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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.
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.
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.
Overuse Injuries in Young Athletes (Part 1)
More than 45 million children ages 6-18 participate in some form of organized athletics, and 75 percent of American families with school-aged children have at least one child participating in organized sports.
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.
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.
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.
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.
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.
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).
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.
The National Institutes of Health (NIH) lists more than 80 common autoimmune diseases including asthma, Crohn's disease, Guillain-Barré syndrome, multiple sclerosis, myasthenia gravis, psoriasis, rheumatoid arthritis, and lupus.
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.
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.
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.
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.
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.
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?
Lessons from Functional Neurology
Chiropractic neurology, also known as clinical neuroscience or functional neurology, is moving the chiropractic profession forward by leaps and bounds.
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.
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.
March, 2003, Vol. 03, Issue 03
Yin and Yang Deficiency, Part VI
By Barbra Esher, AOBTA CI. Dipl. ABT & Ac. (NCCAOM), LAc
This is the last of the series of articles on yin and yang deficiency, By now, you should have a pretty good idea of the primary organs involved and how to differentiate between the two conditions.
Always remember: Before looking at details, go back to the larger picture.Yin is cool, dark, relaxed, quiet, reflective and receptive; yang is warm, light, restless, exciting, outgoing and relatively more aggressive. When comparing the two, yin has a more substantive nature, whereas yang is more energetic. Yin and yang are relative terms; neither exists in isolation. They are in constant dynamic balance.
So, if you keep that in mind, all you are doing when treating yin or yang deficiency is readjusting the relative balance of yin and yang in the body, which is more important than quantity. Depending on the time of day or the season, we all feel different yin or yang qualities, but sometimes we get noticeably out of whack. In the case of a yin deficiency, the opposite back to the body, and determining how yang became so depleted in the first place.
Characteristics of yin are present, i.e., a relative excess of yang. In the case of yang deficiency, look for symptoms you might consider yin, but are actually representative of a relative lack of yang. A person might feel cold day and night, summer and winter, not because of an excess of cool/yin, but because, for some reason, his or her yang has been depleted or damaged. In this case, the treatment plan would have to include adding yang.
Let's start by discussing how to treat yang deficiency with Asian bodywork therapy (ABT); Later on, we'll address lifestyle, diet and environmental changes. I find ABT is often better than acupuncture in the case of deficiencies, because it can be extremely nourishing, tonifying and relaxing. Often, needles can be depleting if overstimulated and left in too long.
General Yang Deficiency Treatment
Anytime there is a yang deficiency, the primary treatment principle involves using moxa or a TDP lamp to tonify and warm yang. Make sure you are correct in your assessment, because you don't want to do this if the person has any excess heat! I don't use heating pads, hot water bottles or hot rocks, because they have no herbal penetrating energetic quality.
A TDP lamp is a strange, expensive device I call a "Chinese magic lamp." I don't think the lamp actually has supernatural powers, and I really don't know why it works - but it does. And every Chinese acupuncturist that I respect uses one. It's a heating lamp made with mineral plates that have the same penetrating action as moxa. It actually adds something into the body energetically that other therapies don't. You can get TDP lamps at any acupuncture supply store, but shop around, because they can be pricy.
To use a TDP lamp, heat it up first, then place it over the point you want tonified. For any yang deficiency, I would place it over Du 4 and Ren 6 for at least 15 minutes each. Make sure not to put it too close for too long, or you will burn the patient. If he or she gets a headache afterward, or if sensory feedback is compromised in any way, stop using it. Common sense rules.
The same goes with moxa. I would caution you not to use any kind of moxa unless you have been properly trained. You can cause serious burns or misgauge treatment, which is not only bad for business, it's not great for your karma or your client's health, either.
A moxa box is easiest, but it's also the smokiest, which can be a problem if you are sensitive to smoke or share your office, particularly since it smells a bit like marijuana. People give me side glances after using it, and I have had police come to my door inquiring about the strange smell. It is a box with no bottom but a screen in the center. You fill it with crude moxa, light it, and set it over an area such as the abdomen or lower back.
A moxa pole is also fairly easy to use. You gently circle over the point, visualizing spiraling the energy into the person's body. Don't overheat it; we are talking tonification here, so, as you know from my previous articles, be gentle, gentle, gentle, like you are petting a cat. Encourage the qi to come to the area.
I am not crazy about big, fat cone moxa that you knock off when it is too hot. It's fine if you like that technique and are good at it, but try to remove the cone before the patient starts screaming.
Since I was trained in Japan, I prefer another way of using direct moxa. I use an ointment called shiunko: a sesame- to rice-grain-sized, super-refined gold moxa cone, lit with incense and burned down to the ointment. It is somewhat labor-intensive, particularly compared to a TDP lamp, but it is quite effective once you know what you are doing.
You can use any of these techniques to warm Ren 6 and Du 4. Using either the pole or direct moxa, warm all of the Du points from Du 2 to Du 14, going up the spine, repeating a few times (general back treatment protocol). This is a powerful technique for tonifying yang; people will jump off the table warm and full of energy. As the Sea of Yang, the Du meridian is the best place to start to access the yang of the body. Warming Du 4, Ren 6 and Du 14 are general ways to tonify and warm yang. Utilize them in any session in which you are using that treatment principle, adding the specific treatment protocols below.
Kidney Yang Deficiency
Start the session with the back protocol above. Po Sum On is an herbal ointment you can rub on the client's lower back and sacrum before hand so the warm feeling lasts longer. Moxa Ki 3, Ki 7 and Bl 52, while the patient is face-down, gently and repeatedly warming each point. Next, hold the lower back area at the level of Bl 23 and Bl 52 with your fingers and heel of your hand, in a "bye-bye" squeeze. As you are holding, gently thumb press up each Kidney meridian on the legs, concentrating on Ki 3 and Ki 7. I suppose you could do this on the table, but the way I do it is on the floor, sitting between the client's knees, supporting their leg up on my knee, working one leg at a time. Obviously, this is not a position you would use unless the client is fully clothed! When the person is supine, moxa Ren 6. At the end of the session, reach under and cup both Bl 23s as you hold both Ki 27s with thumb and forefinger for a few minutes (mu-shu combo).
Spleen Yang Deficiency
Start the session with the general back treatment protocol. Use bilateral thumb pressure on Bl 20, 21 and 22, gently sinking in and holding each point. When your client is face-up, you can use a moxa box or TDP lamp on Ren 6 while you moxa Sp 3, Sp 6, Sp 9 and St 36. If you are using pole or direct moxa, continue up to Ren 9, Ren 12 and St 28, then gently thumb press up the Spleen meridian, one leg at a time, focusing and lingering at Sp 3, Sp 6, Sp 9, using your mother hand on Ren 6. Hold St 36 with firm thumb pressure as you hold Ren 9, Ren 12 and then St 28 bilaterally. Do the same with the other side. End the treatment by cupping your fingers and the heel of your hand under the patient's back, holding Bl 20 and 21 with one hand and Ren 12 with the top hand. Hold for a few minutes. Keeping your bottom hand in place, holding each Lv 13. Again, by doing this, you are holding the Spleen and Stomach shu and mu points simultaneously.
Heart Yang Deficiency
With the client prone, moxa up the Du meridian, as noted in the general back protocol. Go back and moxa both Bl 14s and 15s. Repeat moxa on Du 14, as it is particularly indicated for Heart Yang Deficiency. With the client's palms up, moxa Ht 5 and Pc 6 on each side. Hold Ht 5 with your thumb as the "mother thumb," press up the Heart meridian, ending at Bl 15s, holding Ht 5 with Bl 15s for a few minutes. Go back and hold Pc 6 with your mother thumb, then gently press up the Pericardium meridian as far as you can go, ending as Bl 14s and holding this combination for a few minutes. Repeat these two meridians on the other side. When the person is supine, moxa Ren 6 and Ren 17. Palm press the yin aspect of the arms while holding Ren 17.
It's always a good idea to suggest ways clients can support their health between sessions. For example, if they repeatedly expose themselves to cold weather, yang deficiency may persist. Make sure you tell your clients to bundle warmly, particularly around the waist. In Japan, they wear haramakis, which means "belly wrap-ups," to protect against cold.
The exercise you might recommend for yang deficiency would be any self-cultivation techniques, such as qigong or taiqi. Either one is gently tonifying and warming. If the client has lower back pain caused by yang deficiency, recommend exercises, in addition to stretching, to strengthen the back. If the client participates in more vigorous exercises, such as aerobics or running, and feel tired afterwards, suggest that he or she think about cutting down, stopping or switching to a more gentle form of exercise. Yoga is great if done properly. Again, if the client feels awful afterward, he or she is probably overdoing it. It's not about how great you feel while in class, or how far you can stretch; it's about how good it can help you feel in your everyday life.
Besides exercise, challenges and accomplishments tonify yang. This is one reason many people who retire start to become yang-deficient soonafter. They need to find something else that gives themselves purpose and adds meaning to their lives. Having goals, outside stimulation and activity nourishes yang.
Having sex too often also can deplete yang, especially that of the Kidney; however, Felice Dunas notes that being sexually rejected repeatedly over a period of time will also deplete yang. Continuous rejection can decrease sexual desire to the point of impotency or frigidity, which are symptoms of yang deficiency. When I see a client with a pronounced yang deficiency, I ask if he or she (or the partner) is depressed, and if so, if it has affected their sex life. If either is the case, I highly recommend they seek counseling.
Feng Shui is sometimes referred to as "acupressure for the home." Hope Karan Gerecht, author of Healing Design, says:
Diet is a factor in yang deficiency. Repeatedly eating cold foods inhibits our body's warming function, eventually depleting yang. This includes ice cream and other frozen foods, iced drinks and an excess of raw foods and fruit. Antibiotics are also considered cold and can be damaging if taken over a long period of time.
According to Daverick Leggett, author of Helping Ourselves: A Guide to Chinese Food Energetics, cooking food longer will increase its warming function and will encourage the heat to penetrate deeper into the body. Don't make the mistake of thinking "the hotter, the better," however. Food that is too spicy will cause us to sweat and we will begin to cool off, illustrating how yin and yang transform into their opposite in extreme situations.
Yang tonics tend to be sweet, pungent and warming. Choose foods such as: basil; garlic; lamb; sage; cinnamon; dried ginger; lobster; raspberry; thyme; chestnut; clove; kidney; nutmeg; rosemary; shrimp; and walnut.
Finally, encourage your clients not to rely heavily on stimulants to create the fiery yang vitality in their lives. Eventually, their body's ability to generate yang will be depleted. It's hard to keep going and keep pace with the demands of life. Bringing balance into our lives with self-awareness and self-care allows us to rise to life's challenges when needed ... and take a well-deserved rest afterward!
Click here for previous articles by Barbra Esher, AOBTA CI. Dipl. ABT & Ac. (NCCAOM), LAc.
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