Acupuncture & TCM Blog

The New York State Acupuncture Coalition  addresses the fact that many acupuncturists are trained in and practicing herbal recommendation according to Oriental medicine principles in their practices, yet there has been no regulation of this practice. The coalition seeks to regulate herbal practice within the acupuncture statute not only to ensure protection for practitioners to continue their practice of herbs but, more importantly, to protect the public by setting the standards for safe practice of herbs.

The coalition is conducting a grassroots movement to successfully enact legislative statutory changes to the AOM Licensing Law to more clearly define acupuncture scope of practice, better protect the public, and self regulate our profession.

The coalition is comprised of practitioners, students, alumni associations, professional associations, schools, and patient supporters. This coalition is unique in that, for the first time, it will be proactively seeking to amend legislation in favor the long-term interest and protection of the practice.

As of today, a number of New York schools, including Pacific College of Oriental Medicine, Touro College, New York Chiropractic College, New York College of Traditional Chinese Medicine, Tri-State College of Acupuncture and members of the faculty of the Swedish Institute Acupuncture Program, have stated their support of the coalition's efforts. Additionally, The Acupuncture Society of New York, High Falls Garden, TCM World Foundation, American Traditional Chinese Medicine Society, and United Alliance of New York State Licensed Acupuncturists are in full support of the coalition's efforts.

You can download the Legislative Guide 2008 from the NYSAC home page. Find an overview of NYSAC's legislative goals here.

Hua Tuo, also named Yuanhua, was from Pei Guo Jiao, today's Hao County in Anhui Province. He was a legendary physician in the 2nd century. Hua Tuo sought neither rank nor remuneration. He completely devoted himself to the study of medicine, and achieved outstanding results in many areas. His eminence in ancient China accorded him the name "miraculous healer."

Hua Tuo lost his father at the age of seven. Because his family was quite poor, his mother decided to send him to study medicine under Dr. Cai, a very close friend of Hua Tuo's father. Hua Tuo went to town and met with Dr. Cai. After he expressed his wish, Dr. Cai thought to himself, "Hua Tuo's father was my friend. If I don't take the boy as my intern, the townspeople will think of me as uncaring and disloyal. I'd better take him. However, I need to test the boy to see if he is cut out for medicine."

At that moment, Dr. Cai noticed several of his interns were collecting mulberry leaves outside, but they were having difficulty reaching the leaves on the highest branch. He decided that this would be the first test for Hua Tuo. He asked Hua Tuo, "Can you think of a way to collect the leaves on the highest branch on the tree?" Hua Tuo said, "That's easy enough," and asked for a rope. He tied a small rock at the end of the rope and threw the rope over the highest branch pressing it down, and picked all the leaves on the branch.

Next, Dr. Cai saw two goats engaged in a fight, their eyes were bloodshot with rage. No one could separate the two goats. He decided that this would be the second test for Hua Tuo. He asked, "Hua Tuo, are you able to separate these two goats?" Hua Tuo answered, "Certainly." He fetched two bundles of fresh grass and put them by the goats. The goats had gotten hungry from fighting so they were quick to turn their attention to the grass. The fight was stopped effortlessly. Greatly impressed, Dr. Cai gladly accepted him as intern.

Hua Tuo studied assiduously, and paid a great deal of attention to the clinical aspects of the practice. He became a renowned physician in the Eastern Han Dynasty (25 AD - 220 AD). Nonetheless, the famed Hua Tuo never differentiated his patients. Regardless of the settings, he provided his service focusing only on saving lives and treating illnesses, reflecting his conscientious noble sentiments. He continued to practice medicine throughout his life. In surgery, internal medicine, gynecology, acupuncture, parasitology, and physiotherapy, he attained original insight and masterly expertise.

Hua Tuo was especially adept in surgery. He was the first surgeon to perform a laparotomy in Chinese medical history. To alleviate pain for his patients, he formulated an anesthetic mixture, Ma Fei San or boiled anesthetic powder preparation, which was used to provide general anesthesia. It was not until 1,600 years later, at the beginning of the 19th century that Europeans began to use general anesthesia in surgery.

Once, Hua Tuo ran into a vendor pushing a cart on the street. He had a sallow complexion, and was short of breath. He looked sick. Hua Tuo learned that he had colicky pain in the abdomen, and made the diagnosis of appendicle abscess. Hua Tuo gave the man his boiled anesthetic powder preparation to drink and he was soon anesthetized. Hua Tuo made the incision with a knife, removed the affected tissues, gave him a peritoneal lavage, sutured the wound, and applied ointment to reduce inflammation and promote healing. The patient recovered a few days later and his wound healed quickly.

In the field of obstetrics, Hua Tuo also had delved into it deeply. It was recorded in The Book of Late Han dynasty: General Li's wife was ill and sought treatment from Hua Tuo. After taking her pulse, Hua Tuo concluded that she suffered from complications of fetal death in utero. General Li confirmed that she had problems during her pregnancy but that his wife had already aborted the fetus. Hua Tuo replied,"Her pulse indicates that she still has a fetus present." General Li felt otherwise.

A hundred days later, Li's wife's condition deteriorated. Hua Tuo was asked to see her again. Upon examining her pulse again, Hua Tuo said, "Her pulse is the same as before. This is what I think happened: She had a twin pregnancy. The first twin miscarried and caused her to bleed excessively, and prevented the birth of the second twin, which subsequently died in utero, shriveled up, and got hung up by her spine." Hua Tuo then performed acupuncture on her and gave her herbal medicine to drink. Before long, she went into labor, but was unable to effect delivery of the dead fetus. Hua Tuo explained that since the dead fetus had shrunk it would be difficult to deliver normally, and would require manual removal. Hua Tuo gave instructions to the midwife, and the dead fetus was successfully removed.

In the field of acupuncture and moxibustion (therapy utilizing moxa, or mugwort herb. The mugwort is aged and ground up to a fluff; practitioners burn the fluff or process it further into a stick that resembles a (non-smokable) cigar. They can use it indirectly, with acupuncture needles, or sometimes burn it on a patient's skin), Hua Tuo also made innovative discoveries. Once, a man sought medical treatment from Hua Tuo because he had problems with his feet and he couldn't walk. After checking the man's pulse, Hua Tuo marked several acupuncture points on his back, and applied moxibustion to each point seven times. The patient began to walk soon afterwards. Hua Tuo later summarized his experience in acupuncture and moxibustion, and coined his discovery the " Intervertebral Acupuncture Points". People later termed these points the "Hua Tuo Acupuncture Points," and they are still in use today.

Hua Tuo also devised a set of exercises imitating the movements of tigers, deer, bears, monkeys, and birds called the "Exercise of the Five Animals." It became very popular. One of Hua Tuo's students, Wupu, practiced the Exercise of the Five Animals on a regular basis. Even in his nineties, Wupu remained very strong and healthy with sharp ears, eyes and good teeth.

Hua Tuo occupies an important place in Chinese medical history for his superior medical skills, and his spirit of saving the dying and helping the sick.

Epoch Times - Hua Tuo Miraculous Healer in ancient China

Historical Account from Wikipedia
Hua Tuo came from Qiao in the State of Pei (modern-day Bozhou, Anhui). Besides being one of the most respected physicians in Chinese history, Hua Tuo also devised techniques to enhance health. He developed the Wuqinxi (五禽戲 "Frolics of the Five Animals"), a series of exercises based on movements of the tiger, deer, bear, ape, and crane.

He was well known for being able to diagnose miscarriages by examining a woman's pulse and to tell whether the dead fetus was male or female depending on the position of the fetus. He was also famous for ridding people of parasites that had gotten into their bodies from ingesting uncooked meat. One account was about a snake-like parasite that blocked a man's pharynx and another was about "wriggling red headed" parasites that could cause ulcers. Dong Xi, who had heard of Hua Tuo, introduced him to Sun Ce.

Hua Tuo healed general Zhou Tai who had been gravely injured in rescuing Sun Ce's brother, Sun Quan. Hua Tuo used drugs that healed Zhou Tai's wounds within a month, and Sun Ce rewarded him richly. Cao Cao heard about Hua Tuo and summoned him to his court. Henceforth Hua Tuo was often in attendance. Cao Cao suffered from chronic headaches (which many today believe was a brain tumor) and Hua Tuo would treat Cao Cao with acupuncture to stop the pain.

Later when Cao Cao had taken personal control of the affairs of the state, his pain became worse and more frequent. Hua Tuo told Cao Cao that this kind of illness would need long term treatments and thus Hua Tuo came to treat Cao Cao exclusively...

Fictional Accounts
In the historical novel Romance of the Three Kingdoms, Hua Tuo supposedly healed the Shu Han general, Guan Yu, who had been struck with a poisoned arrow during his Battle of Fancheng. Hua Tuo offered to anesthetize Guan Yu, but he simply laughed that he was not afraid of pain. Hua Tuo used a knife to cut the flesh from Guan Yu's arm and scrape the poison from the bone, and the sounds chilled all those who heard them. During this excruciating treatment, Guan Yu continued to play the board game Go with Ma Liang, without flinching from pain. When later asked by Ma Liang, Guan Yu said that he feigned being unhurt to keep the morale of the army high. After Hua Tuo's successful operation, Guan Yu allegedly rewarded him with a sumptuous banquet, and offered a present of 100 ounces of gold, but he refused, saying that a doctor's duty was curing patients, not making profits. Despite the historical fact that Hua Tuo died in 208, a decade before Guan Yu fought the 219 Battle of Fancheng, this storied operation is a popular artistic theme.

There are 21 states that have acupuncture schools or programs.

1. Arizona
2. California
3. Colorado
4. Connecticut
5. Florida
6. Hawaii
7. Illinois
8. Kansas
9. Maryland
10. Massachusetts
11. Minnesota
12. New Jersey
13. New Mexico
14. New York
15. North Carolina
16. Ohio
17. Oregon
18. Pennsylvania
19. Texas
20. Washington
21. Wisconsin

The remaining 29 states have no acupuncture colleges or programs.

The practice of acupuncture is not allowed in South Dakota and Wyoming.

Only physicians or chiropractors can practice acupuncture in North Dakota, Oklahoma, and Mississippi.

Acupuncture is licensed in the remaining states, a total of 45 states.

Two Experts from Beijing to Talk About Shen (Spirit) in Chinese Medicine

Continuing Education Classes for Acupuncturists & Students

Sponsored by New York College of Traditional Chinese Medicine
10 AM - 5: 30 PM,
November 9, 2008
Room 106, 155 First Street,
Mineola, NY 11501

Jing (Essence), Qi (Energy) and Shen (Spirit) are Three Treasures described in Chinese Medicine. The doctrine also says that the superior practitioners are focusing their treatment on Shen (Spirit), while general practitioners focus on the Xing (Physical).

Recently, most practitioners of Chinese medicine have come to know the importance of Shen (Spirit), but how much this concept is really applied in their practice is still a question mark.

At this November 9 seminar, two experts from Beijing, China will give a talk about applying the concept of Shen in clinical practice.

Fees:
$60 for both talks, discounts for Acupuncture students and NYCTCM alumni

For details on these two seminars and to learn more about the NYCTCM CEU program, please go to the New York College of Traditional Chinese Medicine website CEU page where you can download the registration form.

Acupuncturist Anna Stephens applies needles to patient Linda Aron in efforts to help facilitate Aron's digestion at Postels Community Health Center, part of the Grinnell Regional Medical Center in Grinnell, Iowa. Photo by Doug Wells for USA TODAY

The American Hospital Association says ...that 37% of hospitals around the USA make complementary and alternative treatments available -- including acupuncture, touch therapy, and music and art therapy. A similar survey by the hospital group in 2005 found that one in four hospitals offered such services...

The majority of hospitals say that patient satisfaction is the No. 1 way they determine if an alternative treatment is beneficial, closely followed by clinical data on a treatment. Cleveland Clinic just completed a complementary and alternative therapy pilot program for patients undergoing heart surgery. Half of the patients -- more than 1,700 -- opted for spiritual care, counseling, art, music, touch therapy or guided imagery, and 93% of patients surveyed said the services were helpful.

Guidance from doctor groups for patients with chronic pain has helped bolster doctors' acceptance of complementary treatments, says Richard Nahin, senior adviser for scientific coordination and outreach at the National Center for Complementary and Alternative Medicine.

He cites new guidelines for treating lower back pain issued jointly last year by the American College of Physicians and the American Pain Society, which suggest many alternative therapies as potential treatments. "As doctors become more aware, hospitals will also follow," Nahin says.

USA Today Health News 9-15-2008 for full article

Pentagon researches alternative treatments

The Pentagon is seeking new ways to treat troops suffering from combat stress or brain damage by researching such alternative methods as acupuncture, meditation, yoga and the use of animals as therapy, military officials said. "This new theme is a big departure for our cautious culture," Dr. S. Ward Casscells, the Pentagon's assistant secretary for health affairs, told USA TODAY. Casscells said he pushed hard for the new research, because "we are struggling with" post-traumatic stress disorder (PTSD) "as we are with suicide and we are increasingly willing to take a hard look at even soft therapies." About 300,000 Iraq and Afghanistan war veterans suffer from PTSD or major depression, and about 320,000 may have experienced at least a mild concussion or brain injury in combat, according to a RAND Corp. study released this year.

The Army reported a record 115 suicides last year, and suicides this year are at a rate that may exceed that, said Col. Eddie Stephens, the Army's deputy director for human resources policy. The Department of Veterans Affairs reported last month that suicides among Iraq- and Afghanistan-era veterans from all services reached a record high of 113 in 2006, the latest year for which there were figures.

Some military hospitals and installations already use alternative therapies, such as acupuncture as stress relievers for patients. The research will see whether the alternatives work so the Pentagon can use them more, said Army Brig. Gen. Loree Sutton, head of the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury.

Many of the treatments have been used for centuries, Sutton said, "so it just makes sense to bring all potential therapies to bear." Some soldiers who suffer from PTSD are reluctant to share their experiences in traditional psychiatric therapy, said Col. Charles Engel, an Army psychiatric epidemiologist. He said those soldiers may be more willing to use acupuncture and other alternatives if they are effective.

Initial research this summer with combat veterans showed that acupuncture relieved PTSD symptoms and eased pain and depression, Engel said. "Improvements were relatively rapid and clinically significant," he said.

http://www.usatoday.com/news/health/2008-10-07-holistic_N.htm  for full article

NEJM amicus brief supports failure-to-warn claims against Wyeth Laboratories.

A group of current and former editors of The New England Journal of Medicine, along with several well-known NEJM contributors, recently filed an amicus brief in U.S. Supreme Court, charging pharmaceutical companies with deliberately withholding relevant adverse-reaction data when their profits are at stake. The brief was filed in conjunction with the Wyeth v. Levine case, in which drug giant Wyeth Laboratories is appealing a Vermont Supreme Court decision awarding $6.8 million to Diana Levine, who had to have her arm amputated after improper administration of the Wyeth anti-nausea drug Phenargan.

Levine's lawsuit charges that the drug contained inadequate warnings and instructions for use. Wyeth, in turn, is claiming that FDA authority to approve drug labeling preempts state failure-to-warn litigation regarding prescription medication. In the summary of its argument supporting Levine, the amicus brief stated:

"The argument of Petitioner [Wyeth] and its amici ('Petitioner/Amici') that federal preemption of state law failure-to-warn claims involving prescription drugs will actually make the world a safer place is riddled with factual fallacies. First, contrary to Petitioner's/Amici's necessary premise, the FDA is in no position to ensure the safety of prescription drugs. Not only is the FDA seriously hampered in its ability to determine the risks of drugs before they are approved for sale, but it has proven inadequate to the task of addressing hazards that only become apparent after a drug has been widely marketed to an unsuspecting public. Post-approval dangers posed by drugs placed into the market are unfortunately quite common. However, the FDA's ability to either anticipate these risks or react expeditiously once they have been revealed has been limited by serious information-gathering constraints in both pre- and post-approval settings."

Part of the difficulty the FDA has in addressing drug risks, according to the brief, stems from the fact that it is forced to rely on the manufacturers themselves for outcome data upon which to base its decision to either approve or disapprove a drug. The brief went on to use the examples of three different drugs - Pondimin/Redux, Vioxx and Trasylol - in which the manufacturers allegedly withheld key information from the FDA and strongly argued against stricter label warnings, all the while continuing to market these drugs to an unsuspecting public. In all cases, the companies allegedly manufactured data, ghostwrote articles for medical journals and/or withheld negative findings from the FDA.

The worst of these offenders in terms of estimated patient deaths was the anticoagulant Trasylol, marketed by Bayer. The drug was found to cause kidney failure. According to the amicus brief: "Between 1999 and 2005, Bayer generated over $935 million in revenue from sales of Trasylol with over $353 million in 2005. Bayer forecast that Trasylol would some day generate upwards of $600 million annually." Although exact numbers may never be released, an estimated 242,000 deaths were likely attributable to Trasylol between its release in 1993 and its eventual withdrawal from the market in May 2008.

In light of these examples and others, the brief argues strongly in favor of the FDA and the legal system working together to enhance consumer protection:

"Product liability lawsuits and the FDA have peacefully coexisted for seventy years for one simple reason: they have complementary, rather than conflicting, goals. The tort system complements the federal regulatory structure by providing a mechanism for compensating victims of hazardous drugs. Product liability litigation provides the FDA with key information unearthed in litigation that the agency can use to better protect the public from unsafe and inadequately labeled drugs. At the same time, the tort system and the FDA are similarly constrained.

"Whereas the FDA, as a regulatory body, weighs the risks against the benefits of a drug, in 'failure-to-warn' litigation most state courts require a similar balancing between the cost of care owed to a patient versus the prospective harm."

The brief went on to conclude:

"[G]iven that pharmaceutical companies have been known to equate increased warnings with a loss of sales, they would have an incentive to delay warnings as long as possible. As has been shown, certain pharmaceutical companies have already proven themselves unwilling to prioritize safety over profits, even when faced with the threat of civil liability. It is chilling to imagine how such companies might conduct themselves if the threat of tort liability for dangerous drugs were eliminated entirely by virtue of federal preemption."

The full text of the amicus brief, along with all other briefs filed in the lawsuit, is available online at www.abanet.org/publiced/preview/briefs/nov08.shtml#wyeth.

This article was published in Acupuncture Today, The Acupuncture and Oriental Medicine News Source

Together with acupuncture, herbal medicine is a major pillar of Chinese medicine. The Chinese pharmacopoeia lists over 6,000 different medicinal substances in terms of their properties and the disharmonies that they were helpful with. There are about 600 different herbs in common use today.

Herbs are classified in two major dimensions. The first dimension refers to the temperature characteristics of the herb, namely hot (re), warm (wen), cold (han), neutral (ping), and aromatic. The second dimension refers to the taste property of the herb, namely sour (suan), bitter (ku), sweet (gan), spicy (xin), and salty (xian).

Please go to the http://www.365tcm.com/ blog to read the rest of this article and find more very informative articles on Traditional Chinese Medicine.

I found this chart of median acupuncture earnings by years of experience. Any comments about this?