involve the Liver and Gallbladder channels. Lesions on the head and face involve the Yangming and Shaoyang channels. Traditional acupuncture points will be selected to address both the pathogenic factor and the channels involved. For example, SP10 and LI11 are powerful points to cool the blood and treat skin problems. SP9 and SP6 are famous for treating dampness in the body.

Locally, huatuojiaji points can be needled. These are points located approximately .5 inch lateral to the midline of the spine. These points can be selected based on the dermatome location of the blisters or according to the level of the Back Shu point of the channel involved.

I prefer to use Dr. Tan’s Balance Method, which would identify the “sick” channel – the location of the pain – and select points from the channel that would balance the sick channel. For lesions that wrap around the rib cage, many channels would be affected – UB, LV, GB, and SP possibly. Often very tender points will be found on the opposite arm LU channel between LU5 and LU6. LU balances UB because hand taiyin balances leg taiyang. LU balances LV because they are next to each other on the Chinese cyclical clock. LU balances SP because both belong to the taiyin channel.

Auricular acupuncture or acupressure via the application of vaccaria seeds can be used as a treatment or to supplement the body acupuncture. Points typically used are Shenmen, Lung, thoracic spine, subcortex, endocrine and skin disorder points.

Once the blisters have healed, if pain persists, a technique called plum blossom needling can be used over the painful area. A plum blossom needle has several short, thin needles on the head of a very small lightweight disposable “hammer”. The painful area is tapped with the needled head until there is slight bleeding. Then the area is cupped to withdraw blood.

So, as you can see, there are many approaches to treating shingles with acupuncture.

About the Author:
Joyce Marley is a licensed acupuncturist that provides acupuncture therapy in New Hartford, NY. She writes alternative health articles about acupuncture and Oriental medicine.

Posted by Joyce Marley at 07:05 AM | Acupuncture Treatment of Shingles

Another TCM modality that is often used with good results in the treatment of herpes zoster (shingles) is moxibustion. Moxabustion is the burning of moxa over acupuncture points on the body to penetrate the muscles and activate blood circulation. The main ingredient in moxa is the herb Ai Ye, or wormwood leaf.

Moxa comes in many forms. A moxa stick looks like a cigar. The end is lit and the lit end is held approximately 1 inch from the skin surface. The stick can be moved in a circular motion or used in a pecking motion over the point for several minutes until the area is pink and pleasantly warm. Moxa sticks can be used over DU14, a point located below the C7 vertebra at the base of the neck, to boost the immune system. Moxa sticks can be used to warm the local area.

In the October 2000 issue of the Journal of Chinese Medicine, there is an article on the use of moxa to treat herpes zoster, “Treatment by Moxabustion, Herpes Zoster”. In ancient China, the blisters associated with shingles were likened to a creeping snake, because they often formed a line around the torso. The first patches of lesions were known as the head of the snake. The last were the tail of the snake. And the healthy areas in between were called the middle of the snake.

This article talks of treating the three patterns of herpes zoster with wheat grain sized moxa cones. In TCM, herpes zoster is differentiated into three patterns of disharmony: Liver and Gallbladder Fire blazing, Spleen and Stomach damp heat and Qi and Blood stagnation.

Liver and Gallbladder Fire manifests as red lesions and skin with burning pain and heat, dry mouth with a bitter taste, constipation, yellow urine, irritability, red tongue with a yellow coat and a wiry, rapid pulse.

Spleen and Stomach heat presents with blisters containing thick and yellowish fluid that are easily broken, poor appetite, abdominal distention, pale tongue body with a sticky white or yellow coating, and a slippery rapid pulse.

Qi and Blood stagnation is usually the pattern with post herpetic pain and presents with a purple tongue, dark color at the former site of the herpes lesions, poor sleep and a wiry, thready pulse.

In all three patterns, the treatment method is to use 5 of the small cones at each treatment point. Some oil is wiped on each point to prevent burns, and one at a time the cone is lit and left to burn until the patient feels a hot sensation. Then the cone is immediately removed and the next cone lit until all five have been applied to the point. For all three patterns, moxa is burned at the head of the snake (.5 cm outside of the first lesions to appear), the middle of the snake (clear area between lesions) and the tail of the snake (.5 cm outside the last lesions to appear).

For the Liver and Gallbladder Fire pattern, LV-2 and GB34 are added. For Spleen and Stomach Damp heat, ST-44 and SP-6 are added. And for Qi and Blood stagnation, BL-17 is added.

Treatment using points on the “snake” is likened to securing its tail, chopping off its head and cutting thru its body, so that the snake dies. I’m sure that anyone who has known the pain of shingles will appreciate the metaphor!

About the Author:

Joyce Marley is a licensed acupuncturist with a practice in New Hartford, NY. She writes alternative health articles about acupuncture and Traditional Chinese medicine.

Posted by Joyce Marley at 09:00 AM | Treating Herpes Zoster with Moxibustion

The pain associated with herpes zoster, or shingles, can be debilitating, especially in the elderly. The pain is a combination of burning, itching and stabbing and is especially severe at night. Most adults who develop herpes zoster have had chicken pox as a child. Herpes zoster is a reactivation of the same varicella-zoster virus that can lie dormant in the body after a bout of chicken pox. The virus often invades the ganglia of the spinal nerves and the blisters characteristically break out unilaterally along the dermatome associated with the affected spinal nerve(s). An outbreak of shingles often follows a time of emotional stress and can attack the body when the immune system is compromised.

Western medicine does not have an effective means of treating shingles other than the dosing of pain medications, which may become addictive or have serious side effects. But many techniques are employed in Traditional Chinese Medicine (TCM) to effectively reduce the severity and duration of this disease.

In the September 1994 issue of the Journal of Chinese Medicine, there is an article that discusses the technique called “surround the dragon”. It involves placing fine acupuncture needles around the lesions without regard to traditional acupuncture points. Needles are inserted at 2cm intervals subcutaneously at a 25 degree angle to the skin around the rash. The needles are left in place for 30 minutes. No deqi, or energy sensation is obtained. It is relatively painless for the patient. The number of needles depends entirely on the extensiveness of the rash.

This article discusses a study that was conducted using this technique. Fifty patients between the age of 20 and 91 (with an average age of 64.9) participated in the study. A requirement of the study was that the patient had to be in the acute stage of the disease (less than 16 days from the outbreak of the lesions). The patients were treated daily. The study concluded that the “surround the dragon” method was highly effective to treat the acute stage of shingles, as 45 of the 50 patients (90%), declared themselves free of pain in an average of 4.6 days! This is a significantly shorter duration than the 14 to 21 days that it typically takes for the lesions to dry, scab and fall off. Without acupuncture treatment, pain is almost always present during this 2-3 week period, and often for some time after the lesions have healed.

Additionally, participants were contacted five to twelve months after their acupuncture treatments and 88% had had no pain since. Therefore, the study concluded that this treatment method also reduced the incidence of post-herpetic neuralgia dramatically.

About the Author:

Joyce Marley is a licensed acupuncturist serving the Utica-Rome, NY area. She writes alternative health articles about acupuncture and Traditional Chinese Medicine (TCM).

Posted by Joyce Marley at 04:55 PM | Treating Shingles With "Surround the Dragon" Acupuncture Technique