"Dedicated to my family, my patients, my teachers, and my colleagues.¡Hasta La Victoria Siempre (Always Towards Victory)!"
Moxibustion is another procedure used in East Asian medicine and it involves the burning of an herb called mugwort (àiyè in Mandarin) on different points and areas of the body.Moxibustion is one of the many sub modalities in the acupuncturist's arsenal.Modern TCM theory says the needles are used to move qì while moxa is used for supplementing it. That is modern TCM view on acupuncture and moxibustion.Thus the modern view of moxibustion being a supplementing entity is correct in that respect.Classical literature has shown that moxa is used for either supplementation or for dispersion just as much as acupuncture can used for either moving qì or supplementing qì.Before I discuss the proper functionalities of moxa (àiyè), let us look at the Chinese characters of moxa, jiǔ huǒ.
The character "jiǔ" when translated from Mandarin to English is "something that endures; long-standing."
The character "huǒ" means "fire."
Putting those characters together, "jiǔ huǒ" translates to "long burning fire."This implies that the effects of moxibustion heats up the body and its effects are long lasting.
Moxibustion works on these levels:
Increasing metabolic vacuities within the body (or supplementing the qì or Blood)
Providing analgesic effects (or moving qì and Blood to stop pain)
Building up the immune system (or supplementing the wèiqì)
Lowering blood pressure (or sedating Liver yang when applied to Kid-1{YǒngQuán} or Du-20{BáiHuì})
The way moxa works on body based on scientific thinking starts in the second century.In the second century, Buddhism arrives in China from India along with Ayurveda and breathing techniques (pranayama).According to the philosophy of yoga, chanting "Om" during meditation is based on the concept that everything vibrates.This is the sound that the earth's core makes.That form of thinking goes into Chinese medicine.Moxa has a vibratory effect because there is movement while it's being burnt.The human cell vibrates at a rate of 600 to 900 amgstroms per second.When moxa burns, vibrates at a rate of 900 amgstroms per second.Therefore, its vibrations affect the human body.
The application of moxa depends on the following factors:
The point(s) used
The treatment principle: supplementation or dispersion
Transfer mediums:
aconite (FùZi)
Ginger (Shēng Jiāng)
Garlic (Da Suàn)
Salt
Deer Antler (Lù Róng)
Tangerine Peel (Chén Pí)
Poria (Fú Líng)
Potato
Rice
direct application on the skin (cones)
has it been burned 2/3's of the way down
has it been burned all the way down
5.being burned on top of the needle (needle-head)
The cone-style moxa affects the wèi, qì, andyíng levels of the body, thus making it effective in treating vacuities in the body (qì level) or supporting the immune system (the wèi and yíng levels).Needle-head moxa, where the moxa wool is placed on top of the needles, affects the xuè (blood) level.When moxa in cone form is burnt an odd number of times, its function (depending on which point is being used) becomes supplementing.When moxa cones are being burnt an even number of times (again, depending on the point used) becomes regulatory.Now it's not just the number of cones being used but also the amount of heat being transferred through the points.When the moxa cones are burnt 2/3's of way and the patient feels "warm" the effects are supplementing and the heat is spread put in a smaller quantity.This will affect the wèi, qì, and yíng levels of the body.Similarly, if the cones are burnt 2/3's of the way almost to the surface of the skin, the effects are more dispersive.It will feel "hot" and the circulatory system is increased and the heat is spread out throughout the body.This technique will affect the yin and blood levels of the body.The heat emitted from the burning moxa on top of the needles (in the needle-head technique) conducts itself through the needle to affect the xuè level.Thus, it is effective in treating muscle, tendon, and joint related conditions thereby invigorating the flow of blood to those specified areas.
Another point I want to mention is that moxa overall helps with regulating the zhēngqì (the correct qì).The definition of zhēngqì is the qi that defends the body from exogenous pathogens and gives rise to other forms of qì such as wèiqì, yíngqì,zàngfǔ qì , and jīngluòqì.With that in mind, the zhēngqì is needed for the proper energy dynamics within the body to maintain health.When, the zhēng qì is compromised in serious illnesses such diabetes or autoimmune disease, then the other aforementioned types of qì becomes compromised.As stated before, moxa helps regulate the zhēngqì.In essence, moxa leads to a natural reorganization of the body into its normal components.
Bibliography
Jackowicz, M.Ac., L.Ac., Ph.D., Dr. Stephen J., "Moxibustion Boot Camp," Lecture Notes 2007.
Easton, Darlene, Fundamental Theory of Oriental Medicine, Lecture Notes 2002.
Billy Shonez Singh is a licensed acupuncturist and a board certified Chinese herbalist by the NCCAOM. He is currently practicing in Westbury, NY. His primary focus with East Asian medicine is stress, pain management, diabetic complications, and treating chemotherapy side-effects. He is also the President & CEO of Zen-Ohs Botanicals, Inc.
Big Surprise at
Seminars - People are surprised
when acupuncture quickly helps pain
I am invited to seminars once in a while at churches or
health clubs. During my talk I introduce how traditional Chinese medicine (TCM)
developed. I provide information about what foods should be taken depending on people's
individual constitution based on TCM.
Each body has unique constitution. Some have a cold body and
their hands and feet always are cold. Some feel they have to apologize to the
other party when they shake hands, as their hands are very cold. Some can't go
to bed without wearing socks during sleep.Some people have a warm body. Certain foods may help this body
condition. If anyone eats by the opposite way, for instance cold body with cold
foods, this will harm the body. I believe that some say we have to eat all varieties
of foods. This idea is not always right as this common theory doesn't consider
our constitution.
After the seminar, I give a free acupuncture treatment
depending on the situation. If I do, I offer the treatment to as many patients
as possible. I usually ask them to give me only one symptom they really want to
treat, as we have only limited time. Many
people complain of neck and shoulder or arm pains; a whopping more than 30% of
the attendances. This means they live with pains everyday without proper
treatments. Some couldn't move their neck or have constant neck pains. Some
couldn't raise arms, or their range of motion is very limited. Some can move,
but they feel the pain in a certain position or make a funny sound from the
shoulder.
This is what I usually do during the treatment. I want to
find the painful spots; sometimes only one spot, or multiple spots. When I
press this spot, the patients screams instantly or makes frowned face. This
simple procedure eliminate all kinds of tests, such as MRI, Cat Scan etc. (These
tests try to find where the pain is and how the pain area looks. A person who
doesn't have health insurance may not be able to afford these very expensive diagnostic
procedures.) These tests don't include proper treatment such as prescribing
pain killers, massages, physical therapy, chiropractic methods etc. If all treatment
methods do not work, the other option is a surgery.)
I as an acupuncturist try to find what causes the pain. As soon as the original cause is removed, the
pain will disappear. Tendon inflammation, or tear are western names. I try to interpret
this into acupuncture theory. Inflammation means "caused by heat". Pinched nerve
means stagnation. There are more causes such as Qi and blood deficiency or
stagnation, blood stasis, damp accumulation or phlegm etc. I often explain
these in detail at the seminar. So what I do is just to remove the heat or
stagnation etc. with acupuncture.
After finishing the diagnoses, I tap acupuncture needles on
the patients. People surrounding the patient ask questions such as 'is there is
any pain when tapping in acupuncture needles?' The answer from the patient is
no pain at all or a touching feeling. They wonder how this could happen. The
next thing I do is to press the same painful area or spot to check whether the
pain is reduced or not. About 50% of cases say there is no more pain or don't
scream or make a frowned face instantly. Some say even though there is still
lingering pain, the pain is less than before. Everyone is amazed by the fast response.
Some even ask whether needles are coated with narcotic drugs. Of course, there is
very small group saying there is no change at all. But they also say the pain is
reduced substantially when I remove needles after 30 minutes. The acupuncture treatment
generally lasts about 30 minutes.
Some patients who have had a surgery come to clinic, as
pains still remain the same. Some doctors want to do another surgery, but the patient
has realized that all surgeries are not successful. Please note that any person
with a surgery has a tendency for a slower healing process with acupuncture
treatments. I think this is due to damage on the subjected meridian. I strongly
suggest trying acupuncture treatments before considering a surgery. If
acupuncture treatments don't work in your case, you still have an option for a
surgery. The surgery may be a last option.
I wonder why so many people suffer these kinds of pains,
even though acupuncture is an effective way to make them free from pains, such
as neck, shoulder and arm pains? One reason is we haven't had any education
about acupuncture theory in school and acupuncture is not well-known in the
Western culture. Sometimes they say they are 'afraid of needles' and they don't
realize an acupuncture needle is usually a very small hair-thin needle, not at
all like the large needles used to give vaccinations at their doctor's office. Many
people think acupuncture is kindof mystical, superstitious and non-scientific. The
truth is that acupuncture is very simple, inexpensive and effective and fast treatment.
Reading the title of this new article, you are probably thinking, "How is that possible?"By treating something as simple as back pain with acupuncture and Chinese medicine, you are taking a preventative measure against cancer.It may sound unlikely, or even impossible; but on the contrary, it's quite feasible.
It all starts with an injury.Let us say a 25-year-old man gets into a 30-mile-per-hour car accident.He survived the accident and now has minor upper and lower back pain due to the concussive force of the crash.Over time, the pain comes and goes but the concussive force remains, therefore leading to impeded blood flow to the connective tissues and muscles. In a great amount of time, impeded blood flow in this case leads to lack of oxygen to the surrounding tissues, which is known as ischemia.Ischemia leads to another process known as cell death, because no oxygenated blood is going to the tissues.Eventually, the severity of cell death turns into necrosis because cell death has now spread into other tissues surrounding those affected by the concussive force. Over time, the surrounding necrotized tissues go into a cellular process known as cytotoxicity, which is much more severe than necrosis.Toxins build up in the surrounding and localized muscle tissue, which later leads to cancer, which spreads into tissues.How many times have you heard about people dying of cancer, despite the fact that they did not have cancer in their family health history?
A perfect real-life example of this theory is the case of Sosai Masutatsu (Mas) Oyama.He was born in 1923 and was the founder of Kyokushin karate.He trained under harsh environments and conditioned his hands, legs and feet by striking rocks and trees.He challenged 300 fighters in Japan and fought all of them in a three-day kumite (which in Japanese means "free fight").In short, he pushed himself beyond the limits of human endurance.Yet despite his physical and spiritual strength, he died in 1994 of lung cancer as a non-smoker.Now this is where the theory of concussive force comes into play.As a fighter in his time, martial artists did not have protective equipment to shield their bodies as we do now.When you are fighting the way Masutatsu Oyama did, most of the concussive force coming to your body comes from your opponent's strikes to your ribs, among other body parts like the head, groin and stomach.Despite his physical strength, he was taking concussive force to his body (in his case, specifically the rib cage), which resulted in ischemic tissues, which over time resulted in his lung cancer.
Chinese medical practices like Gua Sha can help treat musculoskeletal problems before they can eventually turn into potentially life-threatening issues.Gua Sha is a modality that incorporates the use of a Chinese soup spoon, or any other hard device, to scrape the surface of the skin until there is bruising and redness.It can be used as a stand-alone treatment or it can be used with one's acupuncture treatment.The theory behind scraping the surface of the skin until it is very red is to bring up any stagnated blood and toxins to the surface of the skin.The stagnated blood and toxins that have been built up cause pain and eventually lead to other problems at a cellular level.Since there is bruising involved, capillaries are destroyed and allowed to regenerate, thus bringing in a fresh supply of nutrients and oxygenated blood to the connective tissues of the body that have been affected by injuries involving concussive force.The bruising and redness that occurs fade away within four to five days.If you want to see this technique done in action go to: http://www.youtube.com/watch?v=fOF9kvjDPsk.
Billy Shonez Singh is a licensed acupuncturist and a board certified Chinese herbalist by the NCCAOM). He is currently practicing in Westbury, NY. His primary focus with East Asian medicine is stress, pain management, diabetic complications, and treating chemotherapy side-effects.
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.
"
Acupuncture with local points ![Reblog this post [with Zemanta]](http://img.zemanta.com/reblog_e.png?x-id=03c80ea3-b7f5-474c-a897-8d7d4d4288e2)
"A salt water injection could help millions of people.. who suffer from ![Reblog this post [with Zemanta]](http://img.zemanta.com/reblog_e.png?x-id=e70308d6-021d-4525-901c-fe37c2a228af)
