China Books

The latest issue is number 90 OUR 30TH BIRTHDAY ISSUE

published in June 2009
CHINESE MEDICINE IN THE WEST: A DISCUSSION BETWEEN PETER DEADMAN, HUGH MACPHERSON, DANIEL MAXWELL, FELICITY MOIR & VOLKER SCHEID In January 1985 The Journal of Chinese Medicine published an edited transcript of a discussion called 'Acupuncture in the West' between Peter Deadman, Ted Kaptchuk, Giovanni Maciocia and Felicity Moir. It was a particularly popular article and to celebrate the 30th anniversary of the JCM we decided to convene another discussion, in London in March 2009. Present this time were Peter Deadman (PD), Hugh MacPherson (HM), Daniel Maxwell (DM), Felicity Moir (FM) and Volker Scheid (VS). All are past or present practitioners of acupuncture and/or herbal medicine. For brief biographies of the participants, please see the end of the article.

INDUCING LABOUR WITH ACUPUNCTURE - CRUCIAL CONSIDERATIONS
Author: Debra Betts
Twenty years ago the treatment principle I would use to induce labour was straightforward - establish contractions. I used strong reducing treatment at acupuncture points indicated for delayed labour, with little underlying diagnostic effort required. The results of this approach were often disappointing; whilst women gave positive feedback, often convinced that the treatment had been successful due to the contractions following treatment, clinical follow up was less encouraging. Their resulting labours were not always efficient and frequently involved medical procedures due to failure to progress, foetal distress or "stuck" babies. There was thus little advantage for these women in using acupuncture. They may have avoided a medical induction but the resulting labours were not the "natural" births they were planning. My subsequent experience of working with midwives led to a more satisfying approach, one that used acupuncture to correct possible problems, with a focus on promoting an efficient labour rather than merely hastening the onset of contractions. This article discusses this approach, and includes four aspects that I now consider crucial for achieving an optimal outcome - that of natural physiological labour. The latest research on using acupuncture for induction is also discussed, including the implications this has for clinical practice.

ALL DISEASE COMES FROM THE HEART: THE PIVOTAL ROLE OF THE EMOTIONS IN CLASSICAL CHINESE MEDICINE
Author: Heiner Fruehauf
This article attempts to fill an obvious gap in the study of Chinese medicine education by presenting a systematic analysis of the role of the five, six and seven emotions in the history and foundational knowledge of clinical medicine. The author analyses the symbolism of relevant pictograms to reveal layers of complex information associated with the topic of the emotions. As an example for the clinical application of emotional therapy in contemporary China, the extensive five element healing system utilised by the Confucian healer Wang Fengyi (1864 - 1937) and his still practising students is presented for the first time in a Western language.

ATOPIC ECZEMA AND THE IMPORTANCE OF RESOLVING FIRE TOXIN
Author: Mazin Al-Khafaji
Skill in treating fire toxin in both the acute and chronic stages of the disease is an essential requirement if atopic eczema is to be successfully resolved. The acute stage because it can offer rapid relief of the distress caused by the extreme itching, discomfort, disturbed sleep, fatigue and embarrassment that are a feature of this disease. The chronic stage because continuing attention to resolving fire toxin after the acute stage has passed is often a fundamental component of achieving a long-term resolution of this recalcitrant condition. Strategies, prescriptions and herbs for the treatment of fire toxin vary according to the presenting patterns and symptoms. This article introduces some of the important features of the diagnosis and treatment of fire toxin in atopic eczema, laying out general principles and illustrating them with the detailed analysis of two case histories.

REFLECTIONS ON THE JCM'S 30TH ANNIVERSARY
Author: Giovanni Maciocia
It gives me great pleasure to mark the thirtieth anniversary of the Journal of Chinese Medicine which has played such an important role in the development of Chinese medicine in the West. The following article is a random collection of thoughts generated over the course of 35 years of practice. They are presented in no particular sequence and therefore the order in which they are discussed does not necessarily reflect their relative importance in my mind. First I consider a subject which has occupied me over many years, namely the differences between the traditional Chinese (mainly Confucian and neo Confucian) view of the emotions and that of our modern postFreudian societies. Secondly, I consider the phenomenon of needle sensation (deqi) and suggest that it can, in part, be replaced by careful point selection. Finally I consider pulse diagnosis, and especially the question of whether the pulse can ever be discounted, even when it appears to contradict other clinical findings.

TEENAGE DEPRESSION AND ACUPUNCTURE
Author: Julian Scott
Depression is very common in teenagers and should be taken seriously. At this time of change, depression can easily increase and develop into violent behaviour, drug dependency and even suicide. In this article we discuss how depression in the teenage years can be helped by acupuncture treatment. We are not suggesting that all teenage problems can be resolved this way; humans are far too complex for that. But frequently there is an energetic imbalance contributing to depression, and if that can be improved, then the teenager may be able to sort out their own problems without much further help. Long and costly visits to therapists can often be avoided. Three main patterns of teenage depression are described, with both their physical and emotional manifestations, and treatment principles and suggestions given. A typical case history illustrates approaches to treatment and likely outcomes.

BOOK REVIEWS JCM 90
FORMULAS & STRATEGIES, 2ND EDITION
by Volker Scheid, Dan Bensky, Andrew Ellis, Randall Barolet
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AURICULAR ACUPUNCTURE & ADDICTION
by Kim Wager with Sue Cox
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The latest issue is number 91
published in October 2009

THE TREATMENT OF ELEVATED FSH LEVELS WITH CHINESE MEDICINE
Author: Daniel Elliott
Follicle stimulating hormone (FSH) levels are routinely tested during biomedical investigations into female fertility. An appropriately low FSH level is frequently required by fertility clinics as an entry requirement for women wishing to receive assisted reproductive technology (ART) treatment such as in vitro fertilisation (IVF). This article presents the diagnosis and treatment of elevated FSH levels according to traditional Chinese medicine (TCM), and puts forward the view that high FSH levels do not necessarily mean that a woman is approaching menopause, but rather simply indicate the current status of ovarian functioning at the time of the test. The author asserts that with the appropriate treatment using acupuncture and Chinese herbal medicine, the proper functioning of the ovaries and anterior pituitary gland - in cases where they have been pathologically affected - can be restored. This process does not, however, necessarily imply that treatment has reversed the aging process or affected the quality of eggs produced. The theory presented is illustrated with three case histories from the author’s own clinical practice.

WHO INVENTED BAGANG?
Author: Charles Buck
Bagang, often translated as "eight principles", is arguably the dominant style of pattern differentiation in contemporary Chinese medicine. In this article the author explores the origins and development of this simple yet profound clinical framework, and concludes that bagang is not, in fact, a 20th century invention by the Chinese communists, but rather has been an integral part of Chinese medicine since its very origins in Han and pre-Han times.

CASE EXAMPLES FROM THE CLINIC OF PROFESSOR ZHOU ZHONGYING: INSOMNIA
Author: Zhu Minwei
Reading and analysing the clinical cases of experienced doctors was an important traditional study method in previous generations, and indeed was one of the methods used by Professor Zhou Zhongying when he was young. The cases of Professor Zhou can not only help us to understand the theories and clinical effectiveness of TCM, but also enable us to learn his adroit skills in making pattern differentiation, determining treatment strategies and applying herbal medicines. This article presents two cases of insomnia treated by Professor Zhou.

PESTLE NEEDLE THERAPY
Author: Henry McCann
Pestle Needle Therapy is an acupuncture method characterised by a unique set of points, specialised tools and their specific methods of manipulation. Until modern times it has remained a secret method, passed down through a lineage to its modern inheritor, Li Zhong Yu, Professor of Acupuncture at the Chengdu University of Traditional Chinese Medicine. This article describes the tools, theory and treatment methods of Pestle Needle Therapy, and includes examples of treatment protocols as well as a case history.

THE TREATMENT OF PELVIC PAIN WITH ACUPUNCTURE: PART 1
Author: Jennie Longbottom
This paper presents an overview of the biomedical model of myofascial pelvic pain (MPP) and its treatment using a Western acupuncture approach. The discussion includes an introduction to the function and anatomy of the pelvic girdle; a definition of pelvic pain, with research that supports the use of acupuncture as an effective intervention in the management of chronic myofascial pelvic pain (CMPP); a clinical reasoning model to assist practitioners in making a correct diagnosis and providing effective intervention for the management of CMPP; a description of the Western acupuncture approach for the deactivation of trigger points within the abdominal wall, pelvic basin and hip; and an exploration of the use of acupuncture in pregnancy-related pelvic pain with relevant support from research trials. Part Two of this paper will be presented in a future issue of this journal, and will demonstrate how the Western and traditional Chinese models of MPP can be integrated. In the opinion of the author, neither model offers all the answers, but the two can be integrated for a successful and sensitive approach to the management of this complex pain state.

BOOK REVIEWS JCM 91
THE COMPLETE STEMS AND BRANCHES
by Roisin Golding
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THE FOUNDATIONS FOR INTEGRATIVE MUSCULOSKELETAL MEDICINE : AN EAST-WEST APPROACH
by Alon Marcus
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THE PATIENT PRACTITIONER RELATIONSHIP IN ACUPUNCTURE
by Leon I. Hammer
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TEN KEY FORMULA FAMILIES IN CHINESE MEDICINE
by Huang Huang
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Features & Articles in this issue

The Jingjin - A 21st Century Reappraisal
Author: David Legge
The jingjin are a network of secondary channels that form part of the channel system of Chinese medicine. Although described in contemporary texts, they have received relatively little attention since their introduction, and are rarely used as tools of diagnosis or treatment in contemporary acupuncture practice. This article surveys the source texts that originally described the jingjin, and explores the clinical utility of these channels from the perspective of modern anatomy and physiology.

About A Pharmacy: An Interview With Mazin Al-Khafaji
Author: Peter Deadman
With legislative changes imminent that may significantly change the practice of Chinese herbal medicine in the UK, this interview with a highly respected UK practitioner explores what is involved in running a successful modern Chinese herbal pharmacy in the West.

Traditional Chinese Medicine and Human Immunodeficiency Virus‑Associated Neuropathy
Authors: Joyce K. Anastasi, Michelle Chang, Bernadette Capili and Nigel Dawes
Peripheral neuropathy is one of the most common neurological complications of human immunodeficiency virus (HIV) infection and continues to impact people living with HIV/AIDS. The pain associated with peripheral neuropathy can be severe and debilitating. Most pharmacological agents are inadequate in symptom management and are accompanied by adverse side‑effects. Acupuncture and moxibustion offer treatment approaches that can reduce HIV symptoms and/or the side‑effects of anti‑retroviral therapy and improve patients’ quality of life.

Clinical Experience of the Treatment of Chronic Skin Diseases by Auricular Point- Pressing Therapy Combined with Chinese Herbal Medicine
Author: Xia Zhi Bo
Nodulocystic acne, chronic urticaria and verruca plantaris are commonly occurring skin diseases in clinical dermatology, and can be difficult to cure. According to the clinical experience of the author, auricular pointpressing therapy in conjunction with Chinese herbal medicine can be effective in treating chronic, stubborn skin diseases. In this paper the author presents three case studies and shares his experience of how to successfully treat chronic skin diseases using this method.

Hierarchy of Patterns in the Clinical Application of Zhang Zhong Jing’s Formulas: An Empirical Approach
Authors: Joon Hee Lee
Zhang Zhong Jing’s Shang Han Lun (Treatise on Cold Damage) and Jin Gui Yao Lue (Essentials from the Golden Cabinet) include over 250 time‑tested herbal prescriptions that are characterised by their clear clinical focus and small number of ingredients. In the original texts the indications for these formulas are not explained in terms of abstract theories, but rather as objective descriptions of clinical patterns. This article provides a brief historical background of Zhang Zhong Jing’s work and discusses the significance of patterns in clinical practice according to the Shang Han Lun and Jin Gui Yao Lue. The author also introduces the concept of the hierarchical nature of patterns (disease pattern, formula pattern and single herb pattern) derived from these texts and the works of the 18th‑century Japanese physician Yoshimasu Todo. Selected case studies demonstrate how these patterns can be combined and cross‑referenced in clinic to arrive at a precisely targeted formula.

Is Stimulation Of The Acupoint Neiguan P-6 Suitable Prophylaxis For Post-Operative Nausea And Vomiting Compared To Or In Combination With Current Pharmacological Prophylaxis?
Author: Peter Trueman
Post-operative nausea and vomiting (PONV) affects up to two million patients annually in the UK alone. It causes severe mental and physical distress for those who suffer from it and increases healthcare costs. Pharmaceutical prophylactic anti-emetic agents, although effective, have potentially life-threatening side effects and are costly. Acupoint stimulation has been suggested as a cost-effective and safe method for combating the problem, either in conjunction with, or in place of, current pharmaceutical practices. Neiguan P-6 acupoint stimulation is as effective as single anti-emetic pharmacological prophylaxis and enhances the anti-emetic effects of pharmacological agents when used in combination. Neiguan P-6 prophylaxis can be recommended for universal use or as a first line anti-emetic for those at moderate risk. Neiguan P-6 stimulation can also be suggested for use in combination therapy for those patients at high risk.

The Treatment of Urinary Incontinence and Frequent Urination: How Modern Scientific Research Can Inform Traditional Acupuncture Practice
Author: Lee Butler
Urinary Incontinence (UI) is a common and costly condition, which many people - especially women - suffer to varying degrees. Those most affected often seek medical treatment, whilst those with milder symptoms may simply choose to live with their condition. This latter group may present to practitioners of Oriental medicine with other concerns, and during treatment may report symptoms of UI. This paper outlines the prevalence of UI, its associated OM patterns of disharmony and the treatment strategies recommended in conventional medicine, as well as exploring modern medical research that can inform acupuncture treatment. Based on this research the author proposes acupuncture techniques that might be adapted and used by practitioners of OM.

Chronic Urticaria and Acupuncture: A Case Study
Authors: Emad Tukmachi and Ziad Tukmachi
This case study reports on the successful use of combined manual and electro‑acupuncture in the management of chronic urticaria. The theory and effectiveness of acupuncture in the treatment of chronic urticaria is also evaluated, concluding that acupuncture offers a fertile field of study for clinical allergy researchers and a potentially effective intervention for dermatologists.

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Features & Articles in this issue

Neck and Shoulder Pain: The Levator Scapulae Muscle
Author: Whitfield Reeves
The levator scapulae muscle frequently contributes to neck and shoulder pain, yet is often overlooked by acupuncturists. A jingluo (channel) approach to pain often leads to treatment of the para-spinal muscles along the Bladder channel and the taut bands of the upper trapezius along the Gall Bladder channel. However, a small portion of the Small Intestine channel lies on the levator scapulae muscle in the region of Jianwaishu SI-14 and Jianzhongshu SI-15. Stagnation in this area is often missed by practitioners due to general pain and spasm of the neck and shoulder region. This article summarises the diagnosis and assessment of levator scapulae dysfunction so that this common site of stagnation may be effectively treated.

Acupuncture and Tuina for Hyperactive Children
Author: Elisa Rossi
This article discusses the Chinese medical treatment of 'hyperactive', 'hyperkinetic' or 'inattentive' children, who may have been diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD). The pathogenesis, main patterns and treatment of the condition are explained, and illustrated with case studies taken from an ongoing pilot study at the Xiaoxiao children's centre in Milan, Italy.

Short-term Effects of Acupuncture on Pulmonary Function and Heart Rate in Patients with Chronic Obstructive Pulmonary Disease
Authors: Diego M. Marino, Kamilla T. Marrara, Valéria A. P. Di Lorenzo, Marcelo L. Silva and Josie R. T. Silva
Few studies have assessed the therapeutic efficacy of acupuncture for patients with chronic obstructive pulmonary disease (COPD). In the trial reported here, six individuals with a diagnosis of COPD were assessed before and after acupuncture treatment. Respiratory function was found to improve after treatment, with increased forced vital capacity and decreased heart rate. This suggests that acupuncture treatment may be effective in the treatment of advanced cases of COPD

Addiction, Recovery and the Five Spirits
Author: Douglas Eisenstark
Substance abuse and drug addiction are often approached in Chinese medicine via theories that describe the damage caused by drugs to the qi of the zangfu. The Chinese medical theory of addiction tends to generalise about disharmony affecting the Heart, Kidney and Liver, while treatment focuses on repairing the damage caused by drugs to specific internal organs. This article introduces a way of viewing addiction through the five spirits of the hun, po, zhi, yi and shen, and makes some tentative associations with the 12 Step Programme.

An Investigation into the Treatment of Interstitial Cystitis with Acupuncture
Authors: Esther Holford and Toni Tucker
This paper investigates the aetiology, pathology, diagnosis and treatment of interstitial cystitis (IC) from the perspective of traditional Chinese medicine (TCM), and evaluates the efficacy of acupuncture in the treatment of IC through a survey of 52 patients (28 respondents) who received both Chinese and Western medical treatment. The study's findings show that acupuncture was perceived to be very effective in treating IC, reducing symptoms of pain, frequency, urgency and nocturia by around half. Three-quarters of the patients studied also reported that acupuncture helped their emotional state. The study showed that respondents had a much higher incidence of immune-related functional conditions than occur in the general population, suggesting that IC is not isolated to the bladder but is part of a wider problem that affects the whole body. Although this study provides insight into IC, it has obvious limitations and is therefore intended to be indicative rather than definitive, and will be used as a foundation for future research in this area.

Gao Zi: Medicinal Syrups in Chinese Medicine
Authors: Dr. Tsueyhwa Lai and Dr. Henry McCann
Medicinal syrups, known as gao zi in modern Chinese, are a traditional - although lesser-known - method of herb administration in Chinese medicine. Gao zi are highly concentrated decoctions, usually made with supplementing herbs and thickened with sugar, gelatin, or fat, which are then used for internal administration. Although they are labour-intensive to prepare, they store well for long periods of time and are easy to take, and are thus an effective way of taking herbal formulas. Since they taste better than normal decoctions, they can improve patient compliance with treatment over a long period of time. This article is an introduction to gao zi in Chinese medicine and gives an overview of their history, characteristics, preparation methods and administration. Exemplar formulas and case studies are also provided to illustrate how gao zi are used in the clinic. Buy this article

Osteoarthritis and Chinese Medicine: An Overview of Theories and Evidence
Authors: Bin Hua & Kylie O'Brien
Osteoarthritis (OA) has been treated with Chinese medicine (CM) for hundreds of years, albeit under the auspices of other clinical descriptors understood within the field of CM. This paper provides an overview of how OA is typically understood and treated within CM. OA has typically fallen under the clinical descriptor of 'bi syndrome' (painful obstruction syndrome). As theory continues to develop, however, new ideas are emerging regarding its pathogenesis that have consequences for treatment - that OA should be considered as a combination of 'wei syndrome' and bi syndrome. The therapeutic thrust of herbal medicine and acupuncture thus shifts from a focus on the Kidney zang to the Liver zang, and consequently different kinds of herbs are chosen within medicinal formulas. The majority of clinical studies into the efficacy of acupuncture and Chinese herbal medicine in the treatment of knee OA have methodological shortcomings, although there is some evidence that acupuncture may be useful in alleviating pain and improving joint function. More studies that are scientifically rigorous are required in this field. Free sample article: download as pdf or read in full text form

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Features & Articles in this issue

Point-Pair Synergy: An Example of Theory and Practice in the Treatment of Immune Disorders
Author: Jason D. Robertson
This article explores the possible physiological mechanisms engaged by the point pair Chǐzé LU-5 (尺泽) and Fùliū KID-7 (复溜), and the use of this point pair in the treatment of autoimmune conditions. The approach to acupuncture therapy described is firmly based in classical Chinese medical theory, in which diagnosis based on channel palpation is combined with channel theory and the concept of point pairs to produce a flexible approach to clinical practice. In order to explain the classical Chinese medical theory relevant to the treatment of autoimmune conditions, the relationship between the Lung, Kidney and defensive qi is discussed - a discussion which touches on many other structures within the classical physiological model.

Battlefield Acupuncture
Author: Heather Pickett
The Battlefield Acupuncture technique was created by Dr. Richard Niemtzow (Col [ret] USAF) for the purpose of rapid pain relief in 2001. The technique incorporates the use of ASP indwelling auricular needles that are placed in a specific order at five distinct locations on each ear. The points used are Cingulate Gyrus, Thalamus, Omega 2, Point Zero and Shenmen. Not every treatment utilises all the points as placement depends on the patient’s response. ASP needles are quick and easy to insert and the technique can easily be incorporated into a busy practice. Non-acupuncturist physicians can be taught this technique which has shown promise for use in the outpatient and inpatient setting.

A Response to Ernst et al.’s 2011 Overview of Acupuncture-Pain Systematic Reviews
Author: Mark Bovey
This article is a response to Ernst et al.’s 2011 paper, ‘Acupuncture: Does it alleviate pain and are there serious risks? A review of reviews’ recently published in the journal Pain. It identifies significant methodological shortcomings and inaccurate reporting that call into question the overall validity of the paper.

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The Curious Case of Ah Fong Chuck, America’s First ‘Licensed’ Acupuncturist
Author: Michael Devitt
After a promising start in the early part of the nineteenth century, the practice of acupuncture all but disappeared in the United States between 1860 and 1970. A small number of Chinese medicine practitioners helped to keep acupuncture alive in some parts of the country during this time. Among the earliest was Ah Fong Chuck, who emigrated to the United States in the 1860s and practised in Idaho for nearly six decades. A classically trained physician and skilled herbalist who also had extensive training in acupuncture, Ah Fong won the legal right to practise medicine in 1901, making him arguably the first 'licensed' acupuncturist in American history.

In Praise of Tea
Author: Peter Deadman
Tea is - after water - the most widely consumed drink in the world, thus making the leaves and buds of Camellia sinensis the most widely consumed herb in the world. It has a long and fascinating history, is deeply infused into the cultures within which it is drunk, and - as numerous studies have shown in recent years - has remarkable health benefits.

Qin Bowei’s 56 Methods: A Clinical Perspective
Author: Jason Blalack
Qin Bowei was one of the most important scholar-physicians and synthesisers of Chinese medicine of the 20th century. This article presents a brief introduction to his system of prescribing, which constitutes a synthesis of the most important clinical ideas in the history of Chinese medicine that pre-dates most of Mao Zedong’s influence on medicine, and differs in a number of ways from the current TCM model. Practical clinical examples of how to use Qin’s treatment methods are also provided to demonstrate how they may be helpful to us today.

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Features & Articles in this issue
The Heavenly Star Points of Ma Danyang
Author: Andrew Nugent-Head
According to the Heavenly Star Poem (first recorded in Wang Guorui's Yuan Dynasty Jade Dragon Classic's Echo of Bian Que Deity's Acupuncture), 'None of the functions of the 360 points are beyond the 11 [Heavenly Star] points'. The same poem states that the clinical effects of using these points can be 'like hot water poured upon snow'. This article explains the history and textual transmission of the Heavenly Star Points of Ma Danyang, and includes comprehensive descriptions of the application of the points and the needling techniques necessary to produce the desired clinical effects.

The Acupuncture Treatment of Female Infertility - with Particular Reference to Egg Quality and Endometrial Receptiveness
Authors: Toni A. Maughan and Xiao-Ping Zhai
Patients undergoing fertility treatment often believe that all that matters when trying to conceive is the number of eggs they have. However, it is actually the quality of these eggs that determines whether an embryo is able to reach the blastocyst stage, implant and continue to develop into a healthy baby. Egg quality is affected by ovarian function and the state of the reproductive environment - for instance the harmonious functioning of the hypothalamus-pituitary-ovarian axis - as well as lifestyle factors and the age of the patient. Tubal or immune factors may further impair a women's chance to conceive. From the Chinese medical perspective the primary gynaecological functions are governed by the Kidney jing, Liver and Spleen. This paper describes the underlying mechanisms of female fertility from a Western as well as a Chinese medicine perspective, and gives acupuncture treatment protocols that can be modified to the patient's individual Chinese medicine diagnosis, to enhance thereproductive environment and create optimal conditions for fertilisation, maternal endometrial receptivity and a subsequent healthy pregnancy.

Community Acupuncture: Making Buckets from Ming Vases
Author: Lisa Rohleder
Community acupuncture – as practised by self-styled 'acupunks' – is a radically different vision and philosophy for the practice of acupuncture in the West. Patients are seen in a group setting, which allows for treatment to be conducted via a high-volume, low-cost sustainable business model. Spa settings and excessive Chinese medicine theory are unnecessary with such a model of treatment, as the needles do all the necessary work. This article describes the vision, aims and underlying philosophy of the community acupuncture movement.

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