The Acupuncture Guru

Two recent research reports find that acupuncture is an effective treatment for several types of chronic pain and has the added advantage of being less costly than standard medical care.

http://www.acupuncturetoday.com/mpacms/at/article.php?id=32651

A new study concludes that acupuncture reduces knee pain and increases mobility for patients with osteoarthritis. There was a pain reduction in 73% of the patients, and researchers noticed an objective increase in knee mobility. Other studies have shown that acupuncture is even more effective that standard biomedical care.

Stressed out? Acupuncture can bring those levels down a notch or two. Not only will it calm the mind, it will also calm the body. The relaxation brought about by acupuncture helps reduce levels of norepinephrine. Norepinephrine causes the adrenal glands to release cortisol, the prolonged release of which, can disrupt immune function.

Still smoking? Ready to kick the habit? Give acupuncture a try. A meta-analysis of randomized controlled trials shows that, with acupuncture, people are 3.5 times more likely to be smoke free after 12 months.

I would like to wish everyone a Happy Thanksgiving. I will be out of the office until Monday morning. Have a safe and happy holiday!

We are pleased to announce our current promotion of therapeutic massage with Joel Jones, LMT through Living Social/Amazon Local. If you've purchased one of the vouchers, please call Joel Jones, LMT, directly to schedule your appointment. He can be reached at 740-361-9841.

Need a massage? Keep an eye out for our next Living Social promotion for a great deal on therapeutic massage provided by Joel Jones, LMT.

To contact Joel, call 740-361-9841

For those of you who have Groupons that are about to expire, do not stress. I will still honor them beyond the expiration date. Give me a call; and we'll get an appointment set up for you.

--Tom

The Groupons that went on sale in January will be expiring tomorrow. However, you can still use them. We will continue to honor them beyond the expiration date. Just make sure to give us a call as soon as you can to get scheduled. A lot of people purchased these; so if you miss us, please leave us a message. 

Gotta stiff neck? Try massaging the acupuncture point, Luozhen. The point is located on the back of the hand between the index and middle fingers, just proximal to the knuckles. Massage the point on the affected side while flexing, extending, and rotating the neck. The point is known to invigorate the qi and blood in the neck region. To see the point location, click on the link below:

http://a7.sphotos.ak.fbcdn.net/hphotos-ak-snc7/s320x320/419214_10150723968460797_147281595796_11747294_29129240_n.jpg

Our latest Groupon did very well. Please call early to book your appointment. If you reach our voicemail, please leave your name and phone number, we will call you back to schedule. Also our Living Social promotion is ending next Thursday, March 15th. Don't worry, if you call before the 15th to book your appointment, we will still honor the voucher even if the appointment is after that date.

Our Groupon promotion is going strong. It ends on Thursday, so if you've been wanting to try it out, this is your golden opportunity.

http://www.groupon.com/deals/arlington-acupuncture-clinic

"Yin Deficiency plays a central role in autoimmune diseases. Specifically, a deficiency of Yin affects cells negatively and may lead to tissue degeneration, apoptosis (programmed cell death), and Qi and Yang deficiency, as well as stasis of Blood and the body's greater susceptibility to pathogens. (please see earlier posts about syndrome differentiation in Acupuncture and Oriental Medicine).

To maintain effective immunity, good health, and normal physiological function, a person must have healthy reserves of Yin, which must be in harmony with Yang, as Yin and Yang are always in a state of dynamic flux. Yin refers to formed substances, such as organs, tissues, cells and body fluids, that is, visible and measurable things. Yang refers to the physiological function of visible things, such as the ability of hydrochloric acid and enzymes to digest food in the stomach or the function of thyroxine in regulating metabolism. Physiological function is based on substance. Without substance, there would be no source for function. Without physiological function, substance exists as nothing more than an inanimate entity. If Yin and Yang separate from each other within the body and become incapable of aiding or assisting one another, life ends. "  Wanzhu Hou, et al, Treating Autoimmune Diseases with Chinese Medicine.

When someone comes to see me for a particular condition, they have usually seen a gazillion of other practitioners. They usually have seen their primary care physician, and at least one or two specialists. And many will have even seen other CAM (Complimentary and Alternative Medicine) providers, including other acupuncturists. I don't mean to imply that any of these other practitioners were less than qualified or weren't any good. Sometimes, the diagnosis was correct in the conventional sense, but the therapy was inadequate or non-existent such as in the case of tinnitus. And occasionally they do miss something. Sometimes it just helps getting a fresh perspective or someone who can just step out of the box a bit. When a patient comes to see me, their condition can be likened to a mystery; and I am the detective that must search for the clues that will help me put the pieces of the puzzle together. One of the most important clues in Oriental Medicine (OM) is the pulse.

In OM, we are looking at several things when we palpate the pulse. I feel not only the rate and the rhythm, but I am also looking at its force (i.e. how strong is the pulse). I will look at its depth (i.e. is the pulse felt at the superficial or deep levels). When I feel the pulse, I will feel with the index, middle, and ring fingers at the same time, and individually. I will feel the pulse on the right and the left side; and I will feel the pulse at different positions both in depth and along the artery.

It is more than just simply placing my fingers on the artery and feeling. It is a subtle art that takes years to master. I do all of this to begin to classify what kind of pulse the patient has (most textbooks of Traditional Chinese Medicine have standardized the pulse to 28 or 29 qualities). Identifying this quality can often be what helps me clinch the diagnosis.  According to the prominent scholar and physician of TCM, Giovanni Maciocia, there are a number of clinical applications of pulse diagnosis such as:

• The pulse is often crucial to clinching the diagnosis
• It is essential to distinguish between Deficiency and Excess (syndromes)
• It is essential to determine the TCM treatment principle
• It is an indicator of an (zang fu) organ problem
• The pulse indicates disharmonies beyond the presenting patters
• The pulse can indicate an underlying Deficiency syndrome in the absence of symptoms¹.

Although pulse diagnosis in OM is difficult to learn and master, it is an important skill to develop and can be the difference in what gives me the final piece of the puzzle that helps me assess and therefore properly treat my patient.

1. Diagnosis in Chinese Medicine: A Comprehensive Guide by Giovanni Maciocia. Churchill Livingston, London, 2004 pp. 457-463.

A lot of patients are puzzled when going to an acupuncturist and are asked, Would you please show me your tongue?" In our experience as patients in the conventional medical scene, this doesn't seem to make a lot of sense. Of course, most of my patients who show me their tongues are usually curious to see what it means.  A lot of them will ask things like "Why do you look at my tongue?"  Or, "What can you see in my tongue that is related to my insomnia?"

The answer to these questions goes right to the heart of one of the key concepts of Oriental Medicine (OM) -- the concept of wholeness/integrity. In OM, the body is viewed as an integrated whole. Any disorder in one area will have an effect globally (i.e. throughout the body). For example, a person may complain of insomnia, and we find that their tongue has a dark red color with no coating. We may feel their pulse and find that it is thin and rapid. Upon further inquiry, we may find that their urine is dark yellow and scanty in volume.  Each of these little pieces fit together to complete the puzzle of assessing their syndrome or pattern of imbalance that manifests with the "symptom" of insomnia.

When we look at the tongue, we are looking at a number of things such as the color, shape, moisture, coating, and any other distinguishing features on the tongue body such as teeth-marks, inflamed/raised taste buds, and cracks in the body of the tongue. Also we look at the spirit of the tongue overall. Is it quivery? Or does it deviate?

We also look at the areas of the tongue that are affected. The ancient Chinese mapped out areas on the tongue that were related to each of the zang fu* organs. For example if a tongue were red on the sides, we might inquire into possible Liver or Gall Bladder** syndromes (patterns of disharmony). Each feature that we notice becomes yet another clue -- another piece of the puzzle -- to be able to determine what is the nature of a person's disease or dis-ease.

Now in my practice, I do not take what is called the tongue picture as sufficient to make any diagnosis. I will look at the overall presentation of symptoms (what the patient presents to me as a complaint) and signs (what I find upon examination).  Based on this overall presentation, I then make my assessment.

*zang fu -- to be discussed in another post

**not necessarily the liver or gallbladder as known in conventional medicine. 

Occasionally a patient will go on the internet to look up more information about their particular syndrome only to be terrified that they might have something seriously wrong with them. They will read all the different diseases associated with their syndrome; and this  once again relates to another aspect of what a syndrome is. It is important to know that a syndrome (i.e. a pattern of disharmony) can manifest as any number of different diseases [or dis-eases]; or it may have not reached the morbid stage where there is any disease at all. The syndrome may only be one's constitutional tendency towards certain health problems. For example, let's take the syndrome, "Kidney Yang Deficiency." Kidney Yang Deficiency may show up as the pattern of disharmony for any number of health issues from erectile dysfunction, lower back pain that is unassociated with an injury, or fibromyalgia. Just because someone has this syndrome does not mean that they will have any of these diseases or even that there is a tendency towards any of these problems. It may simply be one's constitutional makeup and that they may have a tendency to things like cold hands and feet with occasional low back pain and fatigue. 

Not only can one syndrome manifest as any number of different dis-eases, but one disease can be differentiated into a number of different syndromes. Let's take the common cold for example. Let's say that three people come into my office, each with the common cold. Cooper has a slight fever, aversion to cold, runny nose with yellow discharge, sore throat with swollen tonsils. Upon further inquiry, we find that his urine has been darker lately and that he has been particularly thirsty. We look at his tongue and find it to be slightly red on the sides and the front; and we take his pulse and find it to have a floating, rapid quality. Sarah comes into my office later that morning, and she has a cold as well. However, her symptoms are a slight fever, aversion to cold, runny nose with a white discharge, stiff neck, body aches, and sneezing. While her tongue doesn't show any different changes from any previous visit, her pulse has a floating and tight quality. After lunch Jimmy comes into my office. Wouldn't you know it? He has a cold as well. But Jimmy's symptoms are different. While he also has an aversion to cold and a slight fever, he also complains of a dryness of the nose, mouth, and throat. He is sweating slightly and has a dry cough. His tongue is slightly red in the front and a bit dry while his pulse has a floating quality.

Each of these patients have the same disease -- the common cold.  However each also has a different syndrome. Cooper's syndrome is called Wind-Heat, Sarah's is called Wind-Cold, and Jimmy's is called Wind-Dryness. Because each of these syndromes is different, each patient would be treated differently with different acupuncture points and such. In this case, the syndrome differentiation serves to further refine the treatment to better suit the patient.

Over the years, I have had a number of patients come in who had seen other acupuncturists before coming to see me. Many times I would hear something like, "My acupuncturist said that there's something wrong with my kidneys." After taking their history, and doing a physical exam, I will sit down and discuss their diagnosis. Most of the time, it turns out that there was never anything wrong with their kidneys, but rather they had a syndrome such as Kidney Yang Deficiency or Kidney Yin Deficiency. 

In acupuncture and Oriental Medicine (OM), a syndrome is not a disease, but rather it represents an overall pattern of imbalalnce in the body's physiology. A syndrome refers to a summary of the 'pathological changes at that stage [of the disease or dis-ease]." (1)   I reiterate: it's important to understand that a syndrome is not a disease. A person may have no "morbid pathology" at all, but may still be diagnosed with a syndrome. These syndromes will have names such as Liver Qi Stagnation, Kidney Yang Deficiency, or Damp Bi Syndrome. These names are not diseases but rather simply names for patterns of imbalance in the body. 

(1) Advanced Textbook of Traditional Chinese Medicine and Pharmacology, Volume 1. Cai Jingfeng, editor. New World Press, Beijing, 1995, p. 160.