Monday, 13 October 2014

Intro to Chinese Medicine Part 6: Treatment Today

Treatment Today


What can you expect to experience today if you go to see a mainstream TCM or integrative acupuncturist today?


1) You will usually be asked to fill out a lengthy questionaire and to sign a waiver. The former provides the acupuncturist with wide ranging information without having to do an exhaustive interview with you. The latter exists because of the rare side effects that can result from acupuncture. These include bruising, bleeding, swelling, fainting, post-treatment fatigue, and dizziness. No matter the skill of the practitioner side effects will occasionally, though rarely, occur and cannot be avoided 100% of the time. The same is true with any medical procedure.


2) Your pulse will be taken and your tongue will be looked at. These are ways to assess the state of the meridians and internal organs. Excellent practitioners can tell amazing amounts of information from these examinations. You will also be asked various questions about your health and you may be asked to do some simple movements to test muscles and locate injuries.


3) You will be asked to take off as much clothing as is necessary for the acupuncturist to access the points they intend to use. The acupuncturist will return after you are ready and will locate and needle the points. They may also apply moxa and/or cupping. Moxa is a technique where Chinese mugwort (ai ye) is burned near acupuncture points. The heat and the resins of the plant penetrate the point and bring healing. Cupping consists in applying warmed glass suction cups to areas of the body as a way to break up fascial adhesion and blood stagnation and can bring intense relief to muscular injuries and tension.


4) You walk out feeling relaxed. You may feel tired. If you were seeking a treatment for pain you may feel an immediate reduction in pain. Alternately you may feel temporarily more sore. In most cases anywhere from 1 hour to 24 hours later you will feel significant improvement in a pain condition. Other conditions which tend to respond quickly include anxiety, insomnia, and addictions. More systemic issues like immune conditions, digestive problems, reproductive conditions, etc. will usually show improvement only after several treatments.

That brings the first phase of this series to an end......after a hiatus I hope to return with some posts on the history of Chinese medicine.


Sunday, 7 September 2014

Starting Sat Sep 13 I will be accepting patients at Chopra Yoga Vancouver for Ayurvedic counselling:
 Chopra Yoga Ayurveda

Wednesday, 3 September 2014

Intro to Chinese Medical Acupuncture 4: Modern Acupuncture

Modern Acupuncture

There are many different styles of acupuncture being practiced in the West today, often by the same person! Below I've listed and briefly outlines the characteristics of some popular methods as a guide for the patient. Today's post will be a little longer than usual as I thought it best to grow through these in one go.


Intra-muscular Stimulation. This style of acupuncture is unique in that it is for the most part not based in Chinese medical theory. It is an application of acupuncture based on western anatomical theories and used by physiotherapists. It is effective for musculo-skeletal or nervous system injuries and pathologies. IMS uses thicker needles then other systems of acupuncture and the style of insertion and stimulation is more aggressive and consequently is painful. Patients seeking IMS should understand that though it is an effective treatment it is more stressful for the body and requires recovery time from the treatment itself.


Traditional Chinese Medicine practitioners use acupuncture as well as herbs, moxa (burning mugwort held near acupucture points to heat them and infuse them with medicinal oils), cupping and tui na (Chinese message). TCM practitioners commonly integrate Western biomedical knowledge into their practice but are primarily guided by analysis of the health of meridians and organ systems. They may also integrate 5 Element diagnosis and treatment (see last post). Other common additions are auricular therapy (ear points), E-stim (gentle electrical stimulation of the inserted needles) and the insertion of tiny needles or seeds in the ear which are to be retained for 12-24 hours after treatment.

Community Acupuncture/Dr. Tan

Community Acupuncture clinics are distinguished by their innovative set-up where patients are treated in reclining chairs in one room together as opposed to on beds in praivate rooms. This approach allows for lower overhead costs per patient and therefore lower fees for the patient. The use of reclining chairs limits the practitioners to a method which allows for quick diagnosis and the use of points on the arms and legs (since the patient keeps their clothes on).

The system which most Community Acupuncturists use is known as "Balance Method" or "Dr.Tan" after Richard Tan, the Taiwanese inventor of the method. The method uses palpation (feeling the meridians on the arms and legs) and an interview about the location of the patients pain to determine points on the body which will relieve the patients symptoms and move them towards healing by altering the flow of energy in the meridians.

Five Element (Worseley)

Worseley's Five Element acupuncture was developed in Britain by Dr. Worselely based on Japanese and Chinese Five Element theory and Daoist and Confucian philosophy. Five Element Acupuncture is "spirit level" acupuncture, meaning that all ailments are seen as rooted in diseases of the spirit. The patient is believed to have a fundamental wound (known as the "CF" or causative factor) due to trauma which has impeded the healthy flow of energy through the five elemental transformations it is supposed to go through in the body and mind.

The WFE practitioner uses pulse taking, interview, and careful observation to determine the CF of the patient. Usually before the CF is addressed the healer will remove other energetic blocks due to trauma such as aggressive energy.

Five Element (Constitutional)

Five Element Constitutional Acupuncture (FEC) is based on Worseley but has gone in new directions. FEC practitioners are more common in North America. They use many of the same techniques and ideas as Worseley but do not apply them exactly as he did. They see the person in terms of a constitution dominated one or more elements which need to be balanced as opposed to in terms of one key trauma underlying all others.

Trigger Point Therapy

Trigger Point Therapy is a technique adopted by some acupuncturists which is based on western anatomy. It consists in needling muscles at the point where they have the densest nerve bundles. This triggers the muscle to spasm and release and can bring about deep relaxation of tense or traumatised muscles. This technique has some similiarities to IMS (and some physiotherapists also use it) but is gentler.

Korean Style

Koreans have their own styles of acupuncture based on classical Chinese medical traditions as they developed in Korea. These techniques include their own version of 5 Element balancing and needling points on the hands with very fine needles.

Japanese Style

Japanese style (JA) is based on classical Chinese medicine but has significant differences in approach. JA tends to rely more on moxa than the Chinese. They also use the finest needles of any acupuncturists and needle very superficially with a focus on manipulation of subtle energies in the body. In many ways JA is distinguished for its gentility and refinement.


Integrated Neuromuscular Acupuncture System is a system developed by Chinese acupuncturists integrating western biomedical knowledge and clinical testing. It relies heavily on paraspinal points (points beside the spine which stimulate segmental nerves which flow throughout the body), symptomatic points which are empirically known to relieve pain, and homeostatic points which are known to increase immunity and over-all health. INMAS has a unique way of diagnosing the patient's likely recovery time on the basis of palpating homeostatic points.


Most acupuncturists today fall into this category, and the number seems to be ever increasing. These acupuncturists experiment with techniques and information from all of the approaches listed above and mix and match according to whatever they find works with their patients.

Ok, you say. So what can I expect when I walk into the average acupuncturists office? We'll talk about that next week: what you can expect.

Monday, 25 August 2014

Introduction to Chinese Medical Acupuncture 3: The Five Elements

The Elements

The last foundational concept to look at is usually translated into english as "the five elements". This is accepted practice but somewhat misleading. In Chinese the phrase wuxing means something more like "five behaviours". Literally it means "five ways of walking". This more odd sounding translation is helpful in that it prepares us for what the Five Elements actually are, which is five ways that energy behaves in nature and in human beings. These five ways are today understood clinically as patterns of emotion or human behaviour.  

The Five Elements are Water, Wood, Fire, Earth, and Metal. Emotional and psychological energy is said to be continuously cycling through these five elemental behaviours in a person.

The stillness and pure potential of Water feeds the self-expression and expansiveness of Wood, which at the height of its expression becomes Fire- illumination, delight, intimacy and play. Fire generates the nourishing ash of good feelings which feed the  person as Earth. Earth is refined and its precious elements kept as Metal- the persons perceptions of what is truly beautiful and valuable. Metal then dissolves back into the unexpressed potential of Water. A full discussion of the complex implications of this cycle is again beyond our scope but let's look at the Fire element as an example.

The Fire element corresponds to the Heart in the human person. It gives illumination, warmth, and delight. Fire is expressed in human intimacy and play. It is said to be harmed by excessive agitation and by trauma in sexuality, intimacy or play. It is healed by ritual (li).

What does this mean?

Sometimes a person suffers a trauma while their energy is moving through the fire phase of experience. This can be severe enough that energy stops flowing smoothly and organically through that element. The person will usually either obsessively dwell in fire or rigidly avoid it. For example the person may be promiscuous, laugh inappropriately (like while telling a sad story) or treat everything like a game. Conversely they might avoid games, laugh seldom and be sexually repressed.

When there are problems in the fire element it will usually show up in the body in the meridians and organ systems associated with that element, and also in the manifestations of fire in the person's body and mind. The distortion in fire will also effect the other elements. Thus the practitioner must be well trained and highly observant to discern what the root elemental injury is.

Most Chinese Medical acupuncturists emphasize the metaphors of the meridians, internal climate and city-state in their diagnosis and treatment. The Five Element approach is found less often, possibly because it requires great skill.

Next week: modern acupuncture.

Monday, 18 August 2014

Introduction to Chinese Medical Acupuncture 3: The Body as Microclimate and City

Continuing from yesterday's post, where we looked at the Meridians, today we will continue to look at the core ideas of Chinese Medicine. Today we will look at two more key metaphors in Chinese Medicine: weather and the city. 

The Body as Microclimate

To the Chinese the human person is a landscape. In any landscape the balance of climatic elements has to be just right for human comfort: not too much rain but just enough to keep the earth fertile and the air moist. Not too much heat but enough to keep the temperature comfortable and energy moving and transforming. The wind circulating at the right times but not too fiercely or out of season. It is the same with the "micro-climate" of the body.  

The human body can thus be understood as a climate. There can be excess heat (hyper-activity, inflammation, dehydration). There can be too little heat (hypo-activity, poor circulation, slow metabolism, poor digestion). There can be damp (oedema, unprocessed waste). There can be wind inside (tremors, spasms, mania, hypertension) and there can be "evil wind" from outside (viruses and pathogens). 

The practitioner of Chinese medicine feels the pulse, observes the tongue, skin, eyes, demeanour and more. They get a feel for the client's internal climate. Through  acupuncture and other tools like herbs, moxa and cupping (which we will briefly discuss later) they will bring the body back to homeostasis- pleasant and fruitful weather.

For example the acupuncturist may find that the patient suffers from an accumulation of cold and damp. They may needle points that warm the body, stimulate digestion and immune response, and/or stimulate circulation, peristalsis, diaphoresis and diuresis (drain damp through sweating, excretion and urination). 

The Human City

Ancient China was organized around "city-states" more than two thousand years ago. These cities were ruled by a sovereign who had educated ministers and an army. The city had a defensive wall around it to protect against invasion (the immune system). The city had agricultural areas (the digestion) which were irrigated by canals (water metabolism and the circulatory system). Nourishment was kept in storehouses (the organs and the blood) and all was ruled by the emperor and his ministers and generals (aspects of the body-mind). 

The ancient Chinese used this model to think about the functions of the organs in the human body. They created an extended analogy called "zangfu" (storehouses and channels) which is still used to this day (though modified by modern medical knowledge). 

A full description of the zangfu system is beyond the scope of this book. For our purposes I will summarize those aspects of the zangfu system which are most important for acupuncture and most important for patients to understand.

Each "organ" is understood to be a web of activities throughout the body which include, but are not limited to, the physical organ itself. For example the "kidneys" in Chinese medicine also include aspects of what we would call the reproductive, endocrine, adrenal and urinary systems, as well as aspects of cellular function and the functioning of the human genome! 

It is also essential to realize that each organ system has a particular affinity for an acupuncture meridian which influences its functioning. When an acupuncturist says that your kidney energy is low he or she may be referring to any aspect of this larger interconnected system and not to a problem with the kidney organ itself.  

The organs have psychic-emotional components as well as physical. The kidneys, for example, are associated with the deep store of personal will in a person as well as, pathologically speaking, problems with fear.  
Dysfunction in an organ system can lead to problems with immunity, blood circulation, mood, and many other problems which directly or indirectly impact the issues a patient may bring to an acupuncturist. Most acupuncturists will assess the state of the organ systems through interview, history taking, pulse taking and tongue analysis.

So when you go to see an acupuncturist they may diagnose you as having "spleen qi deficiency". In Chinese Medicine the "spleen" (pi) is the organ system which breaks down food, distributes it from the digestion to the body, protects the integrity of tissues and the circulatory system through moderating cellular metabolism, and energizes the integrity of the body-mind in subtle and holistic ways which manifest in strength and focus. The organ known as the spleen is a part of this system, but it also includes the functions of organs and tissues throughout the body. 

Someone with "spleen qi deficiency" may manifest fatigue, poor digestion, oedema, weight gain, and when extreme a sinking feeling in the internal organs. They may also bruise and bleed easily and have poor integrity to their tissues.

A Chinese medical acupuncurist may treat this by needling points on the spleen meridian and elsewhere that support spleen function.

Tomorrow: the elements. 

Tuesday, 12 August 2014

Know Your Points: GB 21 Jianjing (Well at the Shoulder)

The wonderful GB 21 is located on the shoulder muscle between the neck and shoulder joint. It is directly above the nipple, at the high point of the muscle, midway between the spine and the acromion.

This point's actions are mostly for relief of pain and muscular tension. It treats pain and rigidity of the neck and trapezius, difficulty moving the arm, and in general the common patterns of tension and neck pain that haunt our deskwork culture.

GB 21 also treats insufficient lactation and reduces inflammation of the breast tissue (mastitis).

Generally speaking GB 21 moves energy donwards. It can help treat too much energy up in the head as well as headaches and upper body tension.

This point is avioded in pregnancy.

Monday, 11 August 2014

The Meridians (An Introduction to Chinese Medical Acupuncture 2)

In my last post (here) I set out to begin describing the core ideas of Chinese Medicine. All of these core ideas share a conception of the human being as an interdependent and mysterious energetic system where all of the parts influence each other. The mind is not seperate from the body. It is not housed only in the brain but pervades the body. Thoughts and emotions literally circulate throughout the body and in a real sense the body itself "thinks" and "feels". Illnesses are always at once diseases of body and diseases of mind, although they may manifest more strongly in one or the other. 

A healthy body-mind is one which has integrity, vitality and strength. Energy flows within intelligently and freely. An unhealthy body-mind is one which is at war with itself, weakened, fatigued, and filled with confusion and obstructions to the free flow of energy. In order to attain the goal of a vital, strong body with a free and intelligent flow of energy the Chinese have created a number of ways of imagining and analyzing our inner workings. These ways consist of analogies with which the practitioner of Chinese Medicine attunes to the patient.

These analogies imagine the inner being as 1) a world of energy, intelligence and nourishment travelling through channels called meridians; 2) as a city; 3) as a climate; and 4) as rhythmic cycles of elemental transformation. These intersect with the ideas about energy flow and body mind unity mentioned above, as we shall see.

The Meridians

Ancient Chinese believed that nurturing channels of wind and water flowed beneath the earth. This became the science of feng-shui (wind-water) which originally determined where regions of particular fertility and power could be found and later became a total art of auspicious building and home design.

At a point unknown to us it appears that ancient Chinese healers began speculating about similar channels of wind and water in the body whose flow was necessary to health and vitality. They called human wind "qi" (chi) and human water "blood". Qi was and is best understood as a kind of intelligent energy. This is not as "new agey" as it might sound. When you cut your finger the body, with no help from you, knits back together your flesh so well that eventually you will not be able to tell there ever was a cut. Similarly your body identifies and fights off thousands of pathogens a day. Your body processes huge amounts of information, digests food, nourishes itself, and on and on. 

All of this is done by what? The Chinese keep it simple and call it "qi". Qi is an intelligent, self-regulating deployment of energy along specific purposive pathways. Along with the pathways known to western medicine (nerves, veins, tissues) the Chinese observed that qi flowed down other identifiable paths throughout the body that could be influenced by the insertion of metal needles. These pathways afford a subtle but effective way of regulating the health and healing of the body outside of pharmaceutical medicines and surgical procedures.

Acupuncture points are understood to be vulnerable points where the meridians can be influenced. In practice this influence can be both local and distal. In other words acupuncture points influence both their immediate environment and other parts of the body influenced by the meridian the point lies on. It is essential to realize that these effects are not based on theory but on observation: the Chinese have used acu-points this way for two thousand years because they brought patients benefits which could be predicted and repeated. 

How are illness and health imagined in the body? Find out next week: the body as a microclimate