Tuesday, March 6, 2012

The Nature of Ginseng

The most famous herb in the Chinese pharmacopoeia is Panax ginseng, or Ren Shen as it is called in China. Ren Shen translates to Man Root. Man in this case isn’t gender specific. The root resembles a human, or person.
Chinese herbs are defined by their properties and their functions. The properties of ginseng as follows: it is slightly warm in nature, sweet and slightly bitter. Many modern texts describe the temperature of ginseng as “warm”, however traditional writings suggest that the unprocessed nature of ginseng is actually slightly cool, and its warm properties arises only after it is processed.

Growth Environment

Wild ginseng grows in very thick forest. It doesn’t grow at the periphery of the forest, but deep in the mountains. This has less to do with its growth nature and more with the harvesting nature of mankind. To find wild ginseng, one must travel deep into the forest as all of the easily accessible ginseng found at the periphery of the forests have already been picked. The best places to find ginseng nowadays is in the North of China in Jiling, Liaonin, and north of Habei as well some parts of Korea. A good rule of thumb is to look to Northern China where it is cold enough for the ground to freeze in the winter.
Ginseng likes cold, dark and wet weather. Heat, too much light, or not enough moisture will kill it. It is very picky as to the quality of soil in which it will grow. It prefers deep loose soil that extends downward very deeply. It requires humus, or topsoil rich in nutrients of decomposing leaves from neighboring trees. It also prefers water that passes through the soil, rather than stagnating around the root.
Cultivated ginseng is grown on farms in the Northern parts of China and Korea. The environmental needs of this ginseng is the same as wild ginseng, however man-made shade is substituted for the shade of the dense forest.
Ginseng blooms in early summer. It has very tiny flowers that are light yellow and green. After the flower passes, the plant bares a deep red berry. The berry is ovoid, not exactly round.
Wild ginseng is harvested in May and June. It is difficult to find at the end of the growth cycle at the end of the summer, perhaps this is because the blooms and berries are still visible in May and June whereas at the end of summer, they are not. Because of its preciousness, the root is cleaned with a tool made from bone because tradition teaches that ginseng is “afraid of metal” and bone does not frighten it.
Cultivated ginseng is harvested in September and October, at the end of the growth cycle. It requires at least three years of growth before being harvested.
The best quality ginseng has a longer and thicker root. Also, a longer head of the root denotes better quality ginseng. The heavier the better. After the ginseng has been processed, weight is no longer indicative of its quality.
Wild ginseng is very large and big. It is juicy and full of liquid. The wrinkles in the head of the root that are small and compact indicates a better quality herb than ginseng with wide and thick wrinkles on the head. A longer head is better than a short one. The more pearls on the beard roots the better.
Siberian ginseng is a commercial crop from Siberia, just north of the north of China. It has similar attributes to cultivated Chinese ginseng.

The Nature of Ginseng

Ginseng takes its virtue (energy) from heaven growing in the highest mountains. It also pulls in the virtue of the earth, because it requires very deep and rich soil. With these two energies, it gives rise to the “tian de ren” or the virtue of man. Ginseng’s energetic personality contains the same three virtues as man which are heaven, earth and man.
Yin Yang Theory and the Law of regulation
Yin energy likes the Yang environment. Yang environments would include high altitude locations, scanty rainfall, warm, dry, and bright surroundings. Yang energy likes Yin environments. Yin environments would include low elevation locations, moist, cool or cold temperatures, darkness or shade. Ginseng’s growth environment is both Yin and Yang in nature.
Ginseng only grows in the deep forest. It doesn’t grow exposed on the planes. This growth tendency belongs to Yin, but ginseng also prefers high elevations and this is a growth tendency that belongs to Yang. That’s why we say that Ginseng is Yang within Yin. Because ginseng has both a Yin nature as well as a Yang nature in its growth environment it can tonify both body fluids (which is Yin in nature) as well as Qi (which is Yang in nature).
Ginseng grows in a cold and slightly moist environment. It develops attributes opposite to these qualities while at the same time, absorbs these qualities as well. This is why we can call ginseng’s raw form Yang within Yin. The moist, slightly cool energetic resonates with the nature of the Spleen which is an organ that tends to be on the cool and moist side. That is one reason the Spleen can easily suffer form cold and/or dampness as a pathology.
The color of Ginseng is a yellowish white. This indicates that the first Zang organ affected is the Spleen and the second is the Lung. The taste is sweet and it has a moist, slightly cold quality in it’s unprocessed form having absorbed those energies from its growth environment.
The herbal classic “Shen Nong Ben Cao Jing” says that Ginseng tonifies all five Zang organs. We cannot dispute this thought, but believe that there is an order in which the ginseng tonifies. Ginseng works first on the Spleen because the environment in which it grows is metaphorically similar to the spleen; cool and moist.
Ginseng begins by warming and tonifiying the Spleen which ends up pushing liquids up to the lungs, this according to Zang Fu theory as well as the flow of energy in five element theory. The Lungs, which are the mother of the Kidneys, can send the Qi downward there to be stored. Again, this holds true in both Zang Fu theory as well as the mother-child relationship in five element theory. When the Kidney is tonified, it can produce Yin to nourish the Liver, and Heart. So ginseng can tonify all five Zang organs, but it is an indirect tonification. It directly enters the Spleen and Lungs and secondarily the other three Zang organs.
Another reason that ginseng has the ability to tonify all five Zang organs is that it takes years for ginseng to be ready for harvesting, it receives energy from each season and develops a very complex energetic nature. It includes energy from all four seasons which resonate with the five Zang.

Ginseng preparation techniques

  1. Ren Shen (Cultivated variety)
    1. Red ginseng, its color is brown and red. It is slightly transparent. After cleaning the raw root, it is steamed two to three hours, then oven or sun dried. This is the most common variety of ginseng. The body’s length runs form 5 to 20 cm. It’s diameter is 0.7 to 2.0 cm. Its smell is very pleasant, with a slightly bitter taste.
    2. Bian Tao Shen, (Long Edge Ginseng) Similar to Red Ginseng in color and quality. It is longer than red ginseng with a greater diameter. Its branches, too are longer and wider. This suggests a better quality medicine than red ginseng.
    3. Tang Shen (Sugar Ginseng) First the ginseng is placed into boiling water for 3 to 7 minutes, then placed into cold water right away to soak for about 10 minutes, then sun dried. Liu Huang (sulfur) is burned beneath the ginseng to smoke the ginseng. The essence of the Liu Huang (sulfur) passes into the ginseng via the smoke. This is likely a preservative for the ginseng to keep it free of worms. A special needle to puncture tiny holes in the root is used. The ginseng is placed into a highly concentrated sugar water for more than twenty-four hours. Then the ginseng is placed under direct sunlight to dry it out. After the ginseng is dried, it is beaten with a wet towel to soften it. The process is repeated though more holes are not punched into the herb. Once the ginseng has been in the sugar water again for twenty-four hours it is rinsed off and sun, or oven dried. The color becomes a lighter yellow/white. The length is from 3.5 to 12 cm. The diameter is from 0.6 to 2.0 cm. The smell is pleasant. The taste is sweet and slightly bitter.
    4. Bai Ren Shen (White Man Root) This is a kind of sugar cured ginseng. Its quality and shape is very similar to sugar shen. Most of the time it has a good shape (straight) that is very white. It is longer than Red Ginseng. This Ginseng’s beard (the long hairy roots at the end of the branches) is short, but very brittle.
    5. Sheng Shai Shen (Raw Sundried Shen) Of course, this kind of ginseng, is washed until clean and then partially dried by placing beneath the sun for one day. (One full day of sunshine. Very clear, brilliant sunshine is best to really absorb that Yang energy.) The next day, it is smoked with Liu Huang, probably for its preservative properties. Finally, the sun drying process is repeated until the herb is completely dried. The color of the end product will be yellow-brown, mostly yellow, a little brown, crisp and light, the smell is pleasant, the taste is bitter.
    6. Bai Gan Shen (White Dry Shen) The superficial skin of the ginseng is scratched off. When this happens, the color becomes a lighter yellow or white. The quality and shape of this herb is similar to Shang Shai Shen.
    7. Qia Pi Shen (Strangled Skin Shen). The method of preparation is similar to Tang Shen. Ginseng is placed into boiling water for three minutes. The herb is removed until its cold, then replaced into the boiling water. This process is repeated three times. At this point, the ginseng will be thirty percent done. Next the ginseng is put into boiling water for twenty minutes. After it cools, tiny holes are punched into the root like Tang Shen. Next the ginseng is placed into slightly sweetened sugar water. This water isn’t as thick and sweet as what is used for Tang Shen. After the herb has soaked, it is removed and oven dried. This will cause the skin to separate from the body of the root. A bamboo knife is then used to make small indentations into the root, very superficial. The smell is pleasant, the taste is slightly sweet and slightly bitter as is typical of ginseng.
    8. Da Li Shen (Great Force Shen) Fresh, raw ginesent is rinsed for several seconds and then dried very well beneath the sun. (As many days as necessary to fully dry the root.) This is the most natural form of ginseng. This kind of ginseng is not often exported because it has a short shelf life. It has the strongest medicinal effect and is the least prepared. The body length is from 5 to 15 cm. It has a slightly yellow color and is slightly transparent. The beard and branches are cut off to leave only the best part of the ginseng, however the head is left on for consumers to better assess the quality of the herb. The physical properties of this root is hard and crisp. The smell is pleasant, the taste is bitter.
  2. Ye Shan Shen (“Wild Mountain Grown Ginseng”)
    1. The shape looks like cultivated ginseng. The body of the root is wider and shorter. Usually there are two major branches in the body which allows the root to look like a body with two legs. In the head one will find numerous concentric wrinkles. The legs tend to be curved, not straight like cultivated ginseng. The root’s beard (small roots) are much longer than cultivated ginseng. The beard extends one or two times the length of the “legs” of the root. The beardy roots also have pearly spots on them. These pearly spots is the biggest difference between wild and cultivated ginseng. Wild ginseng’s color is a light yellow. The skin of the root is very soft. It’s natural smell (before cooking) is stronger that cultivated ginseng. It is sweet, with a slight bitter quality.
    The preparation procedures for wild ginseng follow the three following methods. See above for details.
    1. Sheng Shai Shen
    2. Tang Shen
    3. Qia Pi Shen
  3. Korean Ginseng:Korean Ginseng of course grows in Korea. It too, comes in both Wild and cultivated varieties. The more Northern, the better the quality, though it is grown in the South as well. Bei Zhi Shen (“fork in the straight road root” probably named such because the shape of the herb is a little bigger and the legs resemble a “Y” in the road.) These herbs are bigger and have a stronger tonification function.
    Production: There is Korean Red Ginseng and Korean White Ginseng. Red is stronger than white. Preparation is the same as Chinese Ginseng.
  4. Siberian ginseng (this refers to the ginseng that grows naturally in Siberia which is known in Latin as eleutherococcus senticosus.)Siberian ginseng’s function is very similar to Chinese and Korean ginseng. It usually has a warmer energetic temperature than Chinese or Korean ginseng. Information on ginseng distinct to Siberia is somewhat lacking because up until very recently, ginseng wasn’t really divided up by the location of its production. This is a more modern differentiation.

Clinical Applications

Ginseng used in formulas that tonify
Spleen or Lung Qi Deficiency: Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction), Si Jun Zi Tang (Four-Gentleman Decoction).
Spleen or Lung Qi Deficiency with cold: Wen Wei San (Warm the Stomach Powder) (Ingredients are Ren Shen (Radix Ginseng), Fu Zi (Radix Aconiti Carmichaeli Praeparata Lateralis), and Gan Jiang (Rhizoma Zingiberis Officinalis)). It should be noted that in ancient times, powder was not the dusty or sandy quality substance we now think of as powder. A better translation might be “very finely diced herbs” which are simply added to boiling water and steeped while in the drinking cup.
Lung Qi Deficiency with Chronic Cough: Ren Shen (Radix Ginseng) with Lu Jiao Jiao (Gelatinum Cornu Cervi).
Lung and Kidney Qi Deficiency Chronic Cough: Ren Shen Gou Qi Tang (presumably Ginseng Lycii Decoction)
Heart Spirit Not Calm: Tian Wang Bu Xin Dan (Heavenly King Tonify Heart Refined Pill) In this formula, ginseng calms shen.
Injury to both the Qi and body fluids: Sheng Mai San (Generate Pulse Powder) Ginseng Tonifies Qi and fluids.
Injury to both the Qi and body fluids: Bai Hu Jia Shen Tang: (White Tiger Plus (Ren) Shen Decoction) (Bai Hu Tang + Ginseng.) Especially good for post febrile disease in which the Qi and fluids have been injured.
Yuan/Source Qi Deficiency and Failure: Du Shen Tang. It is just one ingredient, Ren Shen but a big dosage giving rise to a very thick soup. Good for the condition following a severe loss of blood, vomiting, or diarrhea. Tonifies Yuan Qi. Shen Fu Tang (Ginseng, Fu Zi, decoction) Can be added to tonifies both the Yang and Qi.
Qi and Blood deficiency: Ba Zhen Tang (Eight Treasures decoction) Tonifies Qi to produce more blood.
Qi and Blood deficiency: Zhi Gan Cao Tang (Baked Licorice Decoction), used for deficiency of Qi and Blood with palpitations.
Qi and Blood deficiency: Tai Shan Pan Shi San (“Mount Tai” Solid Rock Powder) Tonifies Spleen Qi and nurtures Blood to avoid miscarriage by calming the fetus and solidifying the pregnancy.
Ginseng used in formulas that tonify righteous Qi to expel evil Qi
Wind-Cold Damp with Qi deficiency: Ren Shen Bai Du San (Ginseng Powder to Overcome Pathogenic Influences)
Summerheat with Qi deficiency: Qing Shu Yi Qi Tang (Clear Summerheat and Augment the Qi decoction)
Constipation due to deficiency of Qi and Blood: Huang Long Tang (Yellow Dragon Decoction)
Constipation due to Spleen Yang deficiency leading to cold and stagnation in the Large Intestine: Wen Pi Tang (Warm the Spleen Decoction)
Ginseng used in formulas that harmonize
Ginseng is used for “he”, one of the eight traditional treatment principles. It is used to regulate and harmonize. It regulates the Shao Yang syndromes, Zang and Fu organs, Liver and Spleen, Stomach and Large Intestine, and fever and chills in malaria.
Shao Yang Disease: Xiao Chai Hu Tang (Minor Bupleurum Decoction)
Stomach and Large Intestine Cold and Heat: Ban Xia Xie Xin Tang (Pinellia Decoction to Drain the Epigastrium) For fullness and bloating in the epigastrium. Especially good for vomiting. Not strong enough for pain.
Heat above, cold below: Huang Lian Tang (Coptis Decoction) Used to regulate the Stomach and Large Intestine, better for upward symptoms or exterior symptoms combined with stomach/colon disharmony. Another indication is abdominal pain and vomiting.
Qi deficiency with Yang Ming excess: Huo Jiang Ban Gan Shen Tang (Magnolia, Raw Ginger, Pinellia, Licorice, Ginseng Decoction) Used for gas and bloating of the abdomen due to Spleen Qi Deficiency with stagnation in the Stomach and Large Intestine.
Shao Yang disease leading to Qi and Blood deficiency: He Ren Yin (Polygoni Ginseng Beverage)
Ginseng used in formulas that clear away evil Qi while tonifying Righteous Qi
Stagnation of food, Qi, and Blood: Zhi Shi Xiao Pi Wan (Immature Bitter Orange to Reduce Focal Distention Pill) In this formula, ginseng helps the digestive function by tonifying the Stomach and Spleen. It is used for food stagnation, and “Ji” (Long-term accumulation of stagnated food, blood and Qi.)
Qi stagnation in the hypochondrium: Bie Jia Jian Wan (Carapax Trionycis Boiled Pill) Used for stagnation of Qi and blood in the Spleen and Liver. Used for hypochondriac enlargements such as splenohepatomegaly.
Ginseng used in formulas that regulate of rebellious Qi
Rebellion of Stomach Qi due to deficiency of Stomach Qi: Xuan Fu Dai Zhe Tang (Inula and Haematite Decoction) Used for Vomiting, belching, bloating or gas due to Stomach Qi deficiency with turbid mucus. In this formula, ginseng tonifies the stomach.
Rebellion of Stomach Qi with heat: Ju Pi Zhu Yu Tang (Tangerine Peel and Bamboo Shaving Decoction) Used for chronic sickness that makes the stomach Qi weak, plus heat in the stomach with belching, vomiting and other rebellious Stomach Qi indications.
Rebellion of Stomach Qi with cold: Ding Xiang Shi Di Tang (Clove and Persimmon Calyx Decoction) Used for hiccups, vomiting, and bloating due to Stomach Qi deficiency with cold.
Rebellion of Stomach Qi due to Liver attacking: Si Mo Yin (Four Milled-herb Decoction) Used for deficiency of Qi which provides the opportunity for the Liver to attack the Stomach leading to nausea and vomiting.
Ginseng used in formulas that regulate Blood
Cold in Ren and Chong meridians: Wen Jing Tang (Warm the Channels Soup) Used for Chong and Ren deficiency allowing cold to stagnate Blood and cause irregular menstruation. In this formula, ginseng tonifies Qi to produce more Blood.

Dosage and cooking instructions

Regular dosage is five to ten grams.
It is better to cook ginseng separately from the rest of the decoction over a lower flame, simmered for thirty to sixty minutes. When the other medicine is prepared, add the ginseng decoction into the rest of herb decoction. Ginseng needs to cook longer to take full advantage of its tonification properties, the longer time is required to steep out all of the active ingredients, and the price of ginseng is such that cooking it separately is more economical.
Another way to use ginseng is to grind it into a powder, or put the powder into a capsule to take everyday. If you just want to take Ginseng alone, the powdered form is okay. Add powder to hot water and drink. If you make ginseng powder, 1-2 grams each dose, 2 or 3 times per day.
If you’re treating a severe or acute problem in an unconscious patient, a larger dosage of 15 to 30 grams is indicated. Make a decoction to put into a feeding tube, or slowly feed the sick person’s mouth to elicit a swallowing reflex to send the tea down the throat.
For some people who only need slight tonification, they can take the regular powdered dosage of 1-2 grams every third, fifth or seventh day. Odd numbered days, or odd number intervals are considered an expression of Yang as odd numbers are Yang and even numbers are Yin. Yang would be tonifying in nature.

Contraindications

Ginseng works against Li Lu (Radix et Rhizome Veratri), they are incompatible.
Ginseng is afraid of Wu Ling Zi (Excrementum Trogopteri seu Pteromi). Ginseng’s “fear” is to say that Wu Ling Zi will lessen the effect of ginseng, but not completely neutralize it.
Ginseng hates Zao Jia, and Jian Lu. Hatred in herbal terms suggests that ginseng will neutralize the effects of Zao Jia and Jian Lu.
When taking ginseng it is better not to eat turnips. The turnip may interfere with the effectiveness of the ginseng.
To avoid the appearance of heat signs or symptoms when one takes ginseng, you can add Tian Men Dong (Tuber Asparagi Chochinchinensis), or Sheng Di Huang (Radix Rehmanniae Glutinosae) to the ginseng decoction.
In some individuals, those with interior excess conditions or severe deficiency conditions, ginseng may create some abdominal bloating. To avoid bloating, add a small dose of Chen Pi (Pericarpium Citri Reticulatae) or Sha Ren (Fructus Amomi) to your ginseng tea.
Make a decoction out of Lai Fu Zi (Semen Raphani Sativi) in the case of severe bloating due to ginseng overdose. Lai Fu Zi (Semen Raphani Sativi) is antagonistic to ginseng and will act to diminish the bloating for this reason.
Some classical herb books say that Fu Ling (Poriae Cocos) is a good guiding herb for ginseng, as it works as an envoy to lead to the Spleen, Heart and Lungs.
It is wise not to use ginseng for heat, excess syndromes or with symptoms of toxic heat (infection).


Sciatica Treated by Acupuncture and Chinese Herbs

I get many letters from people reading this article who want to know what points to press or how to press them. It is difficult to answer this question briefly, but I can say that if you want to simply mash your thumb into any location on the lower back or leg that is sensitive along the trajectory of the sciatica pain, you’ll be helping the problem. Don’t push so hard that it causes a bruise and don’t do it so hard that it makes you cry. Just a little pain is really what you want to shoot for. Use the thumb for points on the legs. For tender points on the buttocks, you’ll want to use your elbow to get in there deeply. More likely you’ll end up using someone else’s elbow, but I’ll leave that up to you. Hold down each point for two minutes.
Now, let’s go a little bit deeper into how acupuncture and herbs benefit sciatica pain.
The causes of sciatica
From the biomedical perspective, the cause of sciatic nerve pain is generally considered structural in nature. Whether it is the bones in the spine, the discs between the spines, or even the muscles in the buttocks, each scenario includes some sort of mechanical irritation to the sciatic nerve which exits the spinal cord in the lower back and travels down the leg into the foot.
From the perspective of traditional Chinese medicine, we look at the pain as one of a number of problems.
Sciatica pain that is aggravated by cold or damp weather.
Sometimes cold or damp qi-energy can get into the acupuncture meridians and cause a dull, heavy pain that radiates along the trajectory of one of the meridians from the lower back to the heel, or anywhere in between. This kind of sciatica is aggravated by cold or damp weather. In fact, many aches or pains that are aggravated by cold or damp weather are considered to be the same problem. Many arthritic conditions fall into this category.
Along with acupuncture, moxibustion is often used for this sort of problem. Moxibustion is the application of heat to the meridians or acupoints. Traditionally, the herb Ai Ye (mugwort) is used in the shape of a cigar with the hot part focused on the part of the body that hurts. Moxa comes in many shapes and sizes. The “cigar” style is popular in American clinics, but again it varies widely. Some clinics favor the use of heat lamps or TDK lamps which are a metal plate that radiates heat.
Another weapon against sciatica that is aggravated by cold or damp weather is an herbal formula that is said to be warm and dry in nature. That will help with any pain in the muscles, nerves or joints that is aggravated by cold and/or damp weather. Du Huo Ji Sheng Tang is its name. It tastes something like a cross between hot coffee and Vicks’ Mentholatum.
Sciatica is worse in the evening, better in the morning and aggravated by fatigue.
Another cause of sciatica is called a deficiency of the Liver or Kidney. That doesn’t mean that there’s anything wrong with your liver or kidney from a biomedical perspective. I capitalize the words Liver and Kidney to remind the reader that I’m really talking about different concepts than the usual organs we think of. Fortunately, it doesn’t matter what we call it. The important thing is that we can make you feel better and in the case of a Liver and/or Kidney deficiency we most certainly can help. The only problem with treating deficiency syndromes is that they can take longer than some of the other causes of sciatica. One way to determine if your sciatica is due to deficiency is if the pain is aggravated by fatigue. Deficiency syndromes tend to have a slow onset and a long duration which is to say that this sciatica is a chronic or long-term condition, not something that just popped up one day.
I have some patients who have responded very well to herbal medicines for sciatica that is aggravated by fatigue. Its good to know exactly what is deficient before treating this. Generally the deficiency is going to be one of the four key substances in Chinese medical theory. Qi, Blood, Yin or Yang. Knowing which is the best way to treat this. However lacking the ability to get a diagnosis, it is the next best thing to get the herb formula that most often applies to this sort of sciatica pain. It is called Jin Gui Shen Qi Wan. You’ll notice that it includes the word “Qi” in its name. Guess what its for? Qi primarily but it can also help with the Yang as they’re related. This formula is about 1,800 years old.
Sciatica pain that is worse in the morning and aggravated by sitting still.
The final factor that can give rise to sciatica really is structural in nature. We call it a stagnation of blood due to local trauma which is to say that you pulled a muscle, or you hurt yourself in a car accident, or maybe you have poor posture and you’re sitting in a chair without enough padding on it. Certain structural issues such as bulging disc can fall into this category too.
Something structural is pinching or irritating the sciatic nerve. This could also be muscle spasms are pinching your sciatic nerve as it passes through the butt region. This is a common cause of sciatica, but as you can see, it is one of three possible causes for your sciatic pain. If this is the cause of your sciatic pain, it will probably help to move around. The pain will be worse in the morning because you haven’t moved much in the night and since the problem is all about a lack of movement of qi energy or blood, the fact that the leg hasn’t moved all night will aggravate that condition of stagnation. Movement or activity will help with this kind of pain. This cause of sciatica is the most responsive to acupuncture and responds the quickest to treatment.
An herbal formula often applied to this issue is called Shao Yao Gan Cao Tang. It is used specifically for when you have tight muscles in the lower back or hip/buttocks. Its action doesn’t affect the nerve directly, only the muscles around the nerve. This particular formula has a lot of gan cao in it. That’s licorice root and with long-term use it can cause a rise in blood pressure because it lowers the urinary output just a bit. If you have hypertension, only take this formula if you have the means by which you can monitor your blood pressure. For the rest of us, it should be fine as is.
When the sciatic pain is worse in the absence of movement, we can assume that there is something stuck causing the pain. The difference between qi stagnation and blood stagnation can be thought of as the difference between a pinched nerve due to tight muscles and a pinched nerve due to a bulging disc. There’s a lot of overlap there and even in Chinese medicine the line between qi and blood stagnation isn’t always that clear. Fortunately, when it comes to treating the pain, it doesn’t really matter.
Treatments
Acupuncture
Fine needles, some so thin as to appear more like wires than needles, would be inserted along the pathway of the pain to move the qi energy locally and dissipate the external pathogen as well as activate the movement of the qi energy to remove the pain. Sometimes other points in the body would be used to treat the damp or cold or wind that may have spread out into the rest of the body in addition to the Urinary Bladder meridian.
Electric stimulation (“electro-stim”) can be used on the needles that pass through the leg to provide an even greater amount of stimulation. Electro-stim is a more recent invention applied to acupuncture. While the treatment principle is not at all “traditional Chinese medicine”, it is a commonly used tool within the acupuncture clinic. The reasoning is that with minute pulses of electricity, the local nerves are over stimulated, not with pain, but with a painless electrical shock. This over-stimulation makes the nerves turn down their own sensitivity, and hence, all the other pain that travels through those nerves is also diminished. This is the basis behind acupuncture anesthesia, and this principle applies to sciatica as well.
Ear Acupuncture
Ear Acupuncture can be used for additional assistance in treating the pain associated with sciatica. Once the needles are removed, seeds can be taped into the ears so as to supply on-going stimulation to these points. These seeds or even magnets can be worn for a few days at a time. Of course, care should be given to the condition of the ear’s skin so as to avoid any infection caused by dirt or moisture collecting beneath the tape used to affix the ear seeds. There are a number of products that your acupuncturist will have access to that make use of flesh color tape, not unlike the flesh color Band-Aid bandages. These pieces of tape needn’t look funny in your ears.
In the past, subcutaneous needles have been used instead of ear seeds. Subcutaneous needles are like tiny thumbtacks. They are also effective, but because the skin is broken, and often times, the needles are not changed everyday, the risk of infection increases. For this reason, I don’t personally suggest this treatment. However if you’re in a position to change the little subcutaneous needle everyday and clean the ear, then they can be an effective adjunct to acupuncture for your sciatica pain.
Qi Gong (Chi Kung)
These exercises direct the qi in the body toward the area of the body where the qi energy is either deficient or stagnant. Personally, I think that qi gong exercises and acupuncture have something in common. In qi gong training, it is said that the shen leads the qi. That means that if you’re doing an exercise in which you are focusing your mind (shen) on your lower back, then the qi goes there, and healing takes place. Acupuncture performs the same function. The funny thing about having a needle stuck into your back is that you think about it. You’re acutely aware of it. It forces the mind to become conscious of that area, and so the qi is led to that area. Qi gong exercises are used in between acupuncture treatments.
Qi gong is about as close to yoga as the Chinese get. Like yoga, there are hundreds of kinds. Some qi gongs move, some stand still, some sit, some stand. Some require superhuman patience and strength; others only require a little mental focus.
External Qi Gong
Sometimes, your practitioner will apply qi to your body from his or hers by placing his or her hands onto your body. Often times, their hands will be very warm, signifying that they’ve successfully directed their own qi energy into their hands for “expression” into you.
As with any therapy that requires touching, it is absolutely essential that you feel comfortable with the treatment. If you don’t, your muscles will tighten up and the therapy will produce negative effects. You don’t want that. If you don’t know how you feel about being touched with either external qi gong or even massage, your body will tell you. A muscle tightening up beneath the pressure of a therapist is called a guarding response. Your body is guarding itself from further injury. If your body senses the opportunity for further injury due to the activities of your practitioner you need to honor that body knowledge. Your body’s really smart, and regardless of how much you like the practitioner, or believe in his or her medicine, your body has the last word, and if it doesn’t like what’s happening, then it is best to listen to your body’s wishes.
If you’re uncomfortable with this type of therapy, please tell your practitioner. On the other hand, if you are comfortable with it, you’ll find that with the right practitioner, this can be among the most significant and moving of all therapies. This technique of external qi gong can certainly begin to look much like the more Christian “laying on of hands” and can have some truly divine manifestations in your life.
Chinese Massage or “Tui Na”
Massage therapy for sciatica can’t be underestimated. At the Chinese hospital (from which I’m actually writing this article) there is a department that does nothing but massage chronic, bed-ridden sciatica patients. The massage therapy is given for twenty minutes, once per day. Along with the other therapies listed in this article, I’ve seen patients undergo life-saving changes. Where one patient was literally carried in by family members, a couple of weeks later, he’s walking on his own, with much less pain, obviously.
Massage therapy usually requires daily sessions. Shiatsu, Anma and the other Oriental message techniques are also valuable. There are a variety of western massage techniques that can also assist, but I’m unable to really assess them in this article. Again, have a treatment and your body will tell you if you liked it or not.
Conclusion
Traditional Oriental medicine has been treating sciatica pain as far back as anybody can remember. While TOM identifies a variety of causes and treatments for the variety of issues that can cause sciatica pain, it should be noted that evolutionarily speaking, we haven’t been standing upright so long as to work out all of the kinks. In another thousand generations this entire issue may be a long distant concern as we’ll have likely developed the necessary structural changes to support our upright body. Until then, we’ll have to look to the distant past for non-surgical, holistic, and safe therapies for sciatica pain.

Acupuncture Anesthesia ii

These are the acupuncture anesthesia protocols of Dr. Wen, hospital anesthesiologist at the Yunnan Province Hospital of TCM, Kunming China.We never really know when Dr. Wen will be beeped next. He’s our translator at the Yunnan Province Hospital of Traditional Chinese Medicine. This hospital does more than TCM, it does a great deal of Western medicine as well, and that includes surgeries.
anes1 Acupuncture Anesthesia
Al Stone inserting a needle into LI 4 to calm anxiety.
That’s when Dr. Wen is called in, he’s an anesthesiologist trained in both the Western methods as well as the traditional ways of acupuncture. This article will more than likely continue to grow through the beginning of February, 1988 when my time with Dr. Wen and the Yunnan Hospital will come to an end. Until then, whenever acupuncture anesthesia is used, I’ll add the protocol to this article and by the time February rolls around (if it hasn’t already) there should be some great information here. Hope it doesn’t put you to sleep.

Orthopedic Surgery On Elbow


A woman in her 60′s presented with a fractured ulnar olecranon. The surgery would include the placing of some nails and other hardware into her olecranon to fasten it more securely to the shaft of the ulna.
Due to her advanced years, it was decided that acupuncture anesthesia would be used instead of Western drugs to avoid any possible adverse reactions.
One half hour before the surgery, while the prep was taking place, we inserted two needles into the patient. One, at Heart 1, and the other at Large Intestine 17. The reasoning for this was to over stimulate the brachial nerve. These two locations are on either side of this nerve and with the additional of electro-stim, we could stimulate the nerve into submission.
Neither needle was inserted too deeply. Just enough to tape down to the patient and get the electro-stim leads securely fastened. Heart one, was taped down along the anterior cubital crease since there would be a certain amount of movement in the arm during the prep for the surgery. Large Intestine 17 was also taped down, though its placement was really designed for the patient’s comfort rather than any other consideration.
The electro-stim began at 100 Hz at a somewhat low setting of amplitude (or “strength”). The patient could feel the tapping of her muscles, but we didn’t really go much further than that. Immediately, there was an anesthesia reaction in her arm. This being tested with a neurological testing needle. This setting didn’t change for the half hour prior to the surgery. The idea being at this point to simply stimulate the body into secreting endorphins. We’re really not yet trying to over accommodate the nerve, even though that is exactly what happened.
Once the surgery began, the patient complained of some discomfort and we turned the strength of the electro-stim up from “1″ to “2″. The idea isn’t to double the amplitude, but to simply turn it up to induce the anesthetic response of the nerve being effected.
We also turned down the frequency form 100 Hz to 50 Hz. The reasoning being that altering the frequency would prevent the nerve from getting used to the stimulation and thus ignoring it.
The controls didn’t once change after the surgery began. The surgery lasted about 45 minutes and went off without a hitch. After the cut was sutured and the nurses were cleaning up the patient, we removed the needles. The patient was in good spirits.

Orthopedic Surgery On The Patellar Ligament


A man in his thirties was to have his knee cap repositioned. One of the tendons holding the knee cap in place had been damaged and so the knee cap had descended to below where it should normally be due to the other muscles pulling it out of position. Acupuncture anesthesia was chosen for this surgery. No drugs were employed.
One half hour prior to the surgery, Spleen 11 and Liver 10 were needled on the leg in question. These two points were attached to an electro-stim machine and we slowly turned up the voltage until there was muscle contraction. Then we rolled back the voltage to just below that point. The stimulation was constant at 100hz.
The needles’ handles were bent to be taped down with surgical tape.
Other points used, also on the same side as the surgery, were Pericardium 6 and Large intestine 4. Again, they were taped down and attached to an electro-stim machine.
The two points on the leg were used mostly to stimulate the tibial nerve, which is the one that would be most effected by the surgery. The two points on the arm had a dual purpose of adding additional endorphin release, as well as calming the Shen (spirit, anxiety), which means calming the patient’s emotional experience of the surgery.
After one half hour, while the rest of the surgical prep took place, we changed the stimulation of the leg points to a mixed stimulation. For one second it was 100hz. And the next second the frequency of the stimulation was 18hz. The two arm points remained unchanged as to their electro-stimulation.
The reasoning behind this was to prevent the tibial nerve from accommodating to the stimulation thus rendering the anesthesia ineffective.
One half hour later, again, the electro-stim was altered on the leg points to an intermittent wave, meaning one second of stimulation at 100k, and one second of no stimulation. The same nerve accommodation reasoning applied here as well.
The surgery went off without a hitch. Afterwords, the patient, who had been fully conscious throughout the entire surgery, was in good spirits and very calm.
This surgery took place surrounding the patella. For surgery that involves the lateral aspect of the leg, the leg points used are Gall Bladder 30 and Urinary Bladder 30. The arm points are the same as in this surgery.

Visit also : Acupuncture Anesthesia
http://acupunctureforall.blogspot.in/2011/05/acupuncture-anesthesia.html

The Treatment of Bell’s Palsy with Acupuncture and Chinese Herbs

TCM therapy has shown some effectiveness in treating the condition both empirically and within clinical trials. This case report introduces a 30 year old male presenting with a typical case of Bell’s palsy. His treatment is currently ongoing and is showing gradual improvement. This case report will also outline current medical knowledge regarding the condition and present treatment protocols from both conventional medicine and traditional Chinese medicine perspectives. It is hoped that this paper will serve as a useful practitioner resource as it will outline effective protocols from both clinical trials and prominent Chinese hospitals. This paper may also provide an educational opportunity for western medicine practitioners seeking to direct Bell’s palsy patients toward an effective and safe therapy option. The importance of prudent management from primary care physicians in addressing viral aspects of this condition will also be stressed. Furthermore, this paper endeavors to encourage further research into the efficacy and safety of traditional Chinese medicine therapies for Bell’s palsy.

Epidemiology

Bell’s palsy or idiopathic facial paralysis is a disease caused by inflammation of unknown origin affecting the facial nerve resulting in acute paralysis of one side of the face. The condition may cause considerable emotional distress because of its characteristic appearance drooping appearance around the eye and mouth thus adversely effecting self-esteem and life experience. Bell’s palsy is seen in approximately 2 to 3 people per 10,000 and may resolve by itself within a few months with severe cases taking up to one year. Unfortunately, up to 10% of patients will experience some degree of permanent paralysis. Conventional treatment includes corticosteroids, antiviral agents, massage, painkillers, botulinum toxin and surgery.
The incidence rates of Bell’s palsy are similar around the world and range between 20 to 32.7 per 100,000 at any one calendar year (Brandenburg and Annegers 1993; DeDiego, Prim et al. 1999; Peitersen 2002). The condition affects similar numbers of males and females and exhibits seasonal variation of incidence with fewer cases in warmer weather (De Diego, Prim et al. 1999). The greater majority of Bell’s palsy patients first noticed their palsy in the morning which suggests that the onset and development of facial palsy occurs during sleep when circulatory dynamics are reduced (Kanoh, Nomura et al. 2005). The right side of the face is affected more often than the left (63%) and diabetes as well as pregnant females in the third trimester exhibit increased incidence (Ahmed 2005).

Aetiology

The facial nerve enters the skull via a small opening in the petrous temporal bone at the base of the skull. The facial nerve services the muscles of the face, the ear, salivary and tear glands and provides some of the sensations of taste on the tongue. In Bell’s palsy, the facial nerve swells and the resulting inflammation disrupts the relay of nervous system messages by nerve compression and degeneration. The subsequent lack of nerve function can be partial or total and mainly prevents facial movement, though salivation, tear production, and facial sensation may also be reduced (Kasse, Ferri et al. 2003). A diagrammatic pathway of the facial nerve has been included as appendix A.
It is hypothesized that the inflammation and swelling of the facial nerve may be caused by combined vascular, infectious and immunological reaction. Numerous infectious agents have been considered including: herpes simplex virus (HSV), influenza virus, varizella zoster virus (VZV), cytomegalovirus, Ebstein-Barr virus, tuberculosis, mumps virus, lyme disease and hepatitis B virus. Of these, herpes simplex virus (HSV) is the most commonly accepted due to consistent serological evidence and is implicated as the etiologic agent in greater than 70% of cases (Billue 1997; WUSM 2005).
It is thought that the HSV virus enters the body through a mucous membrane or skin abrasion and is transported to nerve cell bodies in nerve ganglia where it lays dormant. Various stress conditions can cause the virus to reactivate and cause the condition to manifest. These stresses include menstruation, dental extraction, coldness, or exposure to other infectious agents, particularly upper respiratory tract infection (Roob 1999).
HSV has been observed in saliva (Furuta, Fukuda et al. 1998) as well as muscle biopsy and tears (Kaygusuz, Godekmerdan et al. 2004) of Bell’s palsy patients at significantly higher rates than control groups. One study found that approximately 50% of Bell’s palsy patients show signs of the virus compared to approximately 19% of the normal population (Furuta, Fukuda et al. 1998). However, an opposing trial found HSV as well as VZV to be non-significantly represented in affected groups (Linder, Bossart et al. 2005). The life span of the virus and the timing of testing for HSV may explain these conflicting conclusions. Furuta (1998) discovered in his trial that HSV became undetectable after two weeks onset of Bell’s palsy. The evidence suggesting HSV as the major cause of this condition is demonstrated further by the success of specific antiviral agents which have shown continued success against HSV infections (Adour, Ruboyianes et al. 1996; Allen and Dunn 2004; Allen and Dunn 2005). Furthermore, injections into rat specimens with HSV have recreated facial paralysis in approx 50% of specimens (Gok, Alpay et al. 2005).
Additional infectious agents have been indicated as causative agents for Bells’ palsy. Research has found significant causal relationships to Epstein-Barr virus (Ramos, de Miguel et al. 2003; Kaygusuz, Godekmerdan et al. 2004), hepatitis B (Unlu, Aslan et al. 2003), varicella-zoster virus, cytomegalovirus, mumps virus (Kaygusuz, Godekmerdan et al. 2004) as well as influenza virus, tuberculosis, and lyme disease (Salinas, Alvarez et al. 2004). It is most apparent by these results that a viral infection is indicated as the initiating factor in activating cellular immunity. However, which virus is still not known beyond doubt.

Clinical Features and Diagnosis

Onset:
  • Paralysis: Progresses to maximal deficit over 3 to 72 hours
  • Pain (50%): Near mastoid process
  • Excess tears (33%)
Signs and Symptoms:
  • Facial weakness
    • All branches of nerve: Upper & Lower
    • Unilateral: Bilateral in < 1%
    • Degree: Partial (30%); Complete (70%)
    • Results in mouth droop, eye can’t fully close and face feels heavy
  • Sensory loss
    • Mild or None
    • May be present on face or tongue: On side of paralysis
  • Stapedius dysfunction (33%): High level of sensitivity to sound
  • Taste: Foods may taste slightly different though usually no significant changes
  • Lacrimation: Mildly affected in some patients
(Ahmed 2005; Anon 2005; WUSM 2005)
Typical diagnosis includes matching of events that correspond to the above clinical features and a clinical assessment. The patient is asked to raise their eyebrows, close their eyes and smile. If the person has Bell’s palsy, their eyebrows will raise asymmetrically, they won’t be able to close the affected eye and one side of the mouth will droop (Braunwald, Fauci et al. 2001; Ahmed 2005).

Conventional Medicine – Evidence and Current Therapy

Corticosteroids such as prednisone to reduce inflammation and antivirals such as Aciclovir are the most commonly used treatments. Extensive research has been conducted to find which is the most efficacious with Cochrane reviews completed for both (Salinas, Alvarez et al. 2004; Allen and Dunn 2005). Salinas et al. concluded that corticosteroids do not show significant benefit, however only 4 trials with a total of 179 patients were reviewed (Salinas, Alvarez et al. 2004). Allen and Dunn (2004) reviewed aciclovir alone and in combination with corticosteroids and concluded the results mostly inconclusive. Both reviews confirmed that available studies were insufficiently powered to adequately detect a treatment effect.
In the time since data collection for the Cochrane reviews, animal trials have shown no statistical difference in of the rate or degree of recovery with steroid alone, acyclovir alone or steroid + acyclovir with both found to effectively reduce swelling (Gok, Alpay et al. 2005). A review by the American academy of neurology concluded that steroids are probably effective and acyclovir (combined with prednisone) is possibly effective in improving facial functional outcomes (Grogan and Gronseth 2004). This review included studies which were not assessed by the Allen and Dunn (2004) review and indicated acyclovir and prednisone in combination to be superior to prednisone alone (Billue 1997; Roob 1999; Peitersen 2002; Axelsson, Lindberg et al. 2003; Hato, Matsumoto et al. 2003). Hato et al. (2003) found that combined therapy within 3 days of the onset of palsy was 100 percent effective and early treatment resulted in early remission. In contrast, the recovery rate in patients who started the combined therapy more than 4 days after onset was 86.2 percent (Hato, Matsumoto et al. 2003). Therefore an early combined treatment of prednisone and acyclovir is now considered best practice and current practitioner treatment guidelines reflect this change (Holten 2004). An outline of current treatment is included as appendix B.
According to all 3 systematic reviews surgical decompression of the facial nerve is not considered to be effective for improving facial function (Grogan and Gronseth 2004; Salinas, Alvarez et al. 2004). Botulinum toxin injection is a new treatment approach which as yet has not been tested by a rigorous controlled trial (Vrabec, Toh et al. 2004). Painkillers are used to relieve initial symptoms whilst massage and facial exercise are presumed to encourage neuromuscular retraining leading to quicker recovery when the nerve regenerates.

Traditional Chinese Medicine

Bell’s Palsy is known as Zhong Feng and translates as Wind Attack. It is categorised as External Wind Stroke attack with the main pattern differentiation being Wind invasion due to emptiness of the Channels (Maclean and Lyttleton 1998). Wind is thought to take advantage of the vacuity to enter the body and attack the sinews and vessels in the area of the face. This results in Qi and Blood stagnation causing the inability of flesh to relax or contract (Wolfe 2003). The principle of treatment is to expel Wind and promote the movement of Qi and Blood by scattering Stasis.
Vacuity mostly refers to an insufficiency of Essential Qi. According to the Nei Jing: Despoilation of the Essential Qi results in vacuity. Modern sources state that any disease in which there is an insufficiency of the necessary normal physiologic movement, or in which the functions of the bodies normal regulatory and compensatory actions are reduced, can be described as a vacuity pattern (Teng, Ergil et al. 1999). In TCM terms Qi is the normal regulative and compensative function of the human body (Teng, Ergil et al. 1999). Vacuity patterns emerge slowly over time and can be reflective of a lifestyle of consuming incorrect foods, overwork, stress and indulgence which consumes Qi without replenishment (Teng, Ergil et al. 1999).
Normally Wind-Cold attack would invade through the head and nose and attack the Lung’s Defensive Qi leading to the familiar symptoms of cold and flu (Maciocia 2004). It is a sudden pattern which correlates to modern theories of pathogenic viral attack. In the case of Bells’ palsy the invading Wind-Cold primarily stays in the facial Yang-Ming channels. The Yang Ming is significant because these are the channels that are most abundant in Qi and Blood. In Bell’s palsy it appears that a vacuity pattern debilitates Qi and Blood thus exposing the channels to injury. The first vulnerable portion of the channel is then impaired.

Evidence for TCM

An author search for TCM treatment (acupuncture and herbal medicine) of Bell’s palsy within Google Scholar, Google Print as well as online databases MEDLINE, Cochrane register, Science Direct and PubMED returned numerous citations of which 6 full text papers were retrieved (Zhang, Wei et al. 1991; Xing, Yang et al. 1994; Zang 1999; Stone 2002; Wolfe 2003; He, Zhou et al. 2004). Very limited access to Chinese language papers limited further search results. 5 of the papers concluded excellent results for acupuncture therapy and were useful for treatment protocols (outline in appendix C). He et al. (2004) conducted a Cochrane systematic review which included 3 randomised controlled trials (Liu 1996; Shao 1999; Yu 1999). Two of which used acupuncture (Liu 1996; Yu 1999) while the third used acupuncture combined with drugs (Shao 1999). The studies included a total of 238 patients and showed that the therapeutic effect of acupuncture alone was superior to that of medication or that acupuncture combined with medication was better than medication alone (He, Zhou et al. 2004). However, due to poor reporting methods the quality of trials was inadequate to allow any conclusion about the efficacy of acupuncture and more research with high quality trials was recommended (He, Zhou et al. 2004). The 3 included trial treatment protocols are included in appendix C.
Within the Cochrane review it was mentioned that over 50 Chinese language articles had been reviewed by a previous author between 1984 and 1994. The therapeutic effect of acupuncture was found to be good with the literature reporting the lowest cure rate of 37% and a highest of 100% per cent, averaging 81 per cent (He, Zhang et al. 1995).

Case presentation

30 Year male presented in September 2005 with right side Bell’s palsy. He had woken 6 weeks previously with the condition. The week prior to waking with facial hemiplegia he had experienced cold and flu like symptoms for 1 week and was feeling very tired. During this time he continued to work a physically demanding occupation (plumber) 6 days per week. The day before the onset of Bell’s palsy he experienced a metallic taste in his mouth. Without delay (<18 hrs from onset) the patient consulted with a neurologist who confirmed the diagnosis as mild Bell’s palsy and upon request was administered prednisone for 10 days. When the patient inquired about the use of antiviral medication he was told it would be of no use to his condition as he did not exhibit herpetic lesions approximating the ear canal. Unabated by the prednisone, the Bell’s palsy continued to progress to a more complete facial hemiplegia over the next two days. At presentation he continued to demonstrate almost complete facial paralysis affecting muscles of the eye, mouth, nose and forehead.

Additional information:

Right ear sensitivity to sounds
Right side pain proximal to mastoid process
No ongoing abnormal taste sensation
Increasing incidence of spontaneous lacrimation
Right side shallow nasolabial groove
Presented with extremely low energy
Previous oral exposure to herpes simplex virus 1
History of depression 12 months prior (controlled by medication at the time)
Self employed and long history of working many hours per week without reprieve
Has woken 4am in mornings as long as he can remember
Regular to move bowels, no excessive thirst, normal appetite
Feels tired a lot of the time
Pulse: Wiry and slippery
Tongue: Red tip, red spots, white slightly greasy coat. Trembling tongue.

Treatment:

Chinese medicine diagnosis is External Wind-Cold attacking the channels of the face. Underlying Qi and Blood deficiency with existing Damp and Heat affecting Liver, Spleen and Heart. Initial principle of treatment was to expel Wind and resolve Damp. Second principle of treatment was to invigorate Qi and Blood and promote Blood circulation to the face.
Herbal Formulation used:
Initial: Qin Jiao, Fang Feng, Chuan Xiong, Pu Gong Ying, Dang gui, Xi Xin, Bai Shao, Di Long, Fu Ling, Gan Cao.
Chi Shao, Huang Qin, Bai Zhi and Bai Zhu were used to modify the formula.
Later: Dang Gui, Sheng Di, Huang Qi, Ren Shen, Chuan Xiong, Rou Gui, Hong Hua, Di Long, Bai Shao, Fang Feng, Gan Cao.
Bao He Wan patent was used intermittently to aid digestion
Acupuncture points used:
Stomach 4 (thread toward Stomach 6), Stomach 6 (perpendicular), Stomach 7 (perpendicular), Bitong, Large Intestine 20 (toward Bitong), Small intestine 18 (perpendicular), Stomach 2 (thread toward Large Intestine 20), Gall Bladder 14 (thread to YuYao), San Jiao 17 (toward opposite ear 0.5-1 cun), Stomach 3 (perpendicular), Du 26 (thread toward Large Intestine 19), Du 20 (directed forward), Bladder 2 (thread toward YuYao), Stomach 7 (perpendicular and directed medial), Gall Bladder 20 (perpendicular), Yintang (M-HN-3), TaiYang (M-HN-9), JiaChengJiang (M-HN-18). Significant rubor or sweating was achieved on the affected side every treatment.
Distal points: Stomach 36, Gall Bladder 34, Liver 3, Large Intestine 4, Lung 7, San Jiao 5, Spleen 6.
Topical herbs applied as paste: Chuan Xiong, Rou Gui, Gan Jiang, Ai Ye, Mu Dan Pi
Hand held moxa stick used above face as well as electronic stimulation and strong cupping of Du 14.
Points needled varied slightly each week.
The patient was advised to drink more water, eat less sugars, exercise when energy increases and avoid beer. If alcohol was consumed he should replace with small amount of spirits such as vodka.
The patient’s treatment is still ongoing with twice weekly visits (week 5 at time of writing). Within one week the patient noticed more energy. By the fourth visit some nostril flaring with breathing was noted. Gradual improvement of eye closure was achieved and by the 6th visit could almost close except for the most medial aspect. After 4 weeks the patient began exercising again and energy levels have continued to stay high. Pain proximal to mastoid process largely resolved and moderate improvement noted on facial symmetry by the 8th visit. The patient feels his face is improving for the therapy.
Possible adverse herbal reaction noted at week 3 causing colic-like symptoms after eating. Possibly related to drinking alcohol (beer), and eating rich foods the previous night and exacerbated by the heavier Yin/Blood herbs which impeded the Spleen’s function. Gastrointestinal symptoms continued for approximately 1 week and herbs were discontinued during that time. Upon waking the patient noticed stiffness in knees after needling Gall Bladder 34 and then later for needling Stomach 36- both points were discontinued.

Discussion

The patient is showing gradual improvement. Choosing Yangming combined with Taiyang and Shaoyang points appears to be beneficial. The combination of incorrect foods and herbal exacerbation has delayed the momentum of treatment to this point. However, as the patient will be continuing exercise and increases Qi and Blood supply to his face his progress will hasten. The patient is now aware that he was exposed to this condition from overwork, stress and poor lifestyle. He has been made aware that he will need to continue to improve these aspects to strengthen the body’s resistance to future pathogenic factors.
In the face of research presented in this case report it is difficult to believe that the primary physician refused to administer an anti-viral medication. Furthermore, only at the patient’s request was prednisone prescribed. Despite reviews concluding that neither prednisone nor Acyclovir show significant benefit when used alone, significant evidence now shows that together they have greater effect. Understanding that Bell’s palsy may take up to 72 hours to fully present, studies suggest that early combined treatment is necessary to reduce the risk of permanent damage. It is a source of frustration to the patient and the practitioner that the condition was allowed to continue unabated without appropriate pharmaceutical treatment.

Conclusion

Bell’s palsy is a significantly debilitating condition which can be very slow to improve. This case report has outlined current medical knowledge of the condition and presented treatment protocols from both conventional medicine and traditional Chinese medicine perspectives. The case represents a typical presentation of vacuity syndrome and Wind-Cold pathogenic attack leading to facial paralysis. In this instance it is most likely due to viral pathogen activity or reactivation. Even though this patient’s condition would be classified as severe he has demonstrated some improvement of facial motor function. It is hoped that continuation of therapy will see further improvement. It has also been shown that Bell’s palsy is a condition in which conventional medicine has limited understanding and efficacy. Furthermore, that initial decisions made by primary care physicians regarding drug therapy may greatly influence the prognosis of disease. Chinese medicine has treated conditions such as Bell’s palsy for over a millennia, however, in an era of increasing demand for evidence-based practice, more high quality research is required to understand the efficacy of TCM.

References

Adour, K. K., J. M. Ruboyianes, et al. (1996). “Bell’s palsy treatment with acyclovir and prednisone compared with prednisone alone: a double-blind, randomized, controlled trial.” The Annals Of Otology, Rhinology, And Laryngology 105(5): 371-378.
Ahmed, A. (2005). “When is facial paralysis Bell palsy? Current diagnosis and treatment.” Cleveland Clinic Journal Of Medicine 72(5): 398-401, 405.
Allen, D. and L. Dunn (2004). “Aciclovir or valaciclovir for Bell’s palsy (idiopathic facial paralysis).” Cochrane Database Syst Rev(3): CD001869.
Allen, D. and L. Dunn (2005). “Aciclovir or valaciclovir for Bell’s palsy (idiopathic facial paralysis).” The Cochrane Database of Systematic Reviews(3).
Anon (2005). “Bell’s Palsy.” Better health: Victorian Government Health Initiative: http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Bell’s_palsy.
Axelsson, S., S. Lindberg, et al. (2003). “Outcome of treatment with valacyclovir and prednisone in patients with Bell’s palsy.” The Annals Of Otology, Rhinology, And Laryngology 112(3): 197-201.
Billue, J. S. (1997). “Bell’s palsy: an update on idiopathic facial paralysis.” The Nurse Practitioner 22(8): 88, 97-100, 102-105; quiz 106-107.
Brandenburg, N. and J. Annegers (1993). “Incidence and risk factors for Bell’s palsy in Laredo, Texas 1974-1982.” Neuroepidemiology 12(6): 313-25.
Braunwald, E., A. Fauci, et al. (2001). Harrison’s Principles of Internal Medicine. New York, McGraw Hill.
De Diego, J. I., M. P. Prim, et al. (1999). “Seasonal patterns of idiopathic facial paralysis: a 16-year study.” Otolaryngology And Head And Neck Surgery 120(2): 269-271.
Deng, T., K. Ergil, et al. (1999). Practical diagnosis in Traditional Chinese Medicine, Churchhill Livingstone.
Furuta, Y., S. Fukuda, et al. (1998). “Reactivation of herpes simplex virus type 1 in patients with Bell’s Palsy.” Journal of Medical Virology 54(3): 162-169.
Gok, U., H. C. Alpay, et al. (2005). “Comparisons of steroid, acyclovir, lipoprostoglandin E1 and steroid + acyclovir treatments in facial paralysis: A rat study.” International Journal of Pediatric Otorhinolaryngology 69(9): 1199-1204.
Grogan, P. and G. Gronseth (2004). “Practice parameter: Steroids, acyclovir, and surgery for Bell’s palsy (an evidence-based review): Report of the Quality Standards Subcommittee of the American Academy of Neurology.” Neurology 56(7): 830-836.
Hato, N., S. Matsumoto, et al. (2003). “Efficacy of early treatment of Bell’s palsy with oral acyclovir and prednisolone.” Otology & Neurotology: Official Publication Of The American Otological Society, American Neurotology Society [And] European Academy Of Otology And Neurotology 24(6): 948-951.
He, L., D. Zhou, et al. (2004). “Acupuncture for Bell’s palsy.” Cochrane Database Syst Rev(1): CD002914.
He, S., H. Zhang, et al. (1995). “Review on acupuncture treatment of peripheral facial paralysis during the past decade.” Journal of Traditional Chinese Medicine 15(1): 63-67.
Holten, K. B. (2004). “How should we manage Bell’s palsy?” The Journal Of Family Practice 53(10): 797-798.
Kanoh, N., J. Nomura, et al. (2005). “Nocturnal Onset and Development of Bell’s Palsy.” Laryngoscope 115(1): 99-100.
Kasse, C. A., R. G. Ferri, et al. (2003). “Clinical data and prognosis in 1521 cases of Bell’s palsy.” International Congress Series 1240: 641-647.
Kaygusuz, I., A. Godekmerdan, et al. (2004). “The role of viruses in idiopathic peripheral facial palsy and cellular immune response.” American Journal of Otolaryngology 25(6): 401-406.
Linder, T., W. Bossart, et al. (2005). “Bell’s Palsy and Herpes Simplex Virus: Fact or Mystery?” Otology & Neurotology 26(1): 109-113.
Liu, M. (1996). “Journal of Clinical Acupuncture.” Comparison of Acupuncture and Drug Treatment for 130 Patients with Facial Palsy 12(5,6): 56.
Maciocia, G. (2004). Diagnosis in Chinese Medicine: A Comprehensive Guide. London, Churchhill Livingstone.
Maclean, W. and J. Lyttleton (1998). Clinical handbook of internal medicine. Sydney, University of Western Sydney.
Peitersen, E. (2002). “Bell’s Palsy: the spontaneous course of 2,500 peripheral facial nerve palsies of different etiologies.” Acta Oto-laryngologica Supplementum supplement(549): 4-30.
Ramos, A., I. de Miguel, et al. (2003). “Bell’s palsy and Epstein-Barr virus infection.” International Congress Series 1240: 655-656.


Aculaser Therapy for the Treatment of Cerebral Palsy

Abstract:

A single, open and non comparative study was conducted at Anwar Shah’s First C.P. & Paralysis Clinic and Research Center in collaboration with the Departments of Neurology and Neurosurgery, Children Hospital Lahore, Pakistan to evaluate the effects of ACULASER THERAPY in children suffering from Cerebral Palsy (CP) and associated Neurological Disorders like epilepsy, cortical blindness, spasticity, hemiplegia, paraplegia, quadriplegia, paraplegia, monoplegia, sensory-neural deafness and speech disorders. In all 100 children were treated and the data was gathered during a period of 18 months from December 2003 till June 2005.
This article shows results of the treatment with ACULASER THERAPY in CP children who were treated for minimum 6 weeks and more or had minimum of 10 treatment sessions and more. This paper also shows that those children who were given a break in the treatment for 4 -12 weeks did not show any reversal of the symptoms. These children were classified according to the associated Neurological Disorders.
Analysis of the data showed that out of 81 children with Spasticity and Stiffness 69 showed marked improvement showing 85% improvement rate, out of 54 children with Epileptic fits there was a significant reduction in the intensity, frequency and duration of Epileptic fits in 34 children showing 63% success rate, out of 18 children with Cortical Blindness 13 children showed improvement accounting for 72% efficacy rate, out of 45 children with Hearing Difficulties, 31 showed marked improvement accounting for 69% improvement rate, out of 100 children with Speech Disorders 67 showed improvement reflecting 67 % improvement rate, out of 46 children with Hemiplegia 32 showed improvement in movement, tone and power accounting for 69% improvement rate, out of 36 children with Quadriplegia 25 showed improvement in gross and fine motor functions showing 69% success rate and out of 18 children with Paraplegia of lower limbs 12 showed improvement in weight bearing, standing and movement accounting for 67% improvement rate.

Key Words:

Cerebral Palsy, Laser acupuncture, Aculaser therapy, CP Children, Cortical blindness, Epilepsy, Spasticity, Stiffness, Sensory neural deafness, Speech disorders, Hemiplegia, Quadriplegia, Paraplegia.

Objectives:

To evaluate the effects of ACULASER THERAPY (Laser Acupuncture, Physiotherapy, Color therapy, Magneto therapy) in children suffering from cerebral palsy and associated neurological disorders like epilepsy, cortical blindness, spasticity, hemiplegia, paraplegia, quadriplegia, sensory-neural deafness and speech disorders. In addition to this, to evaluate when this treatment is stopped; is there any regression of the development or reversal of the symptoms.

Background:

It is difficult to estimate exactly how many people have CP. Many people with mild CP are never diagnosed, while others may have multiple disabilities which overshadow their CP. Today, more people have cerebral palsy than any other developmental disability, including Down syndrome, epilepsy, and autism. The incidence of CP is 7 per 1000 live births (Nelson, Essentials of Pediatrics 1998 (1)).
In general there is not any single treatment which addresses physical, mental and cognitive aspects of CP children. This research study is based on the principal of combining and using different treatment modalities like laser acupuncture (Scalp, Auricular & Body Acupuncture) (LLLT), physiotherapy, magneto therapy, color therapy and reflex massage for the treatment of children suffering from CP.

Source and Criteria:

These children were included randomly as they presented at the center. These children were referred to us by the Department of Neurology and the Department of Neurosurgery, Children Hospital & Institute of Child Health Lahore, Pakistan. Those CP children who were treated for minimum 6 weeks and more, or who had minimum of 10 treatment sessions and more were included in the study.

Introduction:

Cerebral palsy (CP) is a term used to describe a group of disorders effecting body movement and muscle co-ordination. The medical definition of CP is “a non-progressive but not unchanging disorder of movement and/or posture, due to an insult or anomaly of the developing brain”. Because cerebral palsy influences the way children develop, it is known as a developmental disability.

Causes of Cerebral Palsy:

Any damage to the developing brain, whether caused by genetic or developmental disorders, injury or disease, may cause CP.

During pregnancy:

Anything which tends to produce a low birth weight baby will increase the likelihood of CP. Factors during pregnancy which may cause CP include:
  • multiple births (twins or triplets)
  • a damaged placenta which may interfere with fetal growth
  • infections
  • poor nutrition
  • exposure to toxic substance, including nicotine and alcohol
  • maternal diabetes, hyperthyroidism or high blood pressure
  • biochemical genetic disorders
  • chance malformations of the developing brain

During labour:

  • premature delivery
  • abnormal positioning of the baby (such as breech or transverse lie) which makes delivery difficult
  • rupture of the amniotic membranes leading to fetal infection

In early childhood:

CP can occur if a young child suffers brain damage due to:
  • infection such as meningitis
  • brain hemorrhages
  • head injury following falls, car accidents or abuse
  • a lack of oxygen (asphyxia) due to accidents such as drowning
  • seizures

What is ACULASER THERAPY?

AcuLaser therapy is a combination of the following treatment modalities:

  • Laser Acupuncture (LLLT), (Scalp, Auricular & Body Acupuncture).

  • Physiotherapy.

  • Magneto therapy.

  • Color therapy.

  • Vitamins & Nutritional advice.

  • Reflex Massage.In this study we used Laser acupuncture (body points, scalp areas and auricular points) Physiotherapy, Color-therapy and Magneto therapy as main treatment modalities. Other treatment modalities were used an adjuvant to these.Acupuncture is one of the oldest treatment modalities which have been successfully practiced in China for the last 4000 years (George T. Lewith (2)). Traditionally acupuncture has been used for various mental and physical disabilities. Especially in the last 35 years with the development of different forms of SCALP ACUPUNCTURE by Dr. Jiao Shunfa (Jiao Shunfa 1997 (3)), Dr Zhu’s Scalp Acupuncture (Zhu Mingqing 1992 (4)) and YNSA (Yamatomo’s New Scalp Acupuncture 1998 (5)) use of acupuncture in neurological and developmental disorders has increased to a greater extent. World Health Organization reviewed and standardized Scalp acupuncture in 1984. In 1988 WHO published the first standard pamphlet on Scalp acupuncture (WHO 1991 (6)). Many studies done all over the world on humans and animals show that Scalp acupuncture is very effective in treating developmental and neurological diseases in children and adults. Research shows that level of certain hormones in the body and cerebral blood flow improves (Xiang L (7)), (Gerhard Litscher (8)).
    Low Level Laser Therapy (LLLT) is the use of low power therapeutic lasers to treat various diseases. Many research studies show that LLLT has various effects on cells and nervous tissue (Tunér, J. 2002 (9). LLLT is used to stimulate wound healing and tissue regeneration (J. Pineal Res. 2003 (10)). Some studies demonstrate that LLLT can be used safely on acupuncture points and different zones or areas on scalp (Harry Lazoura (11)).
    Physiotherapy is widely used as an integral part of the treatment for C.P. all over the world. Hundreds of studies show that physiotherapy helps to a major extent in the treatment of C.P. (J. Parkes, 2000 (12)).
    Magneto therapy is the use of magnets or magnetic fields to treat various diseases. Recent studies show a positive effect of magnet therapy in various neurological and developmental diseases like epilepsy (Seizure. 2003 (13)).
    Color therapy is based on the fact that physiologic functions respond to specific colors. Using colored light for therapy has been in practice a very long time and we see it happening every day, whether we realize it or not. Research was also done to test the effects of colored light on muscles. When subjects were using a hand grip and exposed to blue light, their grip lightened, while other tests have shown that when muscles were exposed to red light the electrical activity in them increased (Therese M Donnelly 2000 (14)).

    Methods & Materials Used:

    This study was conducted at Anwar Shah’s First CP & Paralysis Clinic and Research Center in collaboration with the Department of Neurology Children Hospital Lahore, Pakistan and the Department of Neurosurgery Children Hospital Lahore, Pakistan for a period of 18 months from December 2003 till June 2005. In all 100 children with different types and etiology were treated. There were 54 boys and 46 girls. Their mean age was 3.2 years.
    The history of every child was taken and a primary clinical assessment with initial measurements was done which included Head Circumference (H.C), Height and Weight.
    CT scan and MRI were conducted to rule out surgical lesions in some cases. After primary assessment and initial measurements, the children were treated twice a week with ACULASER THERAPY.
    In this study we used Laser acupuncture (body points, scalp areas and auricular points) Physiotherapy, Color-therapy and Magnetotherapy as main treatment modalities. Other treatment modalities were used an adjuvant to these.
    We stimulated scalp areas first, (scalp areas may vary in size from 1 cm to 3 cm); this was followed by stimulation of body points (body points are small areas on the body measuring almost 1 cm) and auricular points. This study was conducted in very young children who had few and very thin head hair, older children who had thick head hair their parents were asked to shave their heads regularly so we could stimulate their scalp areas properly. We did not follow any single method or school of acupuncture. We actually combined 5-element acupuncture, auricular acupuncture and scalp acupuncture (Jiao Shunfa, YNSA and Dr Zhu) to treat many different cases of CP and associated neurological disorders.
    In classical acupuncture treatment there is no specific formula or set of points to treat any disease and treatment may vary for the same patient on subsequent sessions depending on the response. However, there are some generalizations which could be applied like for spasticity Liver 3 and Gall Bladder 34, for irritability and restlessness Heart 7, 5 (also for the improvement of speech) and Du 20, to increase cerebral blood flow Du 26, 16, 14, etc. On scalp we mainly stimulated motor areas, speech areas, visual areas, brain point, etc. On auricles we stimulated shenmen, sub cortex, back, limbs, etc.
    We used 2 types of soft lasers with different wavelengths. For the stimulation of body and auricular points, we used red HJZ3A He-Ne laser with a wavelength of 632.8 nm 30 mW from the tube and estimated 20 mW at the tip. This laser is manufactured by Guoguang Electric Co of Chengdu, China. For scalp areas we used diode laser with a wavelength of 675 nm, 50 mW manufactured by Wen Zhou Electric Appliance Company Xinke province, China.
    Each body and auricular point was stimulated for 25 seconds (4 J) while scalp areas were stimulated for 45 seconds (18 J).
    In addition to the LLLT every child had a full session of physiotherapy. We used blue light for 20 minutes on face and body in epileptic cases and yellow light for 20 minutes on face and body in non epileptic cases during each treatment session.
    We placed North Pole of 300 gauss magnet under right foot and South Pole under left foot for 5 minutes. South Pole of 300 gauss magnet was placed under the pillow (occipital lobe) for 5 minutes.
    The response of every child was recorded on every visit to the center and physical measurements were done at 6 weeks interval. Photograph of each child with physical dysfunction were taken before, during and after treatment.
    In addition to the treatment at the center their parents were taught the reflex massage which they performed daily at home.

    Total No. of Children Treated:

    In all 100 C.P. children with associated neurological disorders were treated:
    • Children with Spasticity & Stiffness: 81
    • Children with Epilepsy: 54
    • Children with Cortical blindness: 18
    • Children with Hearing difficulties: 45
    • Children with Speech Disorder: 100
    • Children with Hemiplegia: 46
    • Children with Quadriplegia: 36
    • Children with Paraplegia: 18

    Male: female sex ratio:

    Baby boys: 54
    Baby girls: 46
    Male: female sex ratio was 1.27:1

    Age Distribution:

    AGE:No. of Children:
    Less than 1 year13
    1 to 3 years47
    3 to 5 years24
    5 years and older16
    Minimum Age: 04 Months
    Maximum Age: 16 years
    Mean Age: 3.2 years

    Response of C.P Children with Different Neurological Disorders

    Response of C.P Children with Spasticity & Stiffness:
    Out of 81 C.P. children with spasticity and stiffness 69 showed marked improvements as both stiffness and spasticity improved. This accounts for 85% success rate.
    Response of C.P Children with Epilepsy:
    Out of 54 C.P. children with epilepsy 34 showed marked improvements as both the frequency and intensity of epileptic fits decreased. This accounts for 63% success rate.
    Response of C.P Children with Cortical Blindness:
    Out of 18 C.P. children with cortical blindness 13 children showed improvement accounting for 72% efficacy rate.
    Response of C.P Children with Hearing Difficulties:
    Out of 45 C.P. children with hearing difficulties 31 showed marked improvements. This accounts for 69% improvement rate.
    Response of C.P Children with Speech Disorder:
    Out of 100 C.P. children with speech disorder 67 children improved showing 67 % improvement rate.
    Response of C.P Children with Hemiplegia:
    Out of 46 C.P. children with hemiplegia 32 children improved showing 69 % improvement rate.
    Response of C.P Children with Quadriplegia:
    Out of 36 C.P. children with quadriplegia 25 children improved showing 69 % improvement rate.
    Response of C.P Children with Paraplegia:
    Out of 18 C.P. children with paraplegia of the lower limbs 12 children improved showing 67 % improvement rate.

    Possible Side Effects

    Generally we did not experience any adverse effects of ACULASER Therapy like aggravation of epileptic fits or increase in spasticity and rigidity.
    Few minor temporary complications occurred in C.P. children getting ACULASER Therapy. These temporary complications are:
    1. Hyperactivity and Restlessness:
    2. Disturbed Sleep:
    3. Irritability:
    All of these complications were probably related with increased cerebral blood flow. These complications settled in 2 weeks time.

    Discussion

    Cerebral Palsy (CP) is caused by ischemic insult to the developing brain during pregnancy, delivery, perinatal period and first few years of life ( Futagi Y, Shimizu H, 1982 (15)). A very large proportion of CP children suffer from associated neurological disorders like epilepsy, cortical blindness, spasticity, hemiplegia, paraplegia, quadriplegia, sensory-neural deafness and speech disorders. Any one or multiple neurological disorders may affect CP children and compromise the quality of their life.
    ACULASER Therapy aims at improving the blood flow to brain and other affected parts of the body. This is done by stimulating different body acupoints, ear points and scalp areas. In response when these acupoints and scalp areas are stimulated blood flow to brain and various affected parts of the body increases (this is demonstrated with the help of functional MRI or f MRI of the brain) (J. D. Lee , J. S. Chon, H. K. Jeong, 2003 (16)). In addition to this when Low Level Lasers (wavelength 632.5 nm – 915 nm) are applied on skin, this results in biostimulation of the body tissues resulting in increased blood flow and rapid healing of the tissues (Tunér, J. 2002 (8)). The combined effect of LLLT, acupoints and scalp areas stimulation results in increased blood flow to brain and different body parts thus improving the CP and its associated neurological disorders ( Jiao Shunfa 1997 (3), Zhu Mingqing 1992 (4), Tunér, J. 2002 (8), J. Pineal Res. 2003 (9), Parkes, 2000 (12)).
    Studies conducted in different parts of the world involving unconventional treatment modalities like Acupuncture, Acupressure, Laser Acupuncture and Scalp Acupuncture show a very good success rate for the treatment of CP and other Neurological disorders. (Jiao Shunfa 1997 (3), Dr Liang 1984 (17), Dr Petra Fila 1997 (18), Dr Majid Fadaie 2002 (19)).
    In our study, ACULASER Therapy was safe, effective, painless and aseptic; it gave rapid results in most cases. Most children complied easily with the treatment. Changes were observable almost in the first 2 -3 weeks of therapy. In some cases that were coming from far areas, we gave a break in the treatment for 4-12 weeks because of very severe heat in summer. These children maintained the degree of improvement during the break which they achieved with the treatment. We did not observe any regression or reversal of improvement in these children. The best results were in children <2 years of age and the second best group were <5 years of age which signifies that ACULASER THERAPY when instituted earlier gives better results. This is because the weight of the brain of a new born baby is 250 grams and it grows to 1000 grams at 1 year and then till the age of 7 years it reaches around 1300 – 1400 grams maximum. If the treatment is started at an early age when brain size is increasing rapidly, the chances of improvement and recovery are high.

    Conclusion & Recommendations:

    This study concludes that ACULASER Therapy is effective for the treatment of children suffering from CP of various types and associated neurological disorders like epilepsy, cortical blindness, spasticity, hemiplegia, paraplegia, quadriplegia, sensory-neural deafness and speech disorders.
    ACULASER Therapy not only addresses and improves the physical aspect in CP children but also the mental and cognitive aspects.
    ACULASER Therapy if applied at proper time can improve the quality of life of the children suffering from CP and associated neurological disorders associated neurological disorders like epilepsy, cortical blindness, spasticity, hemiplegia, paraplegia, quadriplegia, sensory-neural deafness and speech disorders.
    We strongly recommend that further larger studies should be conducted to evaluate the effects of ACULASER Therapy and this should be adopted as a treatment option for CP along with other modalities.

    References:

    1. Nelson. Essentials of Pediatrics. Third edition, Behrman Kliegman. (1998),
    2. George T. Lewith M.A., M.R.C.G.P., M.R.C.P. (Acupuncture-Its Place in Western Medical Science, Thorsons Publishing Group)
    3. Jiao Shunfa. Scalp acupuncture and clinical cases. Foreign Languages Press, Beijing, (1997).
    4. Zhu Mingqing. Zhu’s Scalp Acupuncture 1992 Eight Dragons Publishing Hong Kong.
    5. Tashikatsu Yamatomo M.D., Ph.D. (Yamtomo New Scalp Acupuncture “YNSA” 1998 Axel Springer Japan Publishing Inc.)
    6. World Health Organization (WHO), Regional Office for Western Pacific, Manila, Philippines Standard Acupuncture Nomenclature, Part 2 revised edition, , (1991)
    7. Xiang L, Wang H. Li Z, TCD observation on cerebral blood flow dynamics inference of cerebral palsy with scalp therapy, Article in Chinese, Shuguang hospital attached to Shaghai University of TCM. PMID: 9388310 (Pub MED-index for MEDLINE)
    8. Effects of acupuncture on oxygenation of cerebral tissue: Gerhard Litscher, Schwarz G, Source: Neurological Research 1998; 20 (Suppl. 1): 28 – 32.
    9. Laser Therapy – Clinical Practice and Scientific Background Tunér, J. and Hode, L., (2002), pp 570 with 1400 Refs. Prima Books AB, Grängesberg, Sweden.
    10. Russel J. Reiter. J. Pineal Res. 2003;34:167-172, Journal of Pineal Research ISSN 0742-3098
    11. Harry Lazoura and Irena Cosic – Bioelectronics Group,Dept. Electrical & Computer Systems Engineering, Monash University Victoria, Australia.
    12. What physiotherapy use by children with cerebral influences palsy? J. Parkes, N. Hill, H. Dolk and M. Donnelly. Child Care Health Dev. 2004 Mar;30(2):151-60. Health and Social Care Research Unit and School of Nursing and Midwifery, The Queen’s University of Belfast, Northern Ireland, UK. j.parkes@qub.ac.uk (Pub MED-index for MEDLINE)
    13. Seizure. 2003 Sep;12(6):373-378. Usefulness of magnetic motor evoked potentials in the surgical treatment of hemiplegic patients with intractable epilepsy. KAMIDA T, BABA H, ONO K, YONEKURA M, FUJIKI M, KOBAYASHI H. Department of Neurosurgery, Oita Medical University, 1-1 Idaigaoka, Hasama-machi, 879-55, Oita, Japan.
    14. Color Therapy by Therese M Donnelly in the Clinician’s Complete Reference to Complementary & Alternative Medicine by Donald W Novey MD, published by Mosby, 2000.
    15. Internal carotid blood flow velocity in children with cerebral palsy by Doppler Ultrasound method. Futagi Y, Shimizu H, Mimaki T, Abe J, Onoe S, Tagawa T, Kajiura I, Sumi K, Yabuuchi H. Brain Dev. 1982;4(1):27-33.
    16. The cerebrovascular response to traditional acupuncture after stroke. J. D. Lee , J.S. Chon, H. K. Jeong, H. J. Kim, M. Yun, D. Y. Kim, D. I. Kim, C. I. Park and H. S. Yoo. Neuroradiology. 2003 Nov;45(11):780-4. Epub 2003 Aug 27.
    17. Liang XY. Cortical blindness treated by acupuncture. Abstract American Journal of Acupuncture 1984; 12:376, ex Chinese acupuncture and Moxibustion 1984; 49 (jun); 13-14.
    18. Petra Fiala. Cerebral Palsy in children, methods and results of acupuncture treatment. Dept of Acupuncture, Institute of Postgraduate Training, Prague, CZ. Abstract of ICMART ’97 international Medical Acupuncture Symposium. (from the Medical Acupuncture Web page).
    19. Application of Laser Acupuncture in Children with Cerebral Palsy by Majid Fadaie MBBS (Pb), Lic AC (China), Medical Acupuncturist in collaboration with Malik Mohammad Nadeem Khan, MBBS, MS, Pediatric Neurosurgeon.2002 (from the Medical Acupuncture Web page).


  • Laser Acupuncture for Carpal Tunnel Syndrome

    This information is provided in response to a request from the public for information on availability of an alternative therapy to treat the painful symptoms of Carpal Tunnel Syndrome (CTS) or Repetitive Strain Injury (RSI). It is not intended to replace medical advice.
    This alternative therapy applies painless, non-invasive red-beam laser light and microamps transcutaneous electrical nerve stimulation (TENS) to acupuncture points on the involved hand.
    Introduction
    The results from that study were published in the July, 2002 issue of the journal, Archives of Physical Medicine and Rehabilitation (Vol. 83, pages 978-988). That abstract is provided here:
    Abstract
    Objective: To investigate whether real or sham, low-level laser therapy (LLLT) plus microamps TENS applied to acupuncture points significantly reduces pain in carpal tunnel syndrome (CTS).
    Design: Randomized, double-blind, placebo control, crossover trial. Patients and staff administering outcome measures, blinded.
    Setting: Outpatient, V.A. hospital, university-affiliated.
    Patients: Eleven mild-moderate CTS cases (nerve conduction study, clinical exam) who failed standard medical or surgical treatment for 3-30 months.
    Intervention: Patients received real and sham treatment series (each for 3-4 weeks), order randomized. Real treatments used red-beam laser (continuous wave, 15 mW, 632.8 nm) on shallow acupuncture points on affected hand; infrared laser (pulsed, 9.4W, 904 nm) on deeper points on UE and cervical paraspinal areas; and microamps TENS on affected wrist. Devices were painless, non-invasive and produced no sensation whether real or sham. Hand treated behind hanging black curtain without patient knowing if devices were turned on (real) or off (sham).
    Main Outcome Measures: Melzack pain score, sensory and motor latencies, Phalen and Tinel signs.
    Results: Significant decreases in Melzack pain score, median nerve sensory latency, Phalen sign and Tinel sign, Post-real treatment series but not Post-sham. Patients able to perform prior work (computer typist, handyman) and stable for 1-3 years.
    Conclusions: This new, conservative treatment was effective to treat CTS pain in this study, larger studies are recommended.

    Acupuncture Improves Sleep - New Research


    New research concludes that acupuncture benefits sleep. A controlled trial conducted on pigs measured sleep outcomes when the subjects received acupuncture at acupoints GV20 and Dafengmen (an acupoint anatomically similar to human GV20, Baihui). Results were measured using an actigraph (Octagonal Basic Motionlogger) and by measuring catecholamine counts in the urine after the application of acupuncture. Pigs receiving acupuncture at Dafengmen for 20 minutes at a depth of 10-20mm showed significant values on the actigraph and urine analysis showed significant changes in the catecholamine count.
    The researchers note that the traditional location of GV20 on pigs does not correspond anatomically to human GV20 and therefore Dafengmen was studied along with GV20. Dafengmen is located using the midline between the ears technique and therefore corresponds to human GV20. Sleep improvements were achieved with Dafengmen. The pigs were kept in a light, humidity and temperature controlled environment and acupuncture was applied for 20 minutes (10-20mm depth) using Seirin J type needles (0.2 X 50mm).
    The actigraph device measures whole body movements and showed significant improvements in sleep in the subjects; total sleep time and sleep efficiency improved in the acupuncture subjects. Urinary analysis used solid phase extraction to determine levels of norepinephrine and epinephrine following application of acupuncture. Norepinephrine lowered significantly in the subjects receiving acupuncture. Epinephrine did not show significant changes from the application of acupoint Dafengmen.
    The researchers note, “Beneficial effects occur when acupuncture is performed at a specific point, indicating that the effects may be induced by transferring the stimulus to the central nervous system….” They postulate that the mechanism by which acupuncture transfers its active effects may involve the trigeminal and greater occipital nerves.

     Reference:
    Ka-ichiro Takeishi, Masahisa Horiuchi, Hiroaki Kawaguchi, et al., “Acupuncture Improves Sleep Conditions of Minipigs Representing Diurnal Animals through an Anatomically Similar Point to the Acupoint (GV20) Effective for Humans,” Evidence-Based Complementary and Alternative Medicine, vol. 2012, Article ID 472982, 6 pages, 2012. doi:10.1155/2012/472982