 |
Clinical Gems |
|
|
|
Clinical Gem
by Henry McGrath, MRCHM, MBAcC |
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.
|
|
| |
Clinical Gem
by Honora Lee Wolfe, Dipl. Ac., Lic. Ac., FNAAOM |
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.
|
|
|
Clinical gem
by Bob Flaws, Dipl. Ac. & C.H., FNAAOM |
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
|
|
