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The Static Postural Pelvic Exam
I include a static postural analysis in my evaluation routine whether you are a patient in pain or an elite-sport athlete in training. In my day-to-day practice, I require patients to stand still while I "just look" at them.
Acupuncture and its Place in the Integrative Healthcare Practice: The Need to Move from Modality to Profession
Acupuncture and oriental medicine (AOM) has grown and flourished from its inception thousands of years ago in China. In surrounding regions of Asia, AOM developed as a response to differing cultural, pathological, health and wellness care needs.
AWB Makes a Difference in the Yucatan
We are in the sleepy town of Izamal, located about an hour from the Merida airport where our group arrived last night. Later that morning, on a bus winding through the dusty roads of the Yucatan, fourteen acupuncturists, two facilitators from AWB and two tour guides make their way to the small rustic town of Popola.
Chiropractic Research in Review
Occupational LBP in Primary- and High-School Teachers; Treating MVA Complications With Chiropractic Care; Neck Pain: Immediate Effects of Active Scapular Correction; Taping Benefits Stride, Step Length in Fatigued Runners.
How to Use Online Video as a Tool to Market Your Practice
Health care practitioners, including chiropractors, should consider online videos as a key element of their Internet marketing strategy. In the next three years, videos are expected to account for nearly 70 percent of all consumer online traffic, according to Cisco.
Happy New Year 2015 Gong Hoy Fat Choi
Welcome to the year of the sheep! We begin a new year guided by the sign of a quietly and creatively organized animal.
Animal Acupuncture Gaining in Popularity
We have just finished the year of the fire hoarse and now it is time to spend some time alone, daydreaming and thinking outside the box in terms of where our profession is headed. The sheep person is well organized and creative so this should not be difficult to do.
We Get Letters & Email
Rethinking Our Approach to Immunization; Coming Together for the Good of Our Patients.
The Conscious Evolution of Healing: Importance of Opening the Sensory Portals in Classical Chinese Medicine
The Chinese medical classics are not just clinical guides. They give advice; ways we can awaken more fully into conscious awareness.
Professionalism and Evidence-Based Health Care
Today's chiropractors are facing a conundrum with the Affordable Care Act and its health care reform requirements, including evidence-based practice and health technology assessment.
News in Brief
While indignation may be your immediate reaction to H.R. 5780, the Protecting the Integrity of Medicare Act of 2014, the American Chiropractic Association suggests the legislation is just what the chiropractic profession needs.
I Felt it in My Fingers First
I'm not afraid to say it. Massage therapists make better acupuncturists. I'll tell you how I know, but first I have a question: What do a microcurrent device, a laser and a hippie massage therapist have in common?
Helping to Create the Healthiest Generation
The imperative to create the "Healthiest Generation by 2030," envisioned by the American Public Health Association (APHA), was in full force at the APHA's 142nd Annual Meeting held in New Orleans from November 15-19, 2014.
Two for One: The Cervical Distraction Test
In today's healthcare system, diagnoses and treatment plans follow a western medical model - especially if you work with attorneys or insurance companies.
The Way of Zen Performance Enhancement
Working with elite athletes and implementing various techniques to keep athletes focused and at their optimal performance for a sustained period of time includes incorporating various meditation techniques that counterbalance their sport-specific physical and mental demands, which is an important element of success throughout the years.
Age and Fertility: Why We Should Worry Less About Age and More About Overall Health
Recently, on one of the acupuncture alumni forums, the topic of age and fertility came up when a practitioner posted a question regarding a patient that was about to turn 40-years-old.
Ringing in the Billing New Year
What are the new modifiers that replace modifier 59? Will they allow doctors of chiropractic to be paid for 97140, manual therapy, when done with chiropractic manipulation?
Trouble Down Under: San Zhen Therapy for Lower Jiao Issues
In the last several columns, I have discussed many clinical options for utilizing San Zhen or Three Needle Therapy. In this installment, I will continue this trend and discuss several foundational patterns which can be found in several very common clinical presentations.
Right Back Where We Started?
More than 25 years after Judge Susan Getzendanner issued her historic opinion in the Wilk v AMA anti-trust case, evidence suggests that despite increasing collaboration between doctors of chiropractic and their allopathic medical counterparts, when it comes to organized medicine, we may be right back where we started.
Movement Assessments: The DC's Sphygmomanometer
I think back to when I was going through chiropractic school outpatient clinic. I was embarrassed to have my family and friends come in for treatment because initial evaluations took three hours to complete.
Show Up and Show Respect
I was recently asked about my chiropractic philosophy. My answer surprised my questioner.
Fight Colorectal Cancer With Folic Acid
CRC is the second most common cause of cancer mortality in the U.S. and Canada. Although genetic susceptibility plays a role in the etiology of CRC, dietary factors, including certain vitamins, have also been shown to influence the development of the disease in various studies.
The App Advantage: Get More for Less
You may have noticed the list of "app-exclusive" articles in the directory on the front page of the print issue and in the Table of Contents on page 4. You can't find these articles in print or even in our online archives.
Three for One: The Cervical Distraction Test
Taking the time to do an exam is important, but it is time spent. The exam serves as a way to physically validate your clinical impression following a history and clinical consultation.
Environmental Toxins: Cause of Modern Illness, Part 2
In Part I of this article, we detailed the variety of environmental toxins assaulting our bodies. These include pesticides and herbicides; plastics; preservatives; cosmetics; gasoline additives, solvents and glues; and heavy metals.
October, 2002, Vol. 02, Issue 10
Yin and Yang Deficiency, Part II
By Barbra Esher, AOBTA CI. Dipl. ABT & Ac. (NCCAOM), LAc
In the last issue of Massage Today, I discussed yang deficiency in general, and yin deficiency in greater depth. If necessary, you can refer back to that article at www.massagetoday.com/archives/2002/09/07.html.As previously mentioned, yin deficiency has heat symptoms, but milder than with a full-heat condition. All of the different syndromes listed below will have any of the general yin deficiency symptoms noted in the previous article.
Kidney Yin Deficiency includes any of the broad symptoms in the chart below (General Yin Deficiency) plus dizziness, vertigo, poor memory and/or tinnitus. This is because the Kidneys nourish the Brain, it being the Sea of Marrow in Chinese medicine. (Capitalization is often used in CM to differentiate between the Western anatomical names and the CM energetic interpretation of the internal landscape.) If there is not enough Kidney yin to nourish the Brain, then there is a gradual onset of dizziness and/or vertigo. Ears relate to the Kidneys in CM. Ear ringing that comes on slowly and is low-pitched implies a possible Kidney yin deficiency. Memory loss is hardly noticeable at first and more short-term, like walking in another room and forgetting why you went there.
Lower back pain is common for any Kidney imbalance, and when Kidney yin is deficient, it feels more "in the bones" than other deficiencies. This is due to the Kidney yin connection with marrow and bones. Kidney yin deficiency can manifest as gradual onset of a dull ache in the lower back, not necessarily connected to a previous injury.
The cause can be overwork over a period of years, particularly if activity is aided by stimulants. This includes always being on the go and overextended; burning the candle at both ends will burn up Kidney yin. Excessive sex, especially during the teenage years, can deplete Kidney yin. Heat from a severe illness can consume body fluids and Kidney yin. Chronic disease also can deplete Kidney yin, along with the yin of the Liver, Heart or Lungs. An extreme loss of blood, such as from endometriosis or fibroids, can exhaust Kidney yin. Last but not least, incorrect treatment is a cause of Kidney yin deficiency. This is not so much a problem with Asian bodywork therapy, but it is a matter of concern if the person is self-treating with herbs or going to an untrained herbalist. Many people use yang tonics from health food stores over long periods of time, which can create heat and damage Kidney yin. If you don't know what you are doing, don't play with fire!
One of Heart Yin Deficiency's key symptoms is a reddened tip of the tongue. (This is common in Heart Fire as well, but more pronounced, with a yellow coating on the tongue.) When emotional issues are involved, there could be a central crack that goes all of the way to the tip of the tongue. When the crack is shallow and the color of the body of the tongue is normal, it reflects a constitutional weakness of the Heart; when the crack is deeper, the tip more red and the tongue swollen, it indicates a more serious emotional/spiritual problem.
Palpitations are a common symptom of any Heart pattern. Some people describe them as a fluttering uneasiness in their chest or an awareness of their heart beating. Insomnia and fidgetiness for no apparent reason can be general yin deficiency symptoms, but if that is the client's predominant concern, it points more specifically to Heart yin deficiency. The Shen/Spirit-Mind is housed in the Heart and anchored by the Blood. Blood is considered yin, and anxiety and uneasiness will result without the Blood/yin substance to hold, calm and sooth the Shen.
Interestingly, the symptoms for Heart Blood deficiency are similar to those for Heart yin deficiency. Both feature palpitations, poor memory, insomnia and anxiety as main indicators. This is because you can't have one deficiency without having the other; Blood is yin -- a moist, nourishing substance. If yin is deficient, Blood will be deficient, and vice versa. You can tell which is predominant by the heat symptoms, or lack thereof. Heart yin deficiency is the main problem when the face is flushed; there is a feeling of heat; the pulse is rapid and thin and the tongue tip is red. Heart Blood deficiency is distinguished from Heart yin deficiency by a dull-pale face (sometimes described as "not shiny and new looking") a choppy pulse and a pale tongue.
As with any yin deficiency, the cause could be a busy, yin-depleting lifestyle. To nourish yin, you must spend an adequate amount of restful and rejuvenating time at home. Added to that, longstanding emotional problems such as worry and anxiety will disturb the Shen, creating heat and depleting yin.
It is also common to see Heart yin deficiency combined with Kidney yin deficiency. The yin-water from the Kidneys can't rise to cool and nourish the Heart resulting in empty-heat flaring up in the Heart. This is more common in middle aged or elderly people. In this case, you will see the Heart yin deficiency symptoms combined with lower back pain.
Liver Yang Rising is actually caused by Liver and/or Kidney yin deficiency. If the cooling yin of the Liver is depleted, the yang becomes hyperactive, rising upwards and causing headaches, dry eyes, dizziness and tinnitus. The heat also causes irritability and anger, emotions usually associated with the Liver. Key symptoms that will distinguish it from other yin deficiencies are irritability, headaches and a thready, wiry, rapid pulse. Keep in mind that this pattern is a combination of excess and deficiency, even though the symptoms of fullness may be more prevalent.
Liver Yang Rising is a fairly common pattern. Stress, frustration, anger and resentment build up over a long period of time, obstructing the free flow of Liver qi. This produces heat, which dries up yin. As described above, yin cannot control yang, which rises to the head. In contrast, the person could be relatively cool in the lower part of the body.
Lung Yin deficiency can include any of the general symptoms plus a dry, unproductive cough or a cough producing a small amount of sticky or blood-tinged sputum. The mouth is dry and the throat is tickly. The symptoms of dryness are of course due to inadequate yin/body fluids. This can be caused by a long illness that depletes the fluids of the Lungs, such as a cold or flu treated with antibiotics, causing the pathogenic factor to become locked in the Lungs. Lung yin deficiency can also be caused by having Lung qi deficiency over an extended period of time. Lung qi deficiency can result from a constitutional weakness, or from breathing being constricted by being hunched over a desk for long hours.
Stomach Yin Deficiency may present as any number of yin deficiency symptoms, but other problems related to the Stomach also may manifest. A Stomach yin deficiency causes a lack of appetite, or hunger but nothing sounds appealing to eat. There may be an achy, uncomfortable feeling in the Stomach and/or epigastric region caused by the Stomach's descending function being impaired from the lack of yin/moisture. The lips, mouth and tongue will be dry from the lack of yin. The Stomach creates the coating of the tongue, so if the Stomach lacks yin, the coating of the tongue has no root. This means the coating is patchy in places or is easily removed, particularly in the center of the tongue.
The most common cause of Stomach yin deficiency is eating late at night. Other bad eating habits will deplete Stomach qi and eventually Stomach yin, such as eating at irregular times; skipping meals; eating while working; or eating too quickly. It's best to sit, relax and chew your food well so the Stomach qi can go in the right direction: downward instead of up to your head!
This series of articles is about yin and yang deficiency, but since I've mentioned the symptoms of Full/Excess Heat for comparison, I've included them in the chart below to differentiate between three common Heat conditions.
At this point, you have enough information that if a client has any symptoms of a heat condition, you should be able to figure out if it is deficient or excess and determine which zangfu/organs are involved.
In next month's article, I will give you a general treatment protocol for yin deficiency, and specific treatments for the different types of deficiencies. I will also include food, lifestyle and environmental support/advice. After that, look for information on yang deficiency differentiation and treatment.
Click here for previous articles by Barbra Esher, AOBTA CI. Dipl. ABT & Ac. (NCCAOM), LAc.
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