resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
News In Brief
A "Modern" Business Model. Acupuncturists may have a new professional atmosphere to consider, as a new concept is on the horizon - at least for one business.
Making Sense of Liver Regulation
In Chinese medicine, the liver has the function of moving and storing qi and blood. In its moving function, the liver smoothly distributes qi and blood to the tendons, muscles and flesh through microcirculation.
How to Correct a Cuboid Subluxation
Cuboid subluxation is a poorly recognized condition, even though it is not uncommon. It has been described in the literature under various names: cuboid subluxation, cuboid syndrome, locked cuboid, dropped cuboid, cuboid fault syndrome or peroneal cuboid syndrome.
Help Save an Important Chiropractic Landmark
The chiropractic profession has a splendid and varied history. Sadly, many landmarks have been lost to bulldozers and wrecking crews, such as the Ryan Building, Little-Bit-O-Heaven, Spears Chiropractic Hospital, and Clearview Sanitarium.
Shedding Light on the Benefits of Heliotherapy
I can't imagine anyone not feeling good strolling in the sun on a beautiful spring day. The sun is responsible for all life on earth and is best illustrated along the equator touting the richest biodiversity on the planet, in stark contrast to the Arctic Circle and South Pole.
Treating the Terrain of Chronic Sinus Infections
Chronic sinus infections can be stubborn to treat, but the therapeutic path forward can be simplified when utilizing three distinct treatment principles which take into account the terrain of the body, and the way in which microbes grow.
Good Works at the Canandaigua VA
Faculty and students of the Finger Lakes School of Acupuncture and Oriental Medicine (FLSAOM) of the New York Chiropractic College have provided acupuncture to veterans at the Veterans' Administration Medical Center (VAMC) in Canandaigua, New York since September of 2007.
Chiropractic: A Great Fit for the White House
Dr. Eric Kaplan is a New York Chiropractic College alumnus; a No. 1 best-selling author whose books include Awaken the Wellness Within and The 5 Minute Motivator; a chiropractor for professional sports teams and elite athletes; and even served as an advisor under the Clinton Administration to the President's Council on Sports & Physical Fitness.
Waist Circumference: A Conversation Starter (Part 2)
Now let's discuss the clinical approach to reducing WC and implementation in today's chiropractic practice. The primary intervention centers around dietary modification and lifestyle habits aimed to reduce adiposity, improve insulin sensitivity and ultimately, diminish systemic metabolic dysfunction.
Scope of Chiropractic Practice: Why Now Is the Time to Expand
In my January article, "Scope of Chiropractic Practice: Is It Time for Change?" I discussed the use of the term primary spine care practitioner, the loss of privileges to diagnose in Texas, and the fact that the definition of "chiropractic" varied from state to state.
The Qi Focus: A Guide to Managing Stress
Stress, are you experiencing heightened stress levels? Your own, and your clients? Is Trumpitis getting to you? I recently polled a cluster of acupuncturists, Asian Bodywork Therapists (ABT) and psychotherapy colleagues on the issue.
The First (Only) Choice for Spinal Pain
The study on NSAIDs for spinal pain summarized on the front page of this issue is intriguing on a number of levels, the most obvious being the conclusion that "compared with placebo, NSAIDs do not provide a clinically important effect on spinal pain, and six patients must be treated with NSAIDs for one patient to achieve a clinically important benefit in the short-term."
The Chiropractor's Guide to CRISPR
Science magazine's "Breakthrough of the Year" award for 2015 was described as "the gene-editing tool called CRISPR." CRISPR stands for "clustered regularly interspaced short palindromic repeats."
Give Your Patients the Ergonomic Advantage
Prolonged sitting contributes to low back pain and is a health risk. When I discuss my POLITE technique practice recommendations with patients, ergonomics may be last, but not least!
What's Bugging You? Probiotics and Your Health
An estimated 100 trillion microorganisms representing more than 500 different species inhabit every normal, healthy bowel. Gut-dwelling bacteria keep pathogens in check, aid digestion and nutrient absorption, and contribute to immune function.
Caring for Refugees in Greece
At the beginning of 2016 I had no idea what was in store for me, but I was looking forward to a personal retreat on the Greek island of Paros; a graduation gift to myself after 22 years of motherhood, and four-plus years of Chinese medicine school.
Integrative Cardiology: The Heart of TCM & Western Medicine
Patient centered therapy is a growing trend in hospitals that are expanding to boutique services.
Toxicity & Kids: The Importance of Environmental Intake
The old adage is true that children are not little adults. Traditional Chinese medicine (TCM) has long known that the physiology of children is unique, as are the diseases that plague them.
NSAIDs No Better Than Placebo for Spine Pain
A meta-analysis of randomized, placebo-controlled trials comparing the efficacy and safety of NSAIDs with placebo for spinal pain concludes that among 6,065 spine pain patients, "NSAIDs reduced pain and disability, but provided clinically unimportant effects over placebo."
Treating LBP the Right Way: Think Natural
An updated clinical practice guideline from the American College of Physicians (ACP) recommends spinal manipulation and other non-invasive, non-drug therapies as first options for acute, subacute and chronic low back pain, rather than pain medications, as stipulated in the original 2007 guideline.
Insomnia Treatment Based on the Yu Theory
In recent years, acupuncture has risen in popularity as a form of alternative or supplemental medicine for the treatment of many different types of disorders.
July, 2007, Vol. 07, Issue 07
Part II: Chronic Problems Related to Gallbladder Dysfunction/Disease
By Dale G. Alexander, LMT, MA, PhD
In part one of this series, I encouraged you to hold in the forefront of your awareness the implications of the gallbladder's anatomic centrality, its tendency to become chronically inflamed, and its capacity to subtly progress in dysfunction toward disease over the course of many years.Also, to refer your clients when you suspect its relevance to their somatic complaints. In this article, you are invited to take a more speculative leap into functional physiology.
What is so important about gallbladder dysfunction along its continuum of progression is that it simultaneously can reduce the efficiency of the gastrointestinal tract and slow the venous and lymphatic drainage back to the heart from all parts south of the diaphragm muscle.
Nature has provided the human gastrointestinal (GI) tract with two important aids to assist its crucial activities of digestion: assimilation of nutrients and the excretion of wastes. These aids are bile from the liver/gallbladder complex and pancreatic juices and enzymes. These fluids share a tube, the common bile duct, which ends in the duodenal portion of the small intestine. I encourage you to seek out an anatomical drawing of this relationship between the liver/gallbladder, pancreas and duodenum.1
Consider what might happen down the line within the rest of the length of the small and large intestine should these digestive aids be omitted or significantly reduced. What effect might this have on our ability to assimilate nutrients and eliminate waste? Also, consider what might happen to the functioning of the pancreas should its juices back-up within the organ.
In many medical textbooks, you will find the two most correlated conditions associated with pancreatitis are the progressive effects of alcoholism and the presence of bile sludge or small gallstones that occlude or reduce the capacity for bile and pancreatic juices to reach the duodenum through their common opening, the papilla of vater/sphincter of oddi.2
When I first read this many years ago, my hands tingled in a composite kinesthetic memory of thousands of clients. Then a central question emerged: What effect might the backflow of pancreatic enzymes have on the overall function of that same organ? Most of the clients I remembered had reported blood sugar irregularities including some officially diagnosed with diabetes. After checking my written notes of these sessions, there appeared a constellation of impressions of what might happen inside the small intestine and the large bowel as food transits the GI tract with little or no bile and pancreatic enzymes.
Immediately, I began to wonder how this might be related to what I repeatedly had experienced as a generalized congestion within the abdominopelvic cavity: food going down, while simultaneously blood and lymph needed to return upward to the heart. There seemed to be a connection. Researching further, I was gratified to discover that the backflow of pancreatic enzymes into the organ had been identified in the general medical literature as one of the contributing factors in the emergence of diabetes mellitus. The literature also confirmed my speculation that chronic pancreatitis occurs more commonly than most practitioners realize.3,4 Pancreatic stone formation also is possible when this occurs.4 I would further propose that chronic inflammation eventually could spread throughout the remaining length of the GI tract.
Let's remember that "itis" infers inflammation. When an organ is inflamed, it occupies more space and may influence the rate of flow, not only within its own vascular tubes, but also its neighboring low-pressure lymphatic and venous vessels. More specifically, due to its swollen size, an inflamed pancreas could mechanically block the flow of surrounding vessels and may contribute to ischemia within these vessels as a result of their reduced rate of flow. It also is possible for the entire pancreas to go into relative states of contracture or even spasm.
We would all feel an acute spasm, yet nature did not endow the smooth muscle of the cardiopulmonary organs, gut tube or the urogenital organs with the same broadband of sensory nerves as it did for the musculoskeletal system and the skin. This is the basis for my postulation that many organ dysfunctions along the continuum of progression toward pathology, often go unnoticed until a critical threshold is reached.
"Many visceral ailments cause no other signs except referred pain. The brain does not know from firsthand experience that the different organs exist and therefore, any pain that originates internally can be localized only generally."2 There is no high-grade sensibility in smooth muscle fibers and inflamed abdominal viscera are not necessarily tender on palpation.5
I propose that the body uses its complex neural net to both express and distribute its internal tensions to the musculoskeletal system, as has been described in previous articles. The body is signaling from the inside out that something needs attention. Let's consider that many of our clients who come to us with chronic somatic complaints reflect the early stages of such physiological progressions long before they could be identified clinically by medical testing procedures.
Continuing with the same example of a partial or complete obstruction of the sphincter of oddi, which prevents both pancreatic and bile fluids from reaching the duodenum in a timely fashion - what are the implications for small intestine's absorption of nutrients? Might this be correlated with the commonly seen swelling along the length of this organ within our bellies as the small intestine attempts to create more surface area in order to do its job of assimilating nutrients without the needed raw materials for digesting fats, proteins and carbohydrates?
My research also revealed that bile salts are considered to have bacteria reducing properties, thus "bacterial concentrations in the small bowel increase with lack of bile salts."4 This might be one of the mechanisms by which inflammation may spread throughout the rest of the GI tract. Infections also might find their way upward into the gallbladder and liver. Interestingly, these seem to be more often associated with partial obstructions than complete obstructions.4
Many clients have brought me their films of barium swallows from upper and lower GI medical testing. In composite, it is common to see portions of the small intestine dramatically narrowed while others are expanded along the many feet of its length. What is happening neurologically at these narrowed portions of the tube? What are the effects of a substantially reduced rate of flow? What are the effects upon the complex web of physiology and internal homeostasis? Might seemingly unexplained weight loss be correlated to this or, for others, part of their subconscious drive to grab for more food, resulting in additional weight gain further straining the function of the pancreas? Many nutritionists have proclaimed we are a nation of malnourished individuals despite our agricultural plenty.
My next speculation proposes that as the small intestine struggles to assimilate nutrients, its abnormal rate of transit becomes a significant factor influencing the timing and full expression in amplitude and force of peristaltic waves within the GI tract. The timely discharge of waste also becomes variable instead of regular. Swinging between constipation and diarrhea is much more of a weekly reality than most people are willing to notice, much less admit. One physician who reviewed this article suggested this description reflects a functional definition of irritable bowel syndrome that afflicts about half of the adult population.6
Now, let us shift our attention more specifically to the venous return system from the lower extremities and the pelvic floor. According to Dr. Barral, the developer of the visceral manipulation approach, the venous blood returning from the left lower extremity has a slightly longer route back to the heart than does the right side venous return.7,8
My clinical experience over 20 years since first beginning to study with Dr. Barral supports this premise of vascular asymmetry and has correlated left leg/foot edema, left hip problems and the presence of hemorrhoids as part of the profile for the progression of gallbladder dysfunction/disease.7 In fact, I've lived it.
Two years ago, I experienced a gallbladder episode in response to multiple family illnesses only to look back over the previous year to remember that I had had the first hemorrhoid in my life six months prior to this episode coupled with occasional bouts with left hip problems and minimal edema in my left calf over many years. My more acute episode reflected Dr. Barral's additional clinical postulation that the gallbladder is the most reactive organ to emotionally charged events outside of the brain and spinal cord.7
In researching anatomy books to explore the venous drainage of the pelvic floor, there is common agreement that "any obstruction in the return flow toward the portal system within the liver causes veins to become varicose," contributing to the development of internal and external hemorrhoids. Another anatomical fact is that many of the rectal veins do not possess the valves that most other veins do, thus they are more susceptible to the effects of muscular straining during defecation.9
However, it is my postulation that relative states of visceral swelling and disturbed peristalsis related to the sigmoid and transverse colon, the small intestine, the pancreas and the gallbladder have a cumulative effect that contributes more significantly to the development of hemorrhoids. Muscular straining just adds overexpansion of the already overfull and overstretched venous vascular walls.
Let's remember that the gallbladder sits in fascial communication with the portal vein of the liver, just anterior to the transverse colon and in approximation to the abdominal confluence of lymph trunks, often referred to as the cisterna chili.10 The gallbladder is the gatekeeper to venous and lymphatic drainage back to the heart. The net effect below the muscular diaphragm is the creation of a bog of swollen and constricted tubes, a damming of venous and lymphatic fluids.
Does everyone have gallbladder dysfunction that will lead to a diseased state? No. However, I have palpated its inflamed state and contracture of the common bile duct, pancreas, small intestine and large intestine across the human life span from babies to clients in their eighties. It is one of the most common progressions I have experienced in 27 years. It is the linkage between these organs and the anatomic centrality of the gallbladder that implicates its participation in so many disturbances of functional physiology. When one considers that "more than half of our blood, 65 percent, may be in our veins"11 on a moment by moment basis, the clinical importance for us to attend to assisting its systemic return to the heart becomes clear.
I would propose that nature does prioritize physiologic function in its survival orientation. Specifically, the assimilation of nutrients is its primary task to keep us trucking with the prime directive of perpetuating the species. The neural priority that the brain gives to recognizing the body parts involved in locomotion over the internal organs derives from the same priority. Difficulties with elimination and venous and lymphatic drainage simply are collateral strains that often lead to unintended damage and the reduction in the quality of our lives.
"We are perfectly adapted to a world that no longer exists."12 I would propose that elements of consciousness and identity consolidation form the modern foundation of our capacity to adapt to a rapidly changing environment within our nervous system. To date, 100 percent of the clients who have come to me with reported or medically diagnosed anxiety problems, all have some degree of gallbladder and other visceral involvement described in this article.
Survival v. quality of life is an ongoing paradox that confronts our species with all of its diversity. Nature's endowments of fight, flight and freeze are the shadow elements of our collective need to create ways to cooperate with one another.13
In order to be thorough, I have decided to extend this series beyond the proposed three. In the next installment, we will explore the relationships between gallbladder/pancreatic dysfunction to how alternate routes of the venous return system may influence cardiac efficiency, blood pressure and the competence of the hiatal junction.
Click here for more information about Dale G. Alexander, LMT, MA, PhD.
Join the conversation
Comments are encouraged, but you must follow our User Agreementcomments powered by Disqus
Keep it civil and stay on topic. No profanity, vulgar, racist or hateful comments or personal attacks. Anyone who chooses to exercise poor judgement will be blocked. By posting your comment, you agree to allow MPA Media the right to republish your name and comment in additional MPA Media publications without any notification or payment.