Online English-Language Resource Designed Specifically
for Chinese Students
Beijing, China (January 6, 2010) --
Educational Testing Service (ETS) has launched a new Chinese-language version of the TOEFL® Go Anywhere website to assist students in preparing for the TOEFL® test, the most widely accepted English-language assessment worldwide. The newly released TOEFL Go Anywhere website, available at www.toeflgoanywhere.org/cn, presents an informative overview of the TOEFL test, valuable test preparation tips, and user-friendly academic tools for students.
Created specifically for Chinese students, the interactive portal serves as an effective planning tool and comprehensive resource to address frequently asked questions regarding the TOEFL test. Through the site's multimedia platforms, students also have the opportunity to learn best practices and study tips from English-language teachers and international students around the world.
Chris Giordano, a student at NYCTCM, gave an overview of Frozen Shoulder from a TCM perspective for his Clinical Acupuncture Practice II class "Treatment of Modern Diseases with Traditional Chinese Medicine".
He describes the basic bioscience of frozen shoulder, then tells us the basic TCM knowledge about frozen shoulder, including major pattern differentiation and major treatment points and needle techniques. He gives techniques for prevention of frozen shoulder, then summarizes current research on the treatment of frozen shoulder with Traditional Chinese Medicine.
"The cause of frozen shoulder is unknown, but it probably involves and underlying inflammatory process. The capsule surrounding the shoulder joint thickens and contracts. This leaves less space for the upper arm bone (humerus) to move around. Frozen shoulder can also develop after a prolonged immobilization because of trauma or surgery to the joint...
The symptoms are primarily pain and a very reduced range of motion in the joint. The range of motion is the same whether you are trying to move the shoulder under your own power or if someone else is trying to raise the arm for you. There comes a point in each direction of movement where the motion simply stops as if there is something blocking the movement. The shoulder usually hurts when movement reach the limit of the range of motion, and can be quite painful at night.
Major Treatments or Medications
Treatment of the frozen shoulder can be frustrating and slow. Most cases will eventually improve, but it may be a process that takes months. Initial treatment and increasing the range of motion of the shoulder with a stretching program. Anti-inflammatory medications may be prescribed.
It is critical that a Physical Therapy program be started and continued to regain the loss of motion.
An injection of cortisone and long-acting anesthetic, similar to novocaine, may bring the inflammation under better control, and allow the stretching program to be more effective. In some cases, injecting a long-acting anesthetic along with the cortisone right before a stretching session with the Physical Therapist can allow the therapist to break up adhesions while the shoulder is numb from the anesthetic.
If progress is slow, your doctor may recommend a manipulation of the shoulder while you are under anesthesia. This procedure allows your doctor to stretch the shoulder joint capsule, and break up the scar tissue while you are asleep. In most cases, a manipulation of the shoulder will increase the motion in the shoulder joint faster than allowing nature to take its course. It may be necessary to repeat this procedure several times.
Related terms in TCM
The first description of frozen shoulder was provided by the French physician E.S. Duplay in 1872. During the 20th century a corresponding Chinese term arose: "50-years shoulder" (wushi jian), referring to the typical age of onset of the disorder; the term frozen shoulder (jianning) is also used in China. While there are numerous references to traditional style Chinese medical treatments for problems of the shoulder area, investigations into the use of the therapies specifically aimed at frozen shoulder have only been described in the last few years.
Pathogenesis
Traditional Chinese Medicine differentiates frozen shoulder into three types:
Wind cold dampness, the most common type
Blood stasis
Deficiency
Frozen shoulder is mostly caused by weakness of the nutrient and defensive systems, asthenia of muscles and joints as well as wind-cold invasion. However, twisting and contusion due to careless exertion or stagnation of Qi and blood due to habitual one-sided sleep pressing the channels and collaterals may also cause "50 year shoulder".
Clinical Manifestations
Pain initially starts on one or two shoulders. It alleviates in the daytime and worsens at night. The condition also aggravates with cold, but alleviates with warmth. Prolonged "50 year shoulder" may result in muscular atrophy.
Major Pattern Differentiation
In TCM, "50 year shoulder" may be differentiated into three types:
More wind pathogen invasion: this will present with more lesion in the tendon. Shoulder pain will extend to the nape and fingers.
More cold pathogen invasion: this will present with more lesion in the bone. Shoulder pain will be severe in the deep area, but will be alleviated by heat.
More damp pathogen invasion: this will present with more lesion in the muscle. The shoulder pain will be fixed, worsening with pressure. There will be local swelling .
Major Acupuncture Points & Needle Techniques for Frozen Shoulder
In TCM, the treatment principle for "50 year shoulder" is to:
Expel wind-cold
Promote Qi and Blood circulation
Remove the obstruction from the channels and collaterals
The method used is strong stimulation, while patient is asked to rotate his/her shoulder.
Needle should be retained for 10-20 minutes.
As a further alternative, Cupping Therapy may be used on the following points:LI-15, SJ-14, SI-10, and the extra point Jianneiling
Acupuncture with Distal Points
One of the earliest Chinese reports of acupuncture treatment of frozen shoulder was published in 1991, based on a simple treatment method. The author of the article, Zhang Maohai, claimed to have found an effective therapy through his experiences. He focused on one acupuncture point, yanglingquan (GB-34), located on the leg, which he said seemed more effective than treating multiple points. The point was needled on one side only, the same side as the affected shoulder. In rare cases where this same side treatment did not seem to be helpful, the point was needled on the other leg instead.
The technique used was deep insertion (2.0-2.5 cun), followed by rotating and thrusting to get the qi reaction; the reducing technique was used for all patients, but deficiency patients were administered the treatment with both reducing and reinforcing techniques. The needle was maneuvered again every 3-5 minutes to maintain the stimulus. In the meantime, the patient was advised to move the shoulder joint. Total needle retention time was about 30 minutes, and five daily sessions made one course of treatment.
After two courses of treatment (with a break of a day or two between courses), the frequency of treatment was reduced to every other day until the condition was resolved to a satisfactory extent. In the event of acute shoulder pain, electro stimulation of the needles was used (intermittent waves, strong intensity).
It was claimed that as a result of this therapy, 64% of the 172 patients so treated were cured, and all the rest (except 8 patients) showed some degree of improvement. In two cases that were detailed, the total treatment involved 10 sessions in one case and 20 sessions in the second case.
The selection of this acupuncture point is of interest. Traditionally, yanglingquan is mainly indicated for treatment of lower limb disorders, such as pain and numbness in the legs and knees, but the effects of stimulating this point are thought to also extend upward along the gallbladder meridian, which traverses the costal region to the shoulder. There, the meridian passes through the point jianjing (GB-21), indicted for stiffness of the neck, pain of the shoulder and upper back, and for difficulty moving the arm. A further basis for using yanglingquan is its reputation for soothing and moistening the sinews. Since the shoulder capsule is contracted, this action is considered important to healing the disorder...
A similar method was described in a report by Feng Zhengen (4), using the extra point lingxia, located 2 cun below yanglingquan (GB-34). The point on the same side as the affected shoulder was needled, while sanjian (LI-3), on the hand, was needled on the opposite side. The patient would move the affected arm during the acupuncture therapy. Treatment was given daily for 10 sessions, followed by a 2 day break and then another 10 sessions. It was reported that of 210 patients treated, 158 cases were resolved, and that all but 12 cases showed some improvement.
The selection of lingxia, rather than yanglingquan was based, according to the author, on the fact that he found a marked tender point at this spot which, when pressed, alleviated the shoulder pain.
Another acupuncture point in this same area of the leg that is used for shoulder disorders is tiaokou (ST-38). It is especially considered for treating acute shoulder pain, and is stimulated while the patient moves the shoulder. Jorge Vas and Emilio Perea-Milla compared the effects of needling tiaokou on shoulder pain when the treatment either did or did not elicit deqi, finding that deqi was important to gaining the desired prompt alleviation of pain. The successful use of tiaokou for frozen shoulder had been mentioned in an early publication by German acupuncturists.
Acupuncture with local points
The points chosen to treat frozen shoulder are often selected from those on the small intestine meridian, especially from SI-9 through SI-12, which run across the shoulder area. A key point is bingfeng (SI-12) at the attachment zone for the shoulder capsule. Bingfeng (grasping the wind; which became the title of a book about the names of acupuncture points; 8), is located by raising the arm, which produces an indentation at this spot. It is used to relieve disorders where there is shoulder pain accompanied by difficulty raising the arm, as occurs with frozen shoulder. In a report published in 1998 (9), results from treating 60 patients with "shoulder-arm" syndrome were relayed.
Although this report did not address frozen shoulder, it claimed to produce marked effects through use of this single point (a second point would be treated for manifestations of the disorder in the forearm or hand).
Local treatment was the primary focus of a recent report by Jin Dongxi and Li Zhingtai, who described treatment of 50 patients with frozen shoulder using acupuncture and massage (10). They stimulated several points on the shoulder, including bingfeng, as well as others on the hand and arm of the same side as the affected shoulder. The points selected for treatment were:
extra point taijian (the name means "lift shoulder;" it is located 1.5 below the anterior part of the acromiom);
extra point jubi (the name means "raise arm;" located 3.5 cun below the anteroinferior part of the acromiom)
Ashi or trigger points around the shoulder should be carefully sought and needled superficially; tiaokou (ST-38) with strong manipulation is useful. Deqi should be sought in the robust patient, with less stimulus in the weak patients. Electroacupuncture at quchi (LI-11), jianyu (LI-15), jianjing (GB-21), and jianzhen (SI-9) at 5 Hz helps; yanglingquan (GB-34) bilaterally for 2 minutes alone often controls pain and releases stiffness. Auricular therapy at shenmen, shoulder, shoulder joint, clavicle, and adrenal points is helpful. The patient should exercise faithfully with a slow warm-up.
Finally, the use of scalp acupuncture should be mentioned. This treatment is frequently used for chronic pain syndromes and was the subject of an evaluation involving 210 cases (15). A point was treated along the vertex-temporal line, which runs from the head vertex baihui (GV-21) to the temple at xuanji (GB-6), about 40% of the way from the vertex to GB-6, which is in the zone corresponding to upper extremity disorders.
The needle was threaded about 30 mm (about an inch) towards the temple (a second needle, inserted close to the same point but angled 45 degrees to the first and crossing its path, was often used to get more intense stimulus). If only one shoulder was affected, the contralateral side would be treated; with both shoulders affected, both sides would be treated.
The patient was advised to relax, focus on the affected shoulder, and carry out shoulder movements during the treatment, while the practitioners manipulated the needles (with repetitive rapid withdrawal about 3 mm, then slower return) at least every 5 minutes and sometimes also massaged the shoulder. The needles would then be retained for 1-2 hours, or up to 1-2 days for severe cases. Typically, treatment was carried out every 1-2 days with seven sessions as a course of treatment. "
Chris then explains how Tai Chi can help prevent frozen shoulder, and gives some exercises and nutritional recommendations, including vitamin D supplementation.
If you suffer from frozen shoulder, the exercises and diagrams are very useful.
You can read the whole paper here. It is a swf file which should open in your browser as a slide show or with Flash. Diagrams and pictures of the acupuncture points are included in the paper.
"A salt water injection could help millions of people.. who suffer from frozen shoulder. The risk-free ten-minute procedure, known as hydrodilatation, involves injecting salty water directly into the shoulder."
The salty water breaks up the adhesion and the patients feel immediate relief.
Hydrodilatation takes just ten minutes and patients go home immediately.
"The procedure involves patients lying on their backs on an X-ray table. The injection is given using X-rays for guidance.
Local anaesthetic and a steroid is then injected to calm down inflammation in the shoulder.
Salty water - at a ratio of less than 1 per cent salt to water - is injected to balloon out the joint.
The normal joint space holds 10ml of fluid but a total of 40ml of fluid is injected.
This lifts the stuck-down adhesions from the bone so that normal movement is restored.
The excess water is then absorbed by the body over the next day or so. Patients are allowed to go home immediately.
"
Learn authentic Acupuncture & Oriental Medicine at New York College of Traditional Chinese Medicine
Join us to hear about the exceptional programs at New York College of
Traditional Chinese Medicine that prepare you for a career in
Acupuncture and Oriental Medicine. Prospective students are invited to
attend an NYCTCM Open House for an overview of the Acupuncture school
& Traditional Chinese Medicine school programs, a tour of the
facility, open discussion, and information on the application process.
Hello everyone, my name is Billy Shonez Singh and I am a licensed acupuncturist and board certified herbalist. I am presenting to you what is acupuncture, what its used for and how a needle is inserted into the body.
If you want more information just go to my website at Zehohs Acupuncture in Commack, NY. Take care and we'll see each other next time.
About Billy Singh, L. Ac. & Zenohs Acupuncture in Commack, NY
Zenohs Acupuncture's lead Practitioner and founder of the Center is Billy "Shonez" Singh. From a young age, Billy had always revered ancient Chinese wisdom. He began firstly practicing martial arts. Years later, Billy's interest in Acupuncture and ancient Chinese healing grew organically from there.
Billy received training from the New York College of Health Professions in Syosset, New York, where he was a student in the Massage Therapy program.
Moving forward from this knowledge base, Billy obtained his Masters Degree in Acupuncture, and is board certified as "Diplomate of Acupuncture" and "Diplomate of Chinese herbology by the NCCAOM (National Certification Commission for Acupuncture and Oriental Medicine).
Billy has also been fortunate enough to train under noted acupuncturist and author, Virginia Doran, LMT, M.Ac., L.Ac., from whom he obtained certification in Facial Rejuvenation Acupuncture.
"In terms of itch, Traditional Chinese Medicine considers that
it connects with wind pathogen. So treating pruritus is always based on
dispelling wind. But for chronic eczema caused by wind from Yin
deficiency and blood dryness, it is worthy to be cautious to use
pungent and warm natural drugs to resolve superficies. Or the condition
would worsen because pungent and warm natural drugs reinforce the wind
of blood dryness. Drugs of pungent and cool nature to resolving
superficies, such as Bo He (Wild Mint) and Chan Tui (Cicida Moulting)
are highly recommended.
Even while the lesion is akin to
neurodermatitis, pungent and warm natural drugs to resolve superficies
can not be abused, or would cause acute outbreak of eczema. Traditional
Chinese Medicine consider that it need to promote blood circulation in
the first place for the sake of dispelling wind, and then wind vanish
naturally after blood stasis removes. So it is suggestive that some
herbs of promoting blood circulation should be added."
Read more at Chinese Medicine Gem blog. He gives TCM diagnoses and possible treatments for common symptoms.
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Our mission is to expand the knowledge, understanding and accessibility of TCM by providing a globally accessible venue for interactive learning and the communal exchange of ideas.
At Rootdown.us we want YOU - the TCM community - to complement and expand on what you find here. We encourage you to add ideas, your first-hand experiences and new information to make Rootdown.us a living, dynamic, and interactive reflection of YOU and YOUR knowledge and contributions."
"In Chinese
folklore, there is a fairy tale that goes with the black-bone chicken.
It is said that the celestial Lu Dongbing made pills of immortality on
Tiger-nose Peak long, long ago. Tiger-nose Peak is also known as
Two-finger Peak of the Wushan Mountain in Taihe. On the day when the
pills of immortality were successfully made, Lu Dongbing invited other
celestial beings to the celebration party, including Tie Guaili, Han
Zhongli, Zhang Guolao, He Xiangu, Lan Caihe, Han Xiangzi, and Cao
Guojiu.
When the celestial beings were drinking wine, a pair of wild
chicken flew from the forest into the pill-making pool and ate the
pills of immortality. The chickens then became a pair of white phoenix.
Lu Dongbing was not glad and reported to Buddha Guanying, but Buddha
Guanying smiled and said: "It's a good opportunity for them to live on
earth." Buddha Guanying pointed at the Tiger-nose Peak, and the white
phoenix immediately became silky fowl."
The black-boned hen is a very good setter and is often used to hatch the eggs of other species that do not set on eggs as well.
"In the Tang
Dynasty, the 'maifengdanyao,' which has the black-bone chicken as the
main ingredient, was thought to be the cure-all medicine for the
gynecological diseases."
Oriental Recipes from NYCTCM Eastern Nutrition Class
See a delicious recipe for Black Boned Chicken and Chinese Yam Soup at the NYCTCM website. Students from the Eastern Nutrition class have published their recipes that show the healthful function of each dish and ingredient in accordance with TCM principles.
Diabetes was discussed in all the earliest ancient TCM tests, including Neijing. According to TCM overconsumption of fatty and greasy food, sweets, emotional disturbances, and a constitution that is too yin is related to developing diabetes. Clinton Choate then analyzes diabetes according to TCM theory, explains treatment according to the Three Burners, giving acupuncture protocol. He explains diabetic complications according to TCM including cataracts and night blindness, edema, skin infectins, neuropathy and strokes. He describes food remedies for diabetes.
This article is helpful to anyone suffering from diabetes who wants to understand it better, and helpful forTCM practitioners.
Basic TCM Knowledge regarding Osteoarthritis of the Knee
In Traditional Chinese Medicine Osteoarthritis (Degenerative Joint Disease) is mostly related to Fixed Bi and Painful Bi.
Fixed Bi Syndrome: The chief manifestations include pain and heavy sensation in the relatively fixed areas of body limbs or joints, numbness of the muscles, aggravation of the condition in rainy days, white greasy tongue coating, and soft slow pulse.
Painful Bi Syndrome: The chief manifestations include severe pain in the limbs and joints as if being stabbed or pricked. In the worst cases, there is fixed pain that is alleviated by warmth but aggravated by cold, better in the daytime but worse at night, limited movements of the joints, no local redness nor feverish sensation, cold sensation in the affected parts, thin white tongue coating, wiry tense pulse.
Pathogenesis
Wind, cold and dampness invasion causes the blockage of the Qi and blood in the meridian. In modern medicine, it is related to aging, endocrine disorder as well as trauma and improper posture.
Clinical manifestations
The onset of osteoarthritis of the knee is insidious. Initially, there is articular stiffness, seldom lasting more than 15 minutes; this develops later into pain on motion of the affected joint(s) and is made worse by activity or weight bearing and relieved by rest. Deformity may be absent or minimal; however, varus deformity of the knee is not unusual.
Imaging
Radiographs may reveal narrowing of the joint space, sharpened articular margin, osteophyte formation and lipping of the marginal bone, and thickened, dense subchondral bone. Bone cysts may also be present.
Major pattern differentiation
Fixed Bi: Pain fixed in the knee joint accompanied by heaviness, stiffness and numbness, sometimes slight swelling.
Painful Bi: Severe pain in the knee joint, aggravated by cold and alleviated by heat.
Treatment Principle: Expel wind, Cold and dampness, improve the meridian circulation and regulate Qi and blood.
Major Acupuncture points and needle techniques Acupuncture points for knee: Xiyan (Ex.), Dubi (ST35), Zusanli (ST 36), Yanglingquan (GB 34)
Alternative Therapies:
Auricular therapy Corresponding area (Knee), Sympathetic, Shenmen
Subcutaneous needling therapy Select local point or tender points Seven-star needle tapping and cupping
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