ACUPUNCTURE: meridian and point

Acupuncturists diagnose human illness in terms of Traditional Chinese Medicine (TCM) which perceives the human organism and it’s processes as flows of Qi or energy; somewhat like the currents, eddies and swirls in a stream or lake. The major currents are called channels or meridians or in Chinese: jing luo.

Twelve of the channels connect with organs in the trunk. Each of the twelve is named for the organ with which it connects. The organ channels and two other channels which follow the front (Ren channel) and rear (Du channel) midline of the body contain the acupuncture points. The names, locations and usages of the points vary with the specific school or nationality of acupuncture. Proper rate of flow and amount of Qi in the channels is the OM definition of health. The acupuncture points are needled to restore or maintain the flow.

Each of the acupuncture points has specific effects on the different currents and/or organs of the body. In Traditional Chinese Medicine there are at least seven very commonly used groups of acu-points.

Transporting Points
There are five transporting points on each channel. They begin at the fingers and toes and stop at the elbows and knees. Beginning at the finger or toe tip, they’re named Well, Spring, Stream, River, Sea. At each point the flow of the Qi resembles that of the body of water it’s named for. At the Well point the flow is slender and thin. The Spring point flow is larger and has direction. At the Stream point the current has depth and more width. The River is wider and deeper yet. And the Sea points are the widest and deepest. The Sea point is also where the Qi goes deep into the body and connects with the organs.

Five Element Points
The Five Element points begin at the finger and toe tips. Each set of points begins with the names of Wood or Metal and continues up the arm or leg until all five elements are represented. The Five Element relationships are key to selection of the points in treatment.

Yuan-Source Points
There is one Yuan-Source point on each organ channel. This point will release Source Qi in the system when needled.

Xi-Acumulating-Cleft Points
The Xi-Cleft-Accumulating points are somewhat like wide shallow spots in a river where the Qi slows and collects. Needling Xi points therefore accesses more Qi and is more effective at clearing a channel than most points.

Mu-Front-Alarm Points
A Mu-Front-Alarm point is on the front of the body and located close to the organ with which it has a diagnostic relationship. Visual examination, obtaining certain reactions when pressing the point or spontaneous sensation at the point are all significant diagnostic information. This is why Mu is also translated as Alarm.

Shu-Back Points
The Shu-Back points are on the back on both branches of the Bladder channel. They are each named for an organ or body part and have the same diagnostic relationship with those parts as the Mu points have with the organs.

Window to the Sky Points
Window to the Sky points are all in the upper third of the body. In one diagnostic model this third of the body is likened to Heaven. If there is poor Qi flow between the upper third and lower thirds then a window must be opened to restore communication between Heaven and Earth. In another model these points are held to facilitate connection to one’s own spirit or to the spirit world thus reconnecting one to heaven.

Herbal Therapy

Chinese herbal medicine works through the physiological action of the herbs, and pays special attention to the powers unleashed through combinations of herbs. For example, a Chinese herbalist will choose an herb for a specific effect and complement it with another herb that will increase that beneficial effect. However, sometimes along with the positive effects an herb may possess qualities that are not suitable for an individual because of his or her unique constitution. Then the herbalist must know what other herbs to add to the mixture to eliminate that undesired action. An herb formula is built to suit the individual diagnoses of each person — there is never one pat prescription for everyone who has the same symptoms. A compound of three or four or more herbs may be designed to address the person’s particular needs.

In Chinese medicine, we do not usually treat specific symptoms with Chinese herbs; instead we treat the symptom complex known as the syndrome. Every individual is different, so even when we use a general herbal combination we can add herbs to individualize the formula.

Chinese herbalists know that there are specific rules for herb combining — some herbs have potentiated effects when combined with certain other herbs. Some herbs are traditionally contraindicated for use in the same formula with other herbs because of negative or toxic effects. Combining Chinese herbs is an art. Two or more herbs may be combined to form an herbal prescription. Some contain only one herb and often we find up to twelve or fifteen herbs in a formula, depending on the condition of the person and the actions of the herbs needed. Medicinal substances are combined in order to enhance the effectiveness of individual herbs within the formulas, to minimize unwanted effects, or to deal with complex situations, and to alter the actions of the substances.

There are many ways to ingest or use Chinese herbal formulas. Formulas may be taken in bulk tea that has been cooked, in liquid extract form in hot water, in powder extract form in pills or hot water, in pills, or even used topically in teas, plasters, liniments as well as many other forms.

In my clinic I use many traditional formulas that have been made into herb pills, often called patent formulas. Various Chinese herb companies produce pills as well as extracts and powders of traditional Chinese formulas. Some companies also produce modern Chinese herbal formulas as well as variations of Chinese traditional formulas for a more Western constitution.

Close supervision is necessary when any type of medication is ingested. This includes Chinese herbal formulas. A person receiving Chinese herbs should be under the care of a competent licensed practitioner who can differentiate any possible side effects of herbs from organic conditions. Receiving herbs from unlicensed or untrained personnel, such as in health food stores, is not good practice.

Side effects are possible with herbal formulas. The most common problem is that persons may have some digestive difficulties immediately upon beginning herbal intake that can last for a few days. This can include diarrhea and/or constipation. This is usually due to the sudden addition of increased fiber in the diet, particularly for those unused to much fiber. If this lasts more than a few days or is severe, several measures are taken to ameliorate the effects. Side effects can generally be controlled through varying the time of ingestion or through altering the dosage. Sometimes we need to change the formulas or give a digestive formula in conjunction.

Chinese Traditional Medicine: ANALYSIS OF SI JUN ZI TANG - FOUR GENTLEMEN TEA

ANALYSIS OF SI JUN ZI TANG - FOUR GENTLEMEN TEA

Below is an analysis of a an extremely common formula. Qi deficiency is the imbalance/pathology for which it is prescribed so the definition of Qi Deficiency is presented first.

Lung Spleen Qi Deficiency:
breathlessness, weak voice, spontaneous sweating, poor or no appetite, tiredness, loose stools, Pulse: empty, Tongue: somewhat faded in color, SOB, No appetite, cough, abdominal distension, watery sputum, tiredness,weak voice, lassitude, dislike of speaking, pale complexion,day sweating, weakness of the limbs, bright white complexion, loose stools, catches colds easily, tiredness,

Treatment Principles
Remember: Illness = Imbalance, Health = Balance
A. General Treatment Principle is always: Restore
Balance
B. Specifically: Remove excess, Supplement deficiency.
C. Is there an Excess? No.
C. What is Deficient in our situation? Zhen Qi
D. Therefore the specific Treatment Priinciple is supplement/tonify Qi.

SI JUN ZI TANG
ROLES AND PROPERTIES OF INGREDIENTS

NOTE: CX = contra-indications
I. King - Ton Qi Category
A. Name: Ren Shen - Ginseng
B. King Actions: Tonifies Source Qi, Tonifies Lung & Spleen Qi.
C. Also generates fluids, slightly Tonifies Heart Qi, calms Shen.
D. CX - Yin Deficiency w/ Heat, Liver Yang Rising, hypertension.

II. Minister - Ton Qi category
A. Name: Bai Zhu - White Attractylodes
B. Minister Actions: Tonifies Qi, Tonifies Spleen, Resolves Damp.
C. Also: stabilizes the exterior-stops sweating, calms fetus.
D. CX - Yin Deficiency w/ heat.

III. Assistant - Drain Damp Category
A. Name: Fu Ling - Poria
B. Assistant Actions: Drain damp, Tonifies Spleen.
C. Also: Resolves Phlegm, calms Heart and Shen.
D. CX - Cold due to Yang Deficiency.

IV. Guide - Ton Qi Category
A. Name: Gan Cao - Licorice Root
B. Guide & Assistant Actions: enters all 12 main channels,
harmonizes herb combinations (mitigates harsh effects), Tonifies Spleen.
C. Also: Tonifies Heart Qi, Clears Heat & Toxins, Tonifies Lung Qi and stops cough, relaxes tendons and relieves spasms and pain, moderates actions of other herbs.
D. CX - excess Damp, Nausea/Vomiting

Analysis - Actions and Balance

I. Treatment Principles of Si Jun Zi Tang
Tonify the Qi, Regulate Damp.

Tonify Qi
This occurs predominantly via the Lungs and Spleen - the two sources of Qi. Ren Shen and Bai Zhu tonify the Spleen & Lung. Ren Shen tonifies Source Qi. Gan Cao assists in tonifying the Spleen.

Regulate Damp
1) Damp accumulates when Spleen Qi is deficient.
2) Excess Damp can result from Ren Shen generating fluids.
3) The Minister and both assistants Resolve Damp and Tonify the Spleen.
4)Fu Ling drains damp compensating/balancing for K&M.

II. Temperature
The temperatures of the component herbs are sl. warm, warm, neutral, neutral. A Qi Deficient person is probably cool (Qi warms). The Temperatures of the component herbs therefore balance each other.

III. Tastes
slightly bitter, bitter, sweet.
A Qi Deficient person is likely to have Excess Damp. Also, Excess Damp results from Ren Shen generating fluids. The energetic actions associated with Bitter are drying and purging. The energetic action associated with Sweet is tonifying. Drying and purging will help to resolve Damp. Sweet and Spleen are both Earth correspondents. Sweet herbs will tonify the Earth Element. When the Spleen is tonified it will regulate Damp more effectively.

IV. Channels
Ren Shen enters the Spleen, Stomach, Lung, and Heart channels to tonify those organs. Bai Zhu enters the Spleen and Lung channels to Tonify those organs. Fu Ling enters the Spleen, Stomach, and Heart channels to tonify those organs. Gan Cao enters all twelve channels carrying the Qi of the King, Minster and Assistant herbs along with it.

There are two objectives of this section. The first is to introduce the lay person to Chinese Herbology. The second is to demonstrate the complexity of the formulas. After even a cursory study of the example above it should be apparent that a lay person should consult a professional before using Chinese medicinal herbs.

Hepatitis C Help

Introduction

Hepatitis C virus (HCV) infection is increasing in the United States and around the world today. HCV infection is the most common chronic blood borne infection in the United States. More than three-quarters of those who are infected will develop chronic liver diseaseand up to 20 percent will develop cirrhosis. It is estimated that there are 8,000 to 10,000 HCV-related deaths each year and the US Centers for Disease Control and the National Institutes of Health expect the rate to triple in the next 10 to 20 years.

The Centers for Disease Control (CDC) estimates that during the 1980s an average of 230,000 new infections occurred each year. The Third National Health and Nutrition Examination Survey conducted during 1988-1994, indicated that an estimated 3.9 million (1.8%) Americans have been infected with HCV. Most are chronically infected and might not be aware of their infection because they do not have apparent symptoms. Infected persons may transmit the virus to others and are at risk for chronic liver disease or other HCV-related chronic diseases during the twenty to thirty years following infection.

General symptoms of Hepatitis C virus

Acute symptoms of Hepatitis C virus include flu-like symptoms, dark urine, light stools, jaundice, fever, fatigue, anorexia, nausea, and itching skin.

Chronic HCV symptoms include fatigue, malaise, weakness, mild fevers, liver pain, decreased appetite, and itching skin. However, many persons infected with HCV do not have obvious symptoms, especially in the early stages of chronic infection with HCV.

HCV infection is found within people of all ages. The highest prevalence rates of chronic HCV infection are found among those aged 30-49 years and among males. The highest incidence of acute hepatitis C is among 20-39 year olds with men having a slightly higher rate of acute infections. Because most HCV-infected people range between 30-49 years old, the number of deaths caused by HCV-related chronic liver disease could increase significantly during the next 10-20 years as more likelihood of complications develop.

While African Americans and whites currently have similar occurrence of acute infection, African Americans have a substantially higher prevalence of chronic HCV infection than do whites. Latinos have the highest rate of acute infection.

The CDC identified most risk factors associated with HCV transmission in the US in case-control studies conducted during 1978-1986. These risk factors included: blood transfusion, injection drug use, patient care or clinical laboratory work employment, sex partner or household member who has had a history of hepatitis, multiple sex partners, and low socioeconomic level. These studies reported no association with military service or exposures resulting from medical, surgical, or dental procedures, tattooing, acupuncture, ear piercing, or foreign travel, although it may be that the frequency of infection through these means may be too low too detect.

Currently, the highest rate of acute infection is among injecting drug users. Acute HCV infection is basically undetected in people who have had transfusions and in hemophiliacs since the early 1990s, since the blood supply in the US has been tested for HCV since 1990, with more sensitive tests developed in 1992.

Chinese Traditional Medicine for HCV

Many people with HCV are turning to Chinese traditional medicine, which has a rich history in the treatment of chronic hepatitis. Hepatitis B — and increasingly, Hepatitis C — is prevalent throughout China, accounting for increased risk of hepatocellular carcinoma in the mainland Chinese population. The Chinese medical system has been dedicated to solving the problem for many years, working to eliminate sources of hepatitis as well as developing treatments for hepatitis using both Chinese traditional medicine and Western medicine.

At the International Symposium on Viral Hepatitis and AIDS held in Beijing in April 1991, more than 100 papers on viral hepatitis were presented, several of which documented positive results of studies of Chinese herbal medicine. Studies of herbal antivirals and Xue-cooling and Xue-circulating herbs for repairing liver damage supported the hundreds of years of practical experience with Chinese herbs for the symptoms of hepatitis.

A literature review by Dr. Kevin Ergil in 1995 revealed at least 55 herbal formulas that may be used to treat hepatitis clinically. Recent herbal studies in China and Australia showed positive results in hepatitis C using similar formulas to those used widely in clinics in the US.

In the US, Chinese traditional medicine is a popular complementary or alternative therapy among patients with chronic liver disease. In a late 1990¡s anecdotal report from one of the largest clinical hepatology practices in San Francisco found that at least 20 to 30 percent of patients report use of Chinese herbal interventions for hepatitis. The level of use is probably underestimated because patients often choose not to divulge the use of complementary and alternative medicine therapies to their Western primary care physician.

Chinese medicine uses nutrition, acupuncture, heat therapies such as moxibustion, exercise, massage, meditation, and herbal medicine for the treatment of people with HCV. Protocols have been developed that have successfully helped HCV infected people to decrease symptoms, normalize or lower liver enzyme levels, and slow down the progression of liver disease.

A pilot study conducted among people co-infected with HIV and hepatitis at the Quan Yin Healing Arts Center in 1995 indicates that acupuncture alone may have an effect in lowering and normalizing liver enzyme levels.

The Hepatitis Help section explores the use of TCM treatment for HCV as well as the use of a comprehensive East/West approach to healing the liver. This section also explores the use of traditional Chinese medicine as both adjunctive and as an alternative to current Western treatment.

HIV Wellness: Living Well with HIV

Toxic Heat and the Human Immunodeficiency Virus: Understanding HIV disease from the Chinese Perspective

Through clinical observation and treatment of thousands of people with HIV and AIDS, clinical evaluation of the tongues of over 600 people with HIV infection and/or AIDS, and the use of pulse diagnosis, I have come to understand that HIV infection is triggered by Toxic Heat, and initially attacks the Spleen and Stomach Organ Systems. They are the central organs involved in this complex syndrome and must be supported throughout the entire course of the disease even when the HIV-related disharmonies expand to involve all the other organ systems as well.

The Impact of Toxic Heat

Toxic Heat creates the initial flu-like symptoms that for many people accompany initial exposure to HIV. And as the Toxic Heat moves more deeply into all systems of the body, it triggers a whole variety of common HIV-related symptoms: pruritis (chronic itching), sore throats, increase in body temperature, feeling like you always have a fever even if one is not present, a nagging sensation that something toxic is present in the body.

Toxic Heat is also responsible for the cascade of Organ System disharmonies in the Spleen and Stomach, Kidney and Liver, which contribute to the major complication associated with HIV infection, wasting. (For detailed information on nutritional management and therapy see the Diet Therapy chapter and the three-part “Wasting Program: The Daily Diary;” “The Cleansing Diet;”“ The Anti-Wasting Program” in The HIV Wellness Sourcebook.)

Role of the Spleen and Stomach Systems in the Progression from HIV to AIDS

The Spleen and Stomach Systems govern the digestive process, transforming food energy and fluid into Qi and Xue (blood). As a result the Spleen and Stomach moisten and nurture all the other Organ Systems and channels.

When Toxic Heat disrupts the Spleen and Stomach Systems, it triggers symptoms that are associated with the very early stages of HIV infection. These symptoms include

• fatigue,
• inability to gain weight no matter how much is eaten,
• loose stools,
• bloating, gas and flatulence and/or dull pain in the abdomen,
• needing to take naps after meals, and/or
• frequent infections.

In addition, symptoms of early stage HIV infection, such as dry skin and lips, set in when the flow of fluids and food essence from the Spleen and Stomach to the Lungs, is disrupted. Often dryness in one area, triggers dampness in another: Spleen Qi deficiency with dampness manifests in early neuropathy (a numbness or tingling sensation often in the hands or feet, lymphadenopathy (swelling and inflammation of the lymph nodes), vaginal candidiasis (yeast) infections, more serious loose stools and/or bloating. Spleen-related diarrhea is prevalent with loose stools and abdominal bloating after eating. Skin rashes, commonly associated with early-stage HIV infection, are a result of Spleen Qi deficiency and Lung disharmonies interacting with the essential substances.

Spleen Qi deficiency also causes deficient Xue (blood). Once this sets in, the door is opened to allow Toxic Heat to enter the depleted blood and penetrate ever deeper into the body. The body them moves into more advanced stages of HIV/AIDS. If unchecked, an increasing depletion of the fluids of the Spleen (the Spleen’s Yin aspect) leads to overall Yin deficiency, which in turn can lead to Yang depletion.

Although today the combination of Western and Chinese therapies can arrest (for some period of time) the progression of HIV infection to end-stage AIDS for many people, when the cascade of Spleen-Stomach triggered disorders causes overall Yin deficiency and Yang depletion, wasting becomes severe. Diarrhea stops. The skin becomes drier and drier. Thirst is unquenchable. Fevers spike every afternoon and often in the evenings. The pulse is rapid, thready and superficial. This is a terminal stage of HIV disease. (ED: Yes it is called HIV disease.) Acupuncture and herbs are used to support the Shen (spirit) and the passing over to a new phase of existence.

Associated Disharmonies and Opportunistic Infections

Toxic Heat and the Spleen-Stomach disharmonies weaken the body’s overall resistance to assault from both internal and external disease factors and allow other organ systems to become involved. This leads to the development of HIV-related disorders and opportunistic infections. For example, if Toxic heat assaults the Lungs, PCP (Pneumocystis Carinii pneumonia) may develop. Xue disharmonies are associated with Kaposi’s sarcoma (a proliferative, circulatory cell disease that causes skin lesions); dampness is associated with candidiasis (yeast infections) and fungal invasions; Yin deficiency and Xue deficiency are associated with MAC (Mycobacterium Avian Complex) ; dampness and Spleen and Lung disharmonies may manifest as chronic sinusitis; disturbed Shen that is associated with mental disturbances that accompany HIV/AIDS; and many more.

Each of these syndromes is detailed in the individual treatment programs in the last section of the book. However, I wanted to make the point here that looking at HIV disease as an assault by Toxic Heat that starts with damage to the Spleen and Stomach, and moves on to include other organ systems and Essential Substances, provides a concise method of describing, diagnosing and treating the whole constellation of HIV-related diseases.

Women’s Health: Managing Menopause

In Chinese Medicine, the symptoms of menopause – hot flashes, palpitations, emotionality, depression, vaginal dryness, change in libido, urinary problems and changes in skin texture are associated with Deficient Kidney Yin; Deficient Liver Xue ; Deficient Kidney Yang; and Deficient Yin and Yang of Kidney. But it is important to stress that menopause is not a disease or a disorder – it is part of the natural progress of life. Any physical or emotional discomfort associated with it can be eased or eliminated.

Managing Menopausal Symptoms

• Pre-menopausal and menopausal women should be vigilant about having regular mammograms, annual Pap smears (even after the period has stopped) and cardiovascular check-ups. For women in high-risk groups such as whites, fair-haired women, those who are very thin, smokers, those with a family history, a bone density scan may be recommended.
• The smartest approach to menopause is to try the least harsh, most natural treatments first: that means change your diet, increase supplements, particularly vitamin, reduce stress levels, increase aerobic exercise routine, avoid caffeine and stop smoking – this is the single worst trigger of symptoms – use acupuncture, herbs, massage and meditation first.
• There are a growing number of physicians who are using Estrogen Replacement Therapy (ERT) or Hormone Replacement Therapy (HRT) as the last resort for menopausal symptoms. Evidence is mixed about the increased risk of breast cancer among women who use ERT, although evidence that the risk of osteoporosis and heart disease is decreased appears overwhelming. However, the lifestyle changes suggested in this comprehensive program and throughout the book may also diminish the risk of brittle bones and heart disease sufficiently to make it unnecessary to take ERT.

In order to relieve your symptoms, follow the guidelines in the general gynecologic program plus the suggestions that follow here.

Understanding Chinese Medicine

What is Chinese Medicine?

Traditional Chinese Medicine (TCM) is a 4,000 year-old system of balancing the body’s own health-preserving forces.

Components of Chinese Medicine

Diagnosis

Find out how Chinese medicine practitioners describe the disharmonies of the body and perform a diagnosis. In this package:

Asking the Questions
No one knows your body as well as you do, so help your practitioner learn about your by answering these questions.

Listening and Smelling
Evaluating your voice and smell can help your doctor zero in on the origins of disharmony.

Pulse and Touch
Did you know there are 28 different pulses? And your reaction to pressure along acupuncture meridians can provide important information.

Tongue, Body Language and Face
Your tongue, body language, and facial color offer strong clues to the location of disharmony.

Acupuncture

Acupuncture is the art of inserting fine sterile metal needles into certain body or ear points to control the body’s energy (Qi) flow.

Moxibustion

Moxibustion is the common herb mugwort (called moxa in Chinese) that is burned over certain points or areas.

Herbal Therapy

Herbal Therapy is integral to Chinese medicine. The herbs selected reflect the type of imbalance which has been diagnosed. Herbal medicine may be used alone or in conjunction with other therapies.

Dietary Therapy

Dietary therapy focuses on improving digestion, increasing energy, and balancing body energy. Food therapy often increases the effect of other treatments.

Exercise/Meditation: Qi Gong

Exercise includes martial arts as well as more subtle movement such as T’ai Chi, Qi Gong, and Yoga. Gym work-outs or aerobic exercise are also suggested. Meditation may include traditional Asian forms as well as relaxation exercises, hypnotherapy, and bio-feedback.

Web Links

Other Chinese Traditional Medicine resources on the Web.