resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Filling the Gap: The Role of Alternative Practitioners in a Broken Health Care System
I have been asked many times what got me into alternative medicine. My answer is simple: I want to truly help and make a difference in people's health.
Vitamin D Fails to Help Knee OA? The Proper Perspective
The March 8, 2016 issue of JAMA includes a study about vitamin D supplementation for osteoarthritis of the knee. This is a really weird study.
Transparency is Key at ASA First Annual Meeting
On March 4th and 5th the American Society of Acupuncturists (ASA) held a successful first annual meeting in Albuquerque, New Mexico.
Recording and Appropriate Billing of Timed Physical Medicine Services
There is a common misunderstanding about timed therapy services and although you do have some knowledge of timed service documentation, based on your comment on the 8-minute rule, your understanding is correct, but incomplete.
Constructing Our Reality: The Primary Channels and Perception, Part 1
My favorite topic of discussion within Chinese medicine is the acupuncture channel systems. First of all, each of us have them. They are part of our bodies; not something external to us. To learn about the acupuncture channels is to learn about ourselves.
Energy: For Life and For Death
Energy is a deep topic in Traditional Chinese Medicine. Qi is understood to underlie all of existence, animated or not, and the qi of the living is studied with special attention.
Building Relationships and Referral Networks with Allopathic Practitioners
Dr. Doug, an orthopedist of 20 years, had heard stories from patients who tried acupuncture. While he was able to address many of their complaints effectively, some appeared to gain additional benefit when their care included TCM.
News in Brief
A Moment of Silence for Dr. Stephen Press; New ACA President Elected; F4CP Offers New MemBership Benefit.
Essentials of Assessment: The Squat
The squat is a simple, fast and functional tool to evaluate patient symmetry and function. As simple and easy as it is to implement, it can yield considerable amounts of valuable, clinically relevant information.
The IME System: A Current Public Health Risk and Solutions That Are Working
I strongly believe in the independent medical examination (IME) system. There are far too many doctors in every profession who are not following E&M protocols and never claim MMI (maximum medical improvement) has occurred for their patients, which has caused financial stress for many private and public carriers.
The Value of Melatonin in Breast Cancer Prevention and Adjunctive Treatment
Although melatonin (MLT) is best known for its sleep-aid properties and as a natural remedy to prevent jet lag, extensive experimental studies suggest it possesses anticancer activity through several biological mechanisms.
Roots in the Community, Branches Far Beyond
The Jung Tao School of Classical Chinese Medicine (JTS) was founded in 1998 by Sean Christian Marshall in Sugar Grove, North Carolina, a small community near Boone in the state's westernmost mountains.
An Interview with Amanda Shayle
JW: Can you share with us some of your history and how you became an acupuncturist? What did you do prior to becoming an acupuncturist? Where did you go to school?
The Rest of the Patient Story
I've written previously about allowing a patient to tell you their story – about taking the time to listen and engage all the aspects of their case history, the injury in question, and the related issues.
Health and Wellness Partnership
Yo San University of Traditional Chinese Medicine and The Wellness Center at the LAC + USC Historic General Hospital recently joined forces to extend care to the residents of Boyle Heights area of Los Angeles.
The Power of Eccentric Exercise: Hamstring Injury Prevention and Rehab
For almost 20 years, I've worked with professional athletes who make a living by running really fast. It goes without saying that hamstring injury (HSI) prevention and rehabilitation is a big part of what they expect from a sports chiropractor.
Business Lesson #1: Adapt or Else
My wife and I recently enjoyed an excellent meal at a restaurant recommended by some friends. We often have concerns about restaurant recommendations, as many have been disappointing.
How to Find and Fix TL Nerve Impingements
The thoracolumbar junction (TLJ) and the peripheral sensory nerves that exit from it are frequent, important and rarely recognized sources of lower back, pelvic and hip pain. Let's outline a clear exam protocol for diagnosing the problem.
The Art of Listening
One of the most important clinical concepts for me was voiced by the legendary physician William Osler. "Listen to your patient, he/she is telling you the diagnosis." After treating literally thousands of patients, it can become almost second nature to quickly discover clues which reveal the underlying diagnosis.
Asking Patients the Right Questions
When was the last time you asked a patient a question? Maybe 30 seconds ago? But, are you asking the right questions to elicit valuable and useful information? As a healthcare provider, you've likely spent hundreds of hours learning to ask the right questions to gather critical health information from your patients.
NCCAOM Launches New Membership Organization
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) recently launched a new national membership organization, the NCCAOM Academy of Diplomates.
September, 2002, Vol. 02, Issue 09
Yin and Yang Deficiency, Part I
By Barbra Esher, AOBTA CI. Dipl. ABT & Ac. (NCCAOM), LAc
It is often said that all of Chinese medicine can be reduced to the fundamental theory of yin and yang. If you practice Asian bodywork therapy, the ability to understand, interpret and apply the concept of yin and yang are essential to one's practice.All anatomy, physiology, pathology and treatment principles boil down to yin and yang. The beauty of yin and yang is that something so simple can be all-encompassing and profound when examined more deeply.
You may remember a past article that presented the basic principles of yin and yang. (Editor's note: See "Got Yin/Yang" in the Dec. 2001 issue, or online at www.massagetoday.com/archives/2001/12/08.html.) Just about every other article I have written has mentioned yin and yang as well, including "Korean Four Constitutional Types, Part I and II" (March/April 2002), in which I discussed taiyang/greater yang and yaiyin/greater yin type of people. That two-part article gave an idea of what someone with an excess of yang or yin might look like from a Korean point of view, but I haven't really discussed in depth how yang or yin deficiency manifests.
It is interesting to see that as people age, they naturally start to get low in their gender-related yin or yang energy. For example, as women age and their yin begins to decline, they go though menopause. They may experience hot flashes, night sweats and frequent waking, which are all symptoms of yin deficiency. Their character also tends to become less yin. Some women grow less meek -- going out, doing more and standing up for themselves. If they become pathologically yin-deficient, they may become agitated, demanding and shrill. This is all relative, I suppose, based on your perspective or proximity to the person (e.g., "Your mother's driving me crazy!" Dad may say).
The opposite happens with men -- their yang decreases and they mellow with age, becoming more yin: easygoing, less confrontational and less combative. It's a good thing this happens to men, because their partners may be going in the other direction! This certainly isn't to the point of being pathologically yang deficient; on the contrary, both men and women may feel more centered, balanced and comfortable with themselves and others as they develop more gender-neutral dispositions.
If yang deficiency develops, men may become sexually impotent, thus the multi-million dollar market for Viagra. Getting up at night to go to the bathroom, cold extremities and lower back pain all point to a possible yang deficiency as well. A man's character may become too mellow, to the point of losing his confidence, becoming listless and apathetic. If he tries to "treat" his boredom with a younger woman, how ironic it would be if he couldn't "perform." It would be safer to get a sports car to prove his masculinity, but better still, he could start Asian bodywork treatments!
Please understand that this is a generalization. We can by no means put everyone in these categories. For one thing, men are not all yang, and women are not all yin. There is a balance of yin and yang within both genders in different proportions. But there is a tendency that you may have noticed for men and women to switch polarities slightly as they age.
This depends on how strong they are constitutionally, and how much they take care of themselves over their lifetime. Stress, drugs, overwork, environment and poor diet can contribute to depletion of yin or yang. This doesn't only pertain to growing older; anyone can become yin or yang deficient at anytime. In future articles, I'll address other causes, along with symptoms and treatment.
The symptoms of yin deficiency are mostly -related, but of small magnitude. This is called because the heat is not caused not by excess yang, but insufficient yin. So if you look at the first drawing below, you will see that it is only because there is less yin that the symptoms appear yang. An excess heat condition will give you symptoms showing the heat is predominant, whereas the heat caused by yin deficiency will be fairly mild in comparison.
Notice in both figures that the horizontal line signifies "normal balance." In the case of yin deficiency, the yang is not excess, meaning, above normal. Instead, there is only more yang, because there is relatively less yin.
The second drawing shows a true full-heat condition -- yang consuming yin.
In this instance, you see symptoms such as a rapid pulse, which signifies heat, but it's also thin or empty, which indicates yin deficiency. If it were rapid and full, it would indicate excess heat. With an excess heat condition, the tongue is deep-red, but with yin deficiency, it's red or even light-red. You will also notice that due to the depleted yin, there will be patchy areas or no coating. A full heat will cause the face to be all red, but with yin deficiency, only the cheeks will be red (called "malar flush" in Chinese-English). A full heat will cause someone to be hot all of the time all over his or her body. On the other hand, yin deficiency will cause mild heat, mainly in the afternoon or evening, night sweats and/or warm hands, feet and chest (called Five-Centers Heat).
Yin-deficient people find that they are thirsty but they don't really feel like drinking a lot, or they take small sips. They want to drink mostly in the afternoon or at night. Those with full heat want cold drinks and have a dry mouth all of the time. Both will have scanty dark urine and suffer from constipation (from being dried up), but those with full heat may have pain as well.
Emotionally, heat causes restlessness, but yin-deficient people experience vague anxiety and are not really able to pinpoint why in particular they feel edgy. They could even be defensive. A person with an excess heat condition is much more obviously agitated, and sometimes arrogant. Any heat will cause difficulty falling and staying asleep, but yin deficiency heat keeps people waking frequently during the night or early morning, whereas with a full heat, their sleep is extremely restless and dream disturbed.
All of these are general yin deficiency signs and symptoms. A person doesn't have to have all of them to be considered yin deficient. Become familiar with them in contrast to an excess heat and then look more deeply to figure out which organ is involved and what the etiology could be.
Yin Deficiency/ Empty Heat Excess Heat/ Full Heat Principle Signs and Symptoms Afternoon, mild fever High fever Night sweating Feeling of heat all day Five Centers Heat Hot all over Scanty, dark urine Scanty dark urine Dry stools, no pain Constipation, pain Thirsty with no desire to drink, or just small sips Thirst for cold beverages Dry mouth and throat at night Constant dry mouth & throat Mentally restless but tired, vague anxiety, fidgety Extreme restlessness, agitation or manic behavior Defensive Offensive or arrogant Waking frequently at night Dream-disturbed and very restless sleep Red line inside eyelid Red eyes Mild red, painless spots Red skin eruptions, burning pain Overextended Driven Complexion Red cheeks/ Malar flush Whole face ted Tongue Red with little coating, or peeled Red with yellow coating Pulse Rapid, thready, empty, floating Rapid, full Treatment method Nourish yin Clear heat
There are five common types of yin deficiencies, and three types of excess heat/fire. You will find others described in texts. In part 2 of this article, I will discuss what I see most frequently in my practice. The beauty of making yourself familiar with the general symptoms for a large category like yin deficiency is that all you then need to memorize are a few key symptoms for each organ/meridian, instead of a long list for each different pathology. In the next issue, I will be able to discuss many syndromes in fewer words, because now you know the basics!
This series of articles is only the tip of the iceberg. For a list of schools that offer in-adepth programs in Asian bodywork therapy, go to www.aobta.org. For information on the national ABT exam, go to www.nccaom.org.
Click here for previous articles by Barbra Esher, AOBTA CI. Dipl. ABT & Ac. (NCCAOM), LAc.
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