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Clinical
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Clinical
Gem
by Henry McGrath, MRCHM, MBAcC |
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Hayfever
Aetiology
The branch, or manifestation, is an invasion of wind heat
or wind cold. Most sources (e.g. Giovanni Maciocia) consider
the root to be a deficiency of the Lung Wei Qi, the Kidney
Yang and the Governing Vessel. However, some sources (e.g.
Bob Flaws) consider Spleen Qi deficiency may be at the
root, especially where nasal discharge is profuse.
Treating the Branch
This is best done when the patient is actually suffering
from the hayfever.
Bi Yan Pian (“Nose
Inflammation Pills”) is an excellent choice, and
clears both wind heat and wind
cold invasions. It contains herbs which disperse
phlegm from the nose, and is said to “clear the
orifices of the face”. It helps stop coughing and
eases throat pain.
Sang Ju Yin is great for
clearing wind heat. It is very effective for the
bad coughing and very
sore throats which tend to accompany wind heat.
It also contains lu gen to moisten the throat: often this
is necessary as the wind heat dries the fluids and depletes
yin in the throat. It is also very good for
red, itchy painful eyes.
Cang Er San is good for
clearing wind cold. It
is particularly good when sneezing is a major problem.
Interestingly, one of the main ingredients, Cang Er Zi,
was said by the great herbalist Li Shi Zhen to strengthen
the Governing vessel. Use of this formula therefore
also treats the Root of the problem as well as the branch.
Treating the Root
The translation of Yu Ping
Feng San, Jade Windscreen, is self explanatory.
It strengthens the Wei Qi of the
Lungs.
If the root of the problem is Kidney
Yang deficiency, one can use Jin
Gui Shen Qi Wan in the preceding autumn or winter.
Although this formula is a Yang tonic, it also tonifies
Yin and clears empty heat. It is therefore appropriate
to use when Yin and Yang deficiency are present.
If the patient shows strong signs of heat from
Kidney Yin deficiency one could balance the formula
by taking another Yin tonic in the evening. Mai
Wei Di Huang Wan is perfect for hayfever sufferers,
because as well as strengthening the Kidney Yin, it tonifies
the Lung Yin and Qi!
If Spleen deficiency and damp/ phlegm are at the root,
one can use Liu Jun Zi Tang to
tonify the Spleen and clear damp and phlegm.
Disclaimer
No medical claims as to the effect or outcome of treatment,
using our range, are made by the manufacturer or balance
healthcare ltd. These products should only be used by
qualified practitioners and no responsibility can be taken
for self medication.
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Clinical
Gem
by Honora Lee Wolfe, Dipl. Ac., Lic. Ac., FNAAOM |
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Warm
needle technique in the treatment of symptomatic lumbar
spondylosis:
Acupuncture can course and free the flow of the channels
and network vessels. It can also regulate yin and yang
and the qi and blood of the viscera and bowels. Warm needle
technique is one of the methods of moxibustion. It refers
to burning moxibustion on the handles of acupuncture needles
once they have been inserted into the body. When warm
needle technique is combined with acupuncture, it makes
use of the power of Herba Artemisiae Argyii (Ai Ye)’s
fire and medicinal effects. It is especially able to promote
the free and easy flow of sinews and vessels which have
become congealed and stagnant, blocked and obstructed.
It promotes the dilation of the blood vessels in the affected
area, speeds blood flow, and eliminates the symptoms of
inflammation. In issue #2, 2003 of the Zhe Jiang Zhong
Yi Za Zhi (zhejiang Journal of Chinese Medicine), Pan
Liang-de and Song Yan-wen published an article comparing
the outcomes of patients with lumbar spondylosis treated
with plan acupuncture and warm needle technique. The title
of that article is “A Comparison of the Warm Needle
Treatment of 50 Cases of Lumbar Vertebral Hyperplasia
with 25 Cases Treated with Plain Acupuncture.” This
article appeared on page 70 of that journal, and a summary
is given below.
Cohort
description:
Altogether, there were 75 cases in this study, all of
whom suffered from long-term, recurrent lumbar soreness
and pain which was sometimes worse and sometimes better.
In those with light discomfort, the main symptoms were
low back stiffness and soreness which were made worse
by taxation and fatigue. In those with heavy discomfort,
there was nerve root pain and aching and pain which radiated
over the entire lumbar region. Pressure on the affected
vertebra elicited pain, and x-rays showed varying degrees
of lumbar vertebral hyperplasia. Other diseases were excluded.
Among these 75 patients, there were 28 males and 47 females
aged 38-75 years. These patients had suffered discomfort
for from seven days to 32 years. They were randomly divided
into two groups, a treatment group of 50 and a comparison
group of 25. In terms of sex, age, and disease course
and severity, there was no significant statistical difference
between these two groups.
Treatment
method:
All the patients in the treatment group received acupuncture
at Shen Shu (Bl 23), Qi Hai Shu (Bl 24), and Da Chang
Shu (Bl 25) with 60mm needles with their tips pointed
towards the lumbar vertebrae. After the needles were inserted
and stimulated with twirling supplementation and draining
hand technique, the needles were retained and a 1.5cm
long piece of moxa roll was burned on the handle of each
needle. Two such pieces of moxa roll were burned over
each point each treatment. Depending on the patient’s
signs and symptoms, other points which were added included
Yao Yang Guan (GV 3) and Wei Zhong (Bl 40). These were
perpendicularly needled with 40mm needles and moxa rolls
were burned on the handles of these needles as well. One
such treatment was given every two days, with 10 treatments
equaling one course of therapy. After a one week rest,
another course of therapy was given if necessary. The
shortest course of treatment was five treatments and the
longest was three whole courses. During this time, patients
stopped taking any other treatment or medications for
this condition. The members of the comparison group received
exactly the same treatment except that moxa was not burned
on the heads of their needles.
Treatment
outcomes:
Cure was defined as complete disappearance of clinical
signs and symptoms with return to normal work and activities
and no recurrence on follow-up after six months. Marked
effect was defined as marked decrease in clinical signs
and symptoms and basic return to normal in function. Improvement
meant that there was a decrease in clinical symptoms and
improvement in function, while no effect meant that there
was no obvious change in clinical symptoms. Based on these
criteria, 28 of the 50 patients in the treatment group
were considered cured, 12 got a marked effect, six improved,
and four got no effect. Therefore, in the treatment group,
there was a cure rate of 56% and a total effectiveness
rate of 92%. In the comparison group of 25, four were
considered cured, five got a marked effect, seven improved,
and nine got no effect. In this group, there was a cure
rate of only 16% and a total effectiveness rate of only
64%. Further, in the 28 patients in the treatment group
who were cured, 14 experienced one course of treatment,
10 got two courses, and four required three courses. In
the four cases on the comparison group who were judged
cured, two required two courses and two required three.
Therefore, there was a statistically significant difference
in both cure rates, number of treatments to cure, and
total effectiveness between these two groups. Although
repeat x-rays did not show any marked change from before
to after treatment, the symptoms of lumbar pain in most
patients receiving the warm needle treatment did either
disappear or decrease.
Discussion:
It is my opinion that this study shows that moxibustion
is not just an optional and dispensible treatment modality.
It is my experience that many Western practitioners tend
to shy away from moxibustion for a variety of reasons:
time, smell, dirt, potential for creating burns, concerns
over fire hazards, etc. While all these concerns are valid
and need to be addressed, this still does not negate the
fact that moxibustion can achieve clinical results that
along acupuncture cannot. Therefore, I believe it is important
to neither overlook or deliberately ignore moxibustion
as a treatment modality. As the above study shows, needles
alone do not always get the job done the same way moxibustion
does.
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Clinical
gem
by Bob Flaws, Dipl. Ac. & C.H., FNAAOM |
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Indigestion
as the main disease in Chinese pediatrics
Twenty years ago, my first
Chinese medical teacher, Eric (Xi-yu) Tao, said that children
only suffer from a single "disease", and that
disease is indigestion. As mentioned above, TCM theory
says that children’s spleens are inherently immature
until at least five or six years of age. Because the spleen
and stomach function as a unit, this means that infants
and young children do not digest foods and liquids as
efficiently as adults. After two decades of practicing
Chinese medicine, I think Tao Yi-sheng (yi-sheng means
doctor in Chinese) was right, at least in terms of the
majority of common childhood complaints.
For
a number of reasons, food stagnation in infants
and toddlers easily transforms into heat. And heat, due
to its inherently yang nature, typically travels up. Yin
and yang are the two main concepts of Chinese medicine.
Everything in the body may be classified as either yin
or yang in relationship to something else. Things that
are yang are moving, warm, active, and tend to travel
up. Therefore, "evil" heat created due to indigestion
in the stomach commonly wafts up to accumulate in the
lungs, throat, ears, eyes, and head, thus manifesting
as cough, sore throat, earache, red eyes, headache, and
fever.
Here, indigestion
may mean colic, stomachache, and abdominal distention
and cramping, but it also means non-digestion of the foods
and liquids taken in. Normally the clear or pure part
of foods and liquids is separated from the turbid or unclear
part. The clear part is sent upward to become the qi and
blood, while the turbid part is sent downward to be excreted
as urine and feces. It is the Chinese ideas of the spleen
and stomach which accomplish this separation of clear
from turbid and their upbearing and downbearing. And this
is exactly what very young children’s spleens and
stomachs are not yet mature enough to do really well.
A health-promoting
diet for young children
The implications of this Chinese theory are several. First,
children should be fed a light, easily digestible diet.
In Chinese medicine, this is called the "clear, bland
diet." Clear, bland foods are easily digestible.
They make the child’s spleen and stomach work less
hard and more efficiently. For infants, this also means
not overfeeding. Breastmilk is the single best food for
infants, but many American mothers overfeed their children.
When even this excellent source of nutrition is not completely
digested, it forms stagnant food in the stomach. When
solid foods are introduced, one should start with easily
digestible foods, like cooked carrots and well-cooked
grains such as cream of rice.
Because
the process of digestion in Chinese medicine is
likened to a process of cooking and distillation, foods
which are cooked are, in general, more easily digested
than uncooked foods. In other words, cooking is predigestion.
Therefore, infants and very young children do best when
they are fed mostly cooked, mashed, partially predigested
foods and when they eat few uncooked, chilled, or cold
foods. Chilled and cold foods "douse" the yang
qi or fire of the spleen. Likewise, drinking too many
liquids and especially with meals "swamp" the
spleen. In addition, foods that Chinese medicine labels
as very "dampening" also easily harm the spleen
when overeaten. These include sugars and sweets in general,
dairy products (and especially chilled dairy products
such as cheese and yogurt), peanut and other nut butters,
and bread.
Based my 20
years of clinical experience, I believe very young
children do best when fed well-cooked and easily digestible
grains, cooked vegetables, cooked fruits, a little raw
fruit, such as apples, pears, and bananas, and small amounts
of lean meat. Liquids should be room temperature or warm.
by Bob Flaws, Dipl. Ac. & C.H., FNAAOM
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