resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
What You Say Isn't Always What Patients Hear
A few years ago, my aunt Edna (name changed for the purpose of this story) suffered a stroke. After a short hospital stay, she was transferred to a nursing home for rehabilitation. When she arrived at the nursing home, Edna requested a private room.
An Emerging Partnership Model
Maryland University of Integrative Health (MUIH) has educated integrative health and wellness practitioners for the last 40 years, originally as an acupuncture clinic and school. The institution's transformative, relationship-centered programs integrate traditional wisdom with contemporary science
Three Tips to Help You Analyze the Acupuncture Case Studies of the NCCAOM Exam
Confirm the answer quickly by the elimination method. Case study:
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.
What's New in Phytonutrition: Mangifera Indica, "The King of Fruits"
One hundred percent pure Indian green mango fruit (mangifera indica), harvested at a special degree of ripeness for efficacy and taste, can now be concentrated as a phytonutrient nutraceutical powder.
How to Stay Sane During the Elections: Understanding Through the Lens of Chinese Medicine
In Chinese Medicine philosophy, everything consists of Yin and Yang. The law of polar opposites – one cannot exist without its opposite.
A Long-Overdue Win for Oregon Medicaid Patients - and the Implications for Other States
Beginning July 1, 2016, Oregon Medicaid patients with spinal pain (cervical, thoracic, lumbar, pelvic) who are determined to be low risk based on a biopsychosocial assessment tool (STarT Back – Keele University) can receive four chiropractic visits per episode.
Acupuncture Muscle Trigger Point and Oriental Medicine Sports Therapy
It is difficult to ascertain the internal condition of professional basketball player Lebron James during game one of the 2014 NBA finals, in which he developed debilitating muscle cramps that led to his premature removal from the game.
The Pertinent Negative
We all have to perform evaluations on patients. Most of us don't like doing it – exams take time, and worse it takes even more time after the evaluation to put together a narrative summary of the findings. Sometimes, this process becomes downright tedious.
Beating the Odds: Interview With Para-Powerlifter Adeline Dumapong-Ancheta
Since October 2015, the FICS Foundation, the charitable organization affiliated with the International Federation of Sports Chiropractic (FICS), has been supporting disabled athletes internationally.
Adventures with the San Jiao
Those of us who have been in practice for several decades relish the way meridians and points reveal new diagnostic clues and new insights. I love to encourage my students to see this as an adventure that goes way beyond the textbooks.
Insuring Quality Control in Herb Importation: An Interview with Wilson Lau
Wilson Lau is the vice president of Nuherbs, a Chinese herb importation company based in San Leandro, California. Before joining Nuherbs, he trained as a lawyer specializing in FDA law.
Kansas Achieves Licensing Law
Kansas Governor Sam Brownback signed House Bill 2615 into law on Friday, May 13, 2016. HB2615 includes provisions for the licensure of acupuncturists in the state of Kansas.
An MD Who Understands the Opioid Epidemic
Doctors of chiropractic have an important role to play in ending the opioid epidemic and dealing with chronic pain by conservative means (see our top story in this issue) – but who's to blame for opioid dependence and abuse in the first place?
Sit or Stand? Analyzing a Mixed Message
I'm more than a bit confused. At my age, that seems to be a rather common occurrence. However, today more than ever, I'm getting a mixed message.
AOM Hospital-Based Practice: A Future Reality?
The natural evolution of health care on the planet is integrative health. We may have some challenges ahead, but based on my research, all indicators are pointing in a positive direction. There seems to be an evolving consciousness among our patient population that is "getting it."
Tai Chi Documentary Premier
First Run Features recently announced the world theatrical premiere of Barry Strugatz's documentary The Professor: Tai Chi's Journey West, which premiered last month at the Laemmle Music Hall in Los Angeles.
Believe it or not, an estimated one-third of your patients have eaten some form of fast food within 24 hours of their appointment with you.
Treating Hip & Groin Pain With Abdominal Release of Upper Lumbar Nerve Impingements
Have you encountered patients with groin and hip pain you can't seem to solve? You know it's not a worn-out hip; you suspect the pain is somehow connected to the spine. But somehow, you just can't help them break through.
Chronic Pain: Become Part of the Solution
I have lectured to more than 7,000 chiropractic physicians over the past five years regarding the chronic pain and opioid epidemic in this country.
Acupuncture's Impact on the World
For several years, I have been hearing about the town of Rothenburg, Germany. It seemed just a dot on a map until I arrived. It is the home of the TCM Kongress which began in 1968. It has been held annually for 47 years and it has only missed one year.
Introducing the Acupuncture Today Digital Edition
In response to the changing habits of our readers, Acupuncture Today will introduce a digital edition of the publication (in addition to our print edition) beginning with the August 2016 issue.
Increasing the Value of Spine Care: CMS Approves New Low Back Pain Registry
The Centers for Medicare and Medicaid Services has approved the Spine IQ Low Back Pain Registry as a qualified clinical data registry for the Physician Quality Reporting System (PQRS) in 2016.
February, 2003, Vol. 03, Issue 02
Yin and Yang Deficiency, Part V
By Barbra Esher, AOBTA CI. Dipl. ABT & Ac. (NCCAOM), LAc
If you've been following this series of articles, you're now familiar with the differences between yin and yang deficiency. At this point, you know yin deficiency in depth and have been introduced to yang deficiency.This article explains how to differentiate the different types of yang deficiency, so you can fine-tune your assessment and treatment. (Editor's note: Barbra's entire series of articles can be accessed online by clicking here.)
When evaluating yin and yang, always consider the big picture. Yin aspects are related to nourishment and substance; yang aspects are more energetic and functional. We need yin and yang; women and men contain both, or they cease to exist. In the first article in this series, I discussed the aging process as it relates to yin and yang. People naturally start to decline in yin, yang or both as they age. If yin wanes, people may have less of a desire to nurture or care for others, or they may become more outgoing or outspoken. Substance also declines - for example, bone density decreases. If yang declines, they may become more relaxed and accommodating to others, but they also may have sexual dysfunction and trouble holding urine throughout the night. (This is discussed a little more extensively in part I of the yin/yang series: www.massagetoday.com/archives/2002/09/07.html.)
Yang deficiency always has some cold symptoms in the pattern, but overall, it does not appear as an excess condition. Most people with yang deficiency present with at least a few of these symptoms:
When you determine there is a yang deficiency, the next step is to decide what organ is primarily involved. It could be Spleen, Kidney or Heart, (capitalized to distinguish the Chinese view of these organs as an orb of influence, rather than what we commonly think of in the West). Actually, yang deficiency could be a progression from qi deficiency, such that organ patterns look the same, but with the addition of cold symptoms. (Editor's note: See the General Full Cold Symptoms chart below).
Spleen Yang Deficiency includes any of the broad symptoms listed in the first chart (above), keeping in mind that there must also be cold symptoms because of the relative lack of yang. Various digestive problems also manifest, such as lack of appetite; a puffy, tired feeling after eating; or loose stools. This is an indication that the Spleen's transportation and transformation function is impaired. For the same reason, if the Spleen can't convert the qi in food to a usable form, a person feels tired, listless or has trouble waking up in the morning. Fluids also will build up, because they aren't being transported and distributed properly (another function of the Spleen).
Poor diet is the primary cause of Spleen yang deficiency. Eating excessive cold, frozen, raw or sweet foods will damage the Spleen. Irregular eating habits; under- or overeating; eating too quickly; or eating while working or driving all can damage the Spleen. Is it no wonder that this is such a common syndrome is our society! Taking too many Chinese herbs with a cold nature also can cause Spleen yang deficiency, so if the patient is taking herbs, make he or she is seeing a qualified herbalist.
To evaluate Kidney Yang Deficiency, check for at least a few of the symptoms in the chart above. There may also be problems with the lower back and/or knee pain, both of which can be relieved by warmth. The Kidneys are closely related to Ming Men Fire, which emanates from the area of the lower back. When it fails to warm the body, the lower back feels cold. Whenever there is cold, there is pain, as the cold contracts and obstructs the free flow of qi. In addition, Kidney yang gives strength and support to the bones of the back and knees, so a deficiency will cause weakness in those areas.
The warmth of Kidney yang is needed for sexual function and fertility so a deficiency causes problems such as impotence, infertility, premature ejaculation or decreased sexual desire. Kidney yang also enervates the zhi, which is the spirit housed in the Kidneys. A deficiency will cause lassitude and a lack of motivation or willpower. Patients with Kidney yang deficiency feel they don't have the energy to do anything, or that they have used up all of their reserves -- which indeed they have!
Kidney yang deficiency often develops from Spleen yang deficiency, so you see symptoms such as edema in the legs, caused by lack of fluid transformation. For the same reason, fluids build up in the tongue, causing it to become swollen.
Kidney qi actually holds the urine in place, but since a deficiency of Kidney qi is often a precursor of Kidney Yang deficiency, you will see symptoms of nocturia (getting up at night to go to the bathroom), dribbling after urination or incontinence (in severe cases).
The causes of Kidney yang deficiency include chronic, longstanding illness; excessive sexual activity; a constitutional deficiency; or a decline of the Kidneys with advancing age. Some medications, such as those used for high blood pressure, will also deplete Kidney yang.
When someone seems to have symptoms of a yang deficiency (especially if his or her hands get cold), suspect a Heart Yang Deficiency. The Heart meridian goes down the arms; if there is insufficient Heart yang, qi can't be transported to the extremities. The person may also have a stuffiness or uncomfortable feeling in the region of the Heart. A cardinal sign for any Heart pattern is Heart palpitations, often described as an awareness of the heartbeat, or a fluttering feeling. These symptoms are caused by insufficiency of the Heart yang in moving the qi in the chest.
Heart yang deficiency can develop from a Heart qi deficiency, so you will see symptoms such as shortness of breath, sweating with no exertion and listlessness. The causes are the same as for Kidney yang deficiency. Heart Yang deficiency can also be caused by a sudden or prolonged loss of blood, which causes a deficiency of Blood, qi and (eventually) Heart yang.
I am including a chart on the symptoms of some excess/full cold patterns (below), but I am not going to explain them in detail, because it's not within the scope of this series. Included are four fairly common syndromes you will see in your practice.
By this point, you should be an expert at differentiating a cold from a hot condition, or an excess from a deficiency. You should also be able to pinpoint the exact organ involved. To complete the picture, next month's article will detail treatment protocols for yang deficiency, addressing each of the zang-fu disharmonies. I'll also include dietary, lifestyle and environmental counseling. Until then, keep your yang-deficient clients warm!
Click here for previous articles by Barbra Esher, AOBTA CI. Dipl. ABT & Ac. (NCCAOM), LAc.
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