resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Time to Fight for Your Medicare Right
I have heard a lot of noise and a lot of debate about what is going on with Medicare. As an ACA delegate, I often get asked: 'What is the ACA even doing?'
Guidelines for the Use of Modifier -52
Modifier -52 identifies that a service or procedure has been partially reduced or eliminated at the physician's discretion. This is to indicate the basic service described by the procedure code has been performed, but not all aspects of the service have been performed.
Don't Ignore the Lower Half of the Pelvis (Part 1)
When your patient complains of lower back or pelvic pain, but your usual treatments are not getting the job done, what do you examine and treat? You may be missing important structures in the lower half of the pelvis.
International Congress on Integrative Medicine
"Bridging Research, Clinical Care, Education and Policy" was the theme for the International Congress on Integrative Medicine and Health 2016 (ICIMH).
Adventures with the Pericardium
My previous column on the San Jiao deserves equal time for SJ's loving partner, the pericardium. I nicknamed SJ the travel meridian – but pericardium can also play a crucial role in air travel.
Know Your Research: Tips for Evaluating Literature Reviews
Clinical and experimental studies are not the only types of published research we might encounter as we look for evidence to inform our practices. One of the most useful types is the literature review, which summarizes a group of studies.
Work Stress and Musculoskeletal Health: Do Your Patients Get the Connection?
Most people underestimate the impact their job has on their health, especially if that job isn't particularly physically demanding. Big mistake.
Are Probiotics Doing More Harm Than Good?
Considerable controversy exists concerning the efficacy of probiotic supplements. Very few human studies show any real positive impact on the microbiome or health. The "promise" of probiotics is based on the few animal studies that suggest a positive effect.
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Illuminating the Hidden, Freeing the Source
Amongst the Primary Channels, from a classical point of view, the small intestine is perhaps the most important channel to understand. It is one of the least used acupuncture channels in modern acupuncture, yet it within it can be found a wealth of theories from the Ling Shu.
What are the Meridians?
The meridian and collateral system (jing luo, hereinafter referred to as "Meridians") is comprised of the main meridian channels (jing mai) and the collateral vessels (luo mai). Jing takes from meaning of the Chinese word pathway (also jing) and are the main branches of the system.
What's New in the NCCIH Strategic Plan
The NIH National Center for Complementary and Integrative Health (NCCIH) released its draft strategic plan 2016-2021 for public comment in early spring of 2016.
A Study of Relationships
Sa-Ahm's five element acupuncture method is known to be one of the most effective acupuncture techniques in Korea because it gives an instant response at the time of treatment and has a high success rate in resolving chronic problems.
Lessons from Functional Neurology
Chiropractic neurology, also known as clinical neuroscience or functional neurology, is moving the chiropractic profession forward by leaps and bounds.
Analyzing Acupuncture Case Studies
Confirm the answer quickly by the elimination method. Take this case study as an example. After two treatments for back pain, a patient presents for a third session complaining of rapid breathing and wheezing that is made worse during cold weather.
Traditional Chinese Herbal Medicine in Taiwan Hospitals
This spring, a team of Western medical doctors and TCM practitioners from Cleveland Clinic traveled to Taiwan to visit Kaiser Pharmaceutical Co. (KP), and China Medical University (CMU), Taiwan's leading integrative medicine hospital.
MPA Media Wins More Publishing Awards
The American Society of Business Publication Editors (ASBPE) has honored Dynamic Chiropractic with a national award and two regional awards for editorial excellence, and sister publication DC Practice Insights with two regional awards for graphic design excellence.
Less Time Than Required
Q: When is it appropriate to use a modifier -52? Can I use it for a timed service when I do less than the time required by the code?
Let's Talk About Biceps Injuries at the Elbow
While most muscles cross over only one joint, the biceps crosses two joints: the elbow and the shoulder. Injuries to the lower biceps cause considerable elbow pain. Here's how to assess and treat an injury to this area conservatively.
Chiropractic in the Eyes of the Public: 2nd Gallup-Palmer Poll
The second Gallup / Palmer College poll has been completed, yielding significant additional data regarding Americans' experiences with and perceptions of chiropractic care.
The Professional and Practice Benefits of Political Activism
Welcome to election season, a vital part of our American culture. Every two years, without fail, we are bombarded with TV, print materials and phone messages seeking our vote.
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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