resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Give Yourself the Digital Advantage
When you see this article in the print version of this issue and swear you read it already, don't be alarmed: you probably did. That's because by that time, the May issue will have been available online in digital format for three weeks.
An Integrated Approach to Chronic Pain
Findings from a unique Medicaid pilot project in Rhode Island involving high-use Medicaid recipients from two health plans were recently presented to the state's Department of Health, demonstrating stellar outcomes with regard to medication use, ER visits, health care costs and patient satisfaction.
Is It Time to Rethink Mental Illness? (Pt. 1)
Invariably, patients will ask their chiropractor about depression or various mental illnesses. Some practitioners will reflexively offer a cervical adjustment, suggest St. John's wort or contemplate a referral to a specialist.
A Major Role in Back Pain: The Multifidus
Back pain affects roughly 80 percent of the population at one time or another and is one of the leading causes of doctor visits.
Why I Quit Doing House Calls
My father was a chiropractor who did house calls, so when I became a DC, I figured doing house calls was part of the job. My March article recalled my experience as a small boy, accompanying my dad while he went to patients' homes to treat them.
Universal Design: Principles & Practice
In many respects, universal design serves as the core of ergonomics. It's also a good tool to use when designing a return-to-work program for injured and/or ill patients. Let's take a closer look at universal design and why it should matter to you and your patients.
News in Brief
ACA Adopts New Governance Model; ACA 2017 Awards; CCA Helps Calif. DCs "Share the Love"; $1 Million to Help Advance the Profession; D'Youville Raises the Bar on Anatomy Education; ErRatum.
Eczema & Acupuncture: A Sound Solution (Part 1)
Eczema affects approximately 3.5 percent of the global population and is one of the most common skin complaints seen by dermatologists.
Taking the Chiropractic Message to the Press
"There is no better place on earth to have a news event," the National Press Club boasts, and it's easy to understand why: Every year, the 108-year-old Washington, D.C.-based organization hosts countless press conferences on the hottest topics impacting America and often the world.
The Visual Error Scoring System: A Concussion Tool
Postural stability and oculomotor function are the most easily recognized physical indicators of neurologic motor dysfunction associated with concussions.
An Unexpected Diagnosis: The Result of Lacking Communication
A couple years ago I had a case that showed me the importance of open communication between health practitioners. We need to show up with less fear, and let go of our judgments so we can do better for the patient.
Bill With Confidence: Learn What to Collect
Q: I am trying to understand what I may collect from my patient when there is insurance. Do I have to accept the amount allowed by the plan or may I collect up to my billed amount? Please note, I am not a member of any insurance plan.
New Relationships, Old Trauma: AOM & Other Healing Strategies
Being in love is one the most beautiful and enjoyable experiences. Most of us are willing to pay almost any price to have that experience, and still often find it elusive or fleeting. Navigating the ups and downs of loving relationships are often challenging — even for the most psychologically balanced among us.
Creating Good Business Buzz
What do patients really think about working with you? Rarely do you hear the whole truth. Those who improve may be candid in their gratitude.
Women's Hormones: A Western & Eastern Perspective
Sometimes it may seem that you require a degree in medicine to understand hormones and how they function.
Is the New Medicare Reporting Exemption Right for You?
What you've heard is not a rumor – there will be exemptions for providers of Medicare patients, with no penalties assessed for offices that do not do Quality Payment Program (EHR, PQRS, MACRA and MIPS) reporting.
Raditation & Your Smartphone: Is it Worth the Risk?
If radial arteries could talk (and in my experience they can to some extent), they would say, "Step away from the smartphone." At least that is the message I am receiving loud and clear as I feel the pulses of many patients.
Balancing Spring Challenges
As the winter months come to a close and warmer spring weather appears, patients may begin to present with new challenging pattern presentations.
A Daily Strategy for Heavy-Metal Detox
In modern society, we are constantly exposed to heavy metals such as cadmium, lead and mercury. These heavy metals have no essential biochemical roles in our body, and conversely, can cause us a great deal of harm if they build up to toxic levels.
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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