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Archive for the ‘TCM and fertility’ tag

Cupping for Competition—and Conception

By David Kreiner MD

August 11th, 2016 at 1:41 am

 

image credit: GraphicsMouse/freedigital photos.net


What treatment might Olympic athletes and fertility-challenged women have in common?

Evidence of Cupping on many competing in the Olympics, especially the swimmers, has made quite a splash…but what is cupping and why the purplish circular marks on the skin?


Cupping is a form of traditional medicine found in many cultures throughout the world. This treatment involves placing cups containing a negative pressure which exerts suction onto the skin that if left on long enough breaks small blood vessels or capillaries resulting in a bruise in the affected area. This sounds painful, but it isn’t.

Cupping is a popular form of Traditional Chinese Medicine (TCM) that works to unblock “Qi”, a form of life energy. Once unblocked, the energy can flow smoothly throughout the meridians or pathways in the body.

With cupping, TCM practitioners, commonly called acupuncturists, help to remove congestion and stagnation (stagnant blood and lymph) from the body and to improve the flow of “Qi” throughout the body.  It also will increase the blood flow to the area upon which the cup is applied.

Musculoskeletal disorders are aided by increasing the flow of blood and “Qi” to the muscles underlying the applied cups.  Hence, Michael Phelps and other Olympians have been going for cupping treatment to alleviate their sore muscles.  Some TCM practitioners will also use cupping to treat breathing problems or respiratory conditions such as a cold, bronchitis or pneumonia.

Cupping may also be utilized to improve fertility in conjunction with acupuncture, moxibustion (heat applied to acupuncture point through burning herbs) and/or herbal therapy.  From a TCM perspective, improving the flow of “Qi” at specific points or meridians may correct an imbalance that is preventing conception.  From a Western scientific view, cupping and acupuncture cause the body to release endorphins.  The endorphin system consists of chemicals that regulate the activity of a group of nerve cells in the brain that relax muscles, dull pain, and reduce panic and anxiety.

It is believed that these therapies may also trigger the release of more hormones, including serotoninSerotonin is a brain chemical that has a calming effect resulting in a serenity that aids the fertility process.  Cupping, like acupuncture, reduces inflammation which could also benefit fertility.  Whether it be the challenge of an Olympic trial or a battle against infertility cupping may be a valuable addition to one’s program.

 

 

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Infertility and TCM Part 14: Did Qi Bo Know Best?

By David Kreiner MD

April 15th, 2015 at 11:39 am

photo: stuart miles/ freedigitalphotos.net

Traditional Chinese Medicine (TCM) evolved over thousands of years as evidenced by several ancient written works including the oldest medical textbook in the history of the world, the Huang-Di Nei Jing (Yellow Emperor’s Cannon of Internal Medicine), dating back to between 300 and 200 BCE.

The book is named for Huang Di, the Yellow Emperor, who lived between 2700 and 2600 BCE.  The legend is that it is a record of the emperor’s conversations with his distinguished physician, Qi Bo.  The Huang-Di Nei Jing consists of 162 articles divided into theory and practice.  The section on theory involves the relationships among the internal organs, the sense organs, and the brain dealing with the concepts of yin and yang as applied to medicine.

In TCM according to the Huang-Di Nei Jing, the yin and yang principle proposes that the bodily organs are interdependent and support each other in harmony.  Disease is defined as a loss of this state of balance both within and among the organs.  Treatment with TCM has always been based on the restoration of the body’s natural harmony with a rebalancing of all the organs.

In all likelihood, the Huang-Di Nei Jing represents a compilation of works drawn from the experience of many TCM leaders over the course of hundreds, if not thousands, of years.  It is reminiscent of the Jewish Talmud which likewise represents contributions from thousands of Rabbis over the course of hundreds of years.  Also, in a fashion similar to the study of TCM, contemporary Jewish scholars study and follow the Talmud much as it was originally written.

The second section of the Huang-Di Nei Jing is a manual on the practice of acupuncture.  Today, this book continues to be used as a reference by contemporary TCM practitioners.

The internal organs are believed according to TCM to be connected by a system of acupuncture points organized along channels (also referred to as meridians) throughout the body.  Each point regulates an aspect of the functional activity related to its channel or associated organ, or sometimes some other channel or organ it may also ultimately connect with or relate to.  Acupuncture points are areas on the surface of the body where the Qi (the body’s life energy) may be accessed as it traverses through one of these channels.  By stimulating or reducing (suppressing or dispersing) at the acupuncture point, the TCM practitioner can regulate the flow of Qi in the channel and/or to a particular organ.

In TCM, pathology may exist secondary to a stagnation of this flow of Qi which disrupts the function of an organ not receiving its normal Qi flow.  Qi may be deficient in which case the treatment would be to increase the Qi in the body and tonify affected organs.  Other pathologies may exist based on excess or deficiency of fluids, heat and blood.  Stagnant blood flow may cause disease, as can excess cold or heat, all of which can affect the flow of Qi as well as the channels and organs in the body.

TCM practitioners often utilize herbs to assist in restoring the harmony in the body and expelling the pathogens which include heat (including summer heat), cold, dampness, dryness and wind which we think of in modern medicine as viruses, bacteria, fungi etc.

In addition to acupuncture, the TCM practitioner may utilize moxibustion which is the application of heat applied to the skin using a vehicle that may include the use of topical herbs.

Cupping, the application of small glass cups or bamboo jars as suction devices on the skin is yet another technique utilized to improve the flow of Qi through the channels in the body.  It is also used to release toxins, clear blockages of Qi and blood, as well as relax muscles.  It can encourage blood flow and sedate the nervous system.  It has been used for cellulite reduction as well as to clear congestion from the common cold or to help patients with asthma.

Modern application of TCM… though based on ancient science, philosophy, and techniques… still resembles that which was performed over 2000 years ago.  I think that… despite its lack of Western scientific explanation, basis, and justification… it remains a viable medical option because of the evidence of cure and palliation that it has brought to so many over the millennia.

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Do you believe there is a place for Eastern medicine practices, blended with Western medicine? Interested in learning more? Post any questions here for Dr. Kreiner.

 

 

 

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Infertility and TCM Part 13: Why TCM Thrives in a Sick Western Society

By David Kreiner, MD

March 19th, 2015 at 12:41 pm

 

image courtesy of stuart miles/freedigitalphotos.net


Why is it that Traditional Chinese Medicine (TCM) has survived for some 2500 years and in fact remains a viable medical option for common health complaints in many contemporary societies?

Few other medical methodologies and treatments experience as much use as TCM even in the US which shares no common tradition, history or beliefs that may otherwise explain its popularity. Need I compare it to the history of Western Medicine, the bulk of which has been thankfully replaced by more contemporary scientific and technological advances?  These new innovations truly appear to be offering more good benefit than the dangerous, risky and unethical medicine popularly practiced in the West as recently as 85 years ago.

In fact, Western Medicine caused much iatrogenic illness until Dr. Ignaz Semmelweis introduced the importance of sterility in medical procedures and Dr. Joseph Lister did the same for surgery in the mid and late 1800’s respectively. It took until 1928 that Penicillin, the first antibiotic, was invented and it was not until 1953 that Jonas Salk invented the first vaccine to prevent polio.

Medical science has made great advances in immunizations which have been enormously successful in preventing disease.  These vaccinations have saved millions from life-threatening diseases.  So why is this not universally accepted as the medical panacea some of us perceive it to be?  The latest knock on this 20th century medical miracle thought by many to be worthy of the Nobel Prize in health and medicine is believable reports that autism is somehow related to these magic vaccines.  After all the experience and research, reasonably scientific folk are having difficulty completely ruling out a relationship.

Antibiotics and immunizations have saved more lives in the past 85 years than the compilation of all infectious deaths comprised from the beginning of time.  We have come a long way from the original discovery of the antibiotic benefits of some moldy bread transmuted to penicillin. However, a malady we face with modern medicine is that Western medical treatment has been developed in total disregard for our society, culture, traditions and environment.  A potential cure must be acceptable with not just proper use but strict disallowance of its improper use.

In the years that we have been blessed by the antibiotic revolution, we have seen commercial abuse in the form of common treatment on farm animals essentially creating antibiotic-resistant bacteria that destroys the effectiveness of that magic bullet that proved the savior against devastating disease making it oft times worthless.  Common overuse of antibiotics among physicians adds to this conundrum.

Environmental pathogens are making people ill including tobacco, stress, and recreational drugs as well as unhealthy diets rich in chemicals, medications, sugar, animal fats, and excess carbohydrates lacking nutritional value.  Food is over-processed and is often eaten to such excess that in combination with sedentary lifestyles in Western Medicine leads to obesity, diabetes and hypertension and in TCM to pathology related to stagnation of Qi, development of damp and other pathogens.

TCM is unique in that it works to improve these underlying factors responsible for making our society so sick.  This is why, though ancient, Traditional Chinese Medicine thrives in our modern albeit sick society.

Prior to the invention of the modern day antibiotic, TCM doctors discovered over the ages the “antibiotic” properties of certain herbs they discovered in their environment.  These ancient medicinals were derived from plants, animals, and minerals.  Other herbal decoctions were created to treat common complaints such as headache, pain, cough, cold, etc. as well as diseases such as gallstones, diabetes, hypertension, menstrual disorders and infertility. Dietary prescriptions are given by TCM practitioners and result in effective diminution of patient symptoms as well as acupuncture treatments aimed to eliminate pathology and correct unhealthy constitutions.

The goal of the TCM practitioner is to improve the individual’s health and well-being by focusing attention on the potential hazards of his/her environment such as stresses, emotions, bad habits, sleep, rest and activity, and diet.  An acupuncture treatment may help nourish deficiencies in the individual’s constitution that can put one at risk of contracting illness.  Herbal remedies can do same as well as eliminate pathologies before they turn into serious disease.

These TCM treatments are not only helping patients live healthier in their environment, the remedies themselves are actually coming from nature without artificial chemical contamination and are much less likely to have deleterious side effects.  It stands to reason that though the science behind TCM precedes the precision offered by the tools available with modern technology, the potential benefits are very much real today.

If you’d like to know more about TCM and how it may enhance your fertility, Long Island IVF is offering a free event on April 23, 2015, during National Infertility Awareness Week, entitled AN Evening of Alternative Medicine and Holistic Approaches to Enhancing Fertility.

All events during NIAW are FREE, but pre-registration is required. Events will fill up quickly. Attendance is limited. If you’ve been trying to conceive without success, please RSVP immediately to reserve your spot by contacting our Patient Services Coordinator, Lindsay Montello at 631-386-5509 or lmontello@liivf.com. You do not have to be a Long Island IVF patient to attend. Please feel free to bring your partner or a friend.

 

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Have you considered TCM for fertility enhancement or any other health issues?

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Infertility and TCM Part 12: Not Tonight, I’ve Got A Headache

By David Kreiner MD

September 30th, 2014 at 10:41 am

 

image courtesy of free digital photos.net/Stuart Miles


“Not tonight, dear, I’ve got a headache.” That well-known phrase is commonly used by both fertile and infertile couples. According to Traditional Chinese Medicine (“TCM”), there are several types of headaches and each relates to several other areas of the body. So, what causes a headache?

The head is the dwelling of the confluence of yang in the body and is closely connected with the organs through meridians and vessels.  When external or internal factors impede the flow of Qi or nutrition to the head or blocks the head orifices headaches can occur.  People experience a variety of headaches with different symptoms related to different syndromes.

Supraorbital Headaches

Supraorbital headaches may be one- or two-sided above the eyebrow and may spread over the entire forehead.   TCM believes that this pain is caused mainly by invasion of wind heat pathogens or wind pathogens that cause stasis of the flow of Qi to the head.  In addition, dysfunction of the stomach and gallbladder meridians are thought to play an important role in causing the headache.

When wind heat is responsible there may be a distending feeling in the forehead accompanied by a teary red eye that is sensitive to the light.  Patients may have exterior symptoms such as fever and aversion to a blowing wind.  The tip of the tongue is red and a thin yellow coating is typically seen on the surface of the tongue.  The pulse is felt strongest with the lightest of pressure over the radial pulse, a so-called “floating” pulse and is rapid.

Wind stasis that blocks the flow of Qi to the head typically induces a stabbing pain over the eyebrow associated with light sensitivity.  It is exacerbated with pressure.  The tongue has a purplish color to it and the pulse is said to have a taut guitar string like quality.

Distending Headaches

Distending or splitting headaches in TCM are usually the result of abundant Qi and blood flowing into the head that lead to localized stagnation, and disturb the head orifices. The usual disharmony patterns are:  Invasion of wind heat, liver yang rising and flaming up of liver fire.

Invasions of wind heat induces a splitting sensation in the head accompanied by fever, aversions to wind, thirst, redness in the face as well as eyes and tongue which is also typically covered by a yellow coating.  The pulse is felt very superficially (“floating”) and is rapid.  Treatment is aimed at expelling wind and clearing heat using herbs and/or acupuncture.

Liver yang rising induces a distending headache associated with dizziness, tinnitus, numbness and/or tingling in toes and/or fingers, insomnia, lumbar pain, weakness in the knees and redness in the face and tongue which has a yellow coating.  The pulse is said to feel like a “guitar string” and is rapid.  These symptoms may be exacerbated by emotional stress.  Treatment is geared towards calming the liver, subduing yang and nourishing kidney and liver which also is accomplished with herbs and acupuncture.

Flaming up of liver fire likewise causes a distending headache but said to be more severe splitting accompanied by bloodshot eyes, a bitter taste, lower chest discomfort, irritability, dreams that disturb sleep, a red tongue that has both a yellow and greasy coating and the pulse is “guitar string”-like and rapid.  Treatment is to clear the heat and eliminate dampness.

Heavy Sensation Headaches

Patients sometimes describe headaches that are characterized by a heavy feeling in the head. This feeling is commonly seen in tension headaches, headaches from stress felt in the neck or headaches due to functional disorders.

According to TCM, dampness is the most common factor causing the heavy sensation headache. As dampness pathogens are said to be turbid and heavy in nature, they tend to obstruct the flow of Qi in the meridians. Other disharmonies such as stagnation of the liver, dysfunction of the middle burner and improper ascending of lucid yang can also result in a heavy sensation headache.

Wind dampness obstructs the flow of Qi inducing the heavy sensation headache accompanied by fatigue, heavy sensation in the limbs, chest stuffiness, lack of appetite, urinary problems, loose bowels and a greasy white tongue coat.  The symptoms may be aggravated during humid or rainy weather.  Treatment is to dispel wind and eliminate dampness.

Damp heat will cause heavy sensation headaches or distending headaches associated with a red face and tongue covered by a yellow coating.  Patients describe a hot sensation in the body, irritability, lack of appetite, chest stuffiness, abdominal distension, scanty yellow urine and constipation.  Typically symptoms worsen in the afternoon.  Treatment is to clear the heat and eliminate dampness.

Phlegm dampness obstructs Qi flow in the meridians to the head causing the heavy sensation headache typically also with dizziness and a foggy feeling.  Patients may also experience chest oppression, stomach upset, excessive sputum, fatigue, a bulky tongue with teeth marks and a greasy white-coated tongue.  Treatment is to invigorate the spleen eliminate damp and phlegm and restore the flow of Qi.

Stagnation of the liver can cause headaches with heavy sensation and dizziness, chest discomfort, stomach upset, belching, depression, forgetfulness, lack of appetite and loose bowels and dreams that disturb sleep.  Symptoms worsen with emotional stress.  Treatment is to sooth the liver, regulate Qi and harmonize the organs of the upper abdomen known as the middle burner.

Qi deficiency of the middle burner (including Spleen, Stomach and Gall Bladder) in addition to causing the heavy sensation headache can cause dizziness, paleness, fatigue, shortness of breath, lack of appetite loose bowels and a pale tongue.  Invigorating the middle burner, replenishing Qi and promoting the ascent of lucid yang are treatments for this ailment.

With all this going on, is it any wonder people often use headaches as a lovemaking excuse?

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Have you ever used…or would you consider using… acupuncture to treat chronic or severe headaches?

 

 

photo credit:

http://www.freedigitalphotos.net/images/Herbs_and_Spices_g68-Chinese_Herbal_Medicines_p55066.html/Stuart Miles

 

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Infertility and TCM: Part 10: The Examination

By David Kreiner MD

July 11th, 2014 at 2:07 pm

 

image courtesy of stuart miles/freedigitalphotos.net


An acupuncturist selects particular points along the various Qi meridians on the body depending on the patients’ complaints and their diagnoses as determined by the following four key aspects of the acupuncturist’s examination; inquiry, inspection, palpation and listening/smelling.

The acupuncturist takes a history which is not just limited to the chief complaint but focuses on diet, bowel habits, lifestyle, etc.  He/she will observe the patient during the visit paying particular attention to body habitus (physique), gait, complexion, hair, and much more.  The acupuncturist inspects the tongue for size, color, moisture, coating as well as any additional features such as spots, tooth marks and cracks.  Using varying degrees of pressure, he/she will palpate a patient’s radial pulse with three fingers pressuring superficially, deep to the bone and in between.  He/she will palpate the abdomen as well as the Qi meridians searching for tenderness. Finally, he/she will gather information by listening and smelling as diagnostic patterns vary depending on the characteristics of all of the above.

Treatment will depend on a particular pattern or patterns of disharmony that are identified. In addition to acupuncture, treatment could include moxibustion, cupping, tui na manipulation or massage and/or herbal therapies.  An acupuncturist assesses the root cause of the patient’s problem and will usually treat both the cause and the symptom complaints as it is believed that without correcting the root cause of a problem, symptoms will recur even if initially relieved.

I will review the significance of the findings from the examination and the different disharmony patterns that can be identified by virtue of this examination in future posts.

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Does the TCM examination seem more thorough than a typical Western medicine examination?

 

 

 

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Infertility and TCM: Part 9: Tong Bing Yi Zhi.

By David Kreiner MD

June 29th, 2014 at 8:34 am

 

image courtesy of stuart miles/ freedigitalphotos.net

According to Western Medicine, a particular disease is caused by a specific pathogen and the Western Medicine treatment is directed at that pathogenic factor. However, Traditional Chinese Medicine (TCM) recognizes that two people may react differently to that same pathogen.  They refer to this as Tong Bing Yi Zhi.  For example, in one individual the symptoms may appear as Damp heat syndrome and in another as Yin deficiency with false heat syndrome. In TCM, despite the common pathogen, patients would be treated differently depending on the syndrome identified. Syndrome identification is based on 4 diagnostic methods: inquiring, palpation, inspection and listening/smelling. This information is gathered and analyzed to identify the syndrome that a patient is experiencing.

 

On the other hand, two people with two different Western diagnoses such as menopause and hyperthyroidism may experience the same TCM syndrome from their respective pathologic conditions, Yin deficiency with false heat. This is also referred to as Tong Bing Yi Zhi.  In this case it refers to treating different diseases the same because they result in the same TCM syndrome.  In the first case TCM treats the same disease differently because as a result of the varying natures and constitutions of patients the symptoms resulting from the same pathologic condition often varies. To clarify, we do not need to know in TCM what diseases the patients have. We treat them according to TCM by their syndrome diagnosis.

Syndromes are differentiated based on several different factors. There are eight principles of paired opposing conditions including; Exterior and Interior, Cold and Heat, Deficiency and Excess, and Yin and Yang. These general principles are the basis for categorizing all the syndromes. The other syndromes are differentiated according one of the following  theories such as; Qi, blood and body fluids, the theory of the Zang-Fu organs, the theory of the six channels or meridians of Qi, the four levels of heat invasion, and the three burners or sections of the body.

It is through the four diagnostic methods above that the practitioner identifies the syndrome affecting the patient. He/she will choose the particular treatment specific for the syndrome modified by the age and health of the patient. This can include Tui-Na massage, acupuncture, moxibustion, cupping, and herbal medicine all directed at specific points in the body depending on the syndrome.

To me, as a Western physician trained to direct treatment for a particular pathogen or disease, I am very attracted to differentiating treatment based on its specific effect on the individual patient. We know that the same disease can have different resulting effects on people and that different diseases can affect some individuals in the same way. Therefore, the concept of directing therapy based on the effect the pathogenic factor has on the individual appears to me to be an effective way to treat a patient. If a physician were to combine the Western pathogen-directed therapy with TCM treatment based on the syndrome affecting the individual then the East-West combination therapy I believe should be most ideal.

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Does the Western pathogen-based treatment plan seem sufficient or does the idea of blending it with Eastern principles of syndrome-based treatment seem like it’d be a complementary bonus?

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Infertility and TCM (Part 8): The Promise of Blending Western and Eastern Medicine

By David Kreiner MD

June 10th, 2014 at 6:34 pm

 

 

image courtesy of stuart miles/freedigital photos.net

As I approach the midway point of my second semester of studying Traditional Chinese Medicine (TCM) I realize that I believe much more strongly in the effectiveness of these ancient healing arts.  I have begun to work on recharging the Qi in my body by performing Qigong exercises and improving my abdominal breathing.  I stimulate my Qi meridians throughout my body daily to improve the flow of Qi in my body.  I even have performed some acupuncture on myself that I am convinced has helped relieve some minor arthritic pain as well as other symptoms that I have developed over the years.

I foresee a time when many physicians will utilize acupuncture to fill some voids that I have witnessed in Western Medicine.  Patients with aches and pains, chronic cough, urinary complaints and other common health issues often are either overlooked by Western physicians or inadequately treated.  TCM treatments of acupuncture, moxibustion, cupping and herbal therapies may offer an effective alternative to pharmaceuticals and surgery with less risk and fewer side effects.  I have seen benefit from these “manipulations of Qi” and believe that as the Western public becomes more aware of TCM it will become a commonplace mode of therapy.

Perhaps, even more exciting to me is the use of TCM as an adjuvant to Western Medicine.  We know that sophisticated Western laboratory and diagnostic testing is very effective in establishing Western diagnoses that are amenable to pharmaceutical and surgical therapeutics.  TCM, used as an adjuvant to these treatments offers a unique opportunityto improve the constitution of individuals thereby increasing their natural abilityto fight disease.  Also, by working through a different pathway TCM holds promise to increase the effectiveness of the Western Medicine treatment. 

This is the reason TCM/acupuncture combined with Western Medicine provided by high quality IVF centers offers patients their optimal chance for pregnancy success. 

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Have you, or has anyone you know, used TCM/acupuncture as an adjuvant to IVF or another assisted reproductive technology? Did you feel it made a difference?




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Infertility and TCM (Part 7): The Doctor as the Acupuncture Patient

By David Kreiner MD

April 27th, 2014 at 11:35 pm

 

credit: stuart miles/freedigitalphotos.net

In case it has not been clear up until now, I have my doubts about the scientific explanations regarding acupuncture.

Perhaps, it is too much to ask a 58 year old Western-trained physician to believe in something he cannot see, feel or measure. However, being a younger member of the baby boomer generation I now have my own set of common physical complaints ranging from arthritic joint pains to urinary changes to sleep issues, and more. Therefore, I thought it would be at least interesting if not helpful to go for an acupuncture exam and treatment.

Of course, I was not a typical acupuncture patient since I am a physician who does not entirely accept acupuncture as an effective alternative form of traditional health care. You might say that I am an open-minded skeptic with some very typical complaints for a man my age.

As instructed, I arrived early at the Acupuncture clinic in my school in order to fill out the questionnaire, a routine in most doctors’ offices including my own.  After completing the extensive questionnaire (which made me feel as if I were writing my memoirs) I was called in and brought to a room with a fairly comfortable-looking stretcher/bed. I gowned and for the next 20 minutes answered the acupuncturist’s questions about my complaints, my dietary and bowel habits, exercise routine and more. There were some unusual questions like what foods do I yearn for, do I have bad breath or odors, do I dream, etc.

Then the examination began. I extended both arms over a pillow to have both radial pulses palpated in three positions from just proximal to the wrist crease to about two inches up going towards the elbow crease. Much focus and time was spent on this. After the acupuncturist completed his study of my pulses, he began a very thorough inspection of my tongue along its entire length and on both sides.  Being quite curious about the acupuncturist’s findings I asked him about what he learned about me from the examination.  

Based on my pulse, I showed evidence of weakness in the liver and heart but it was suggested that my beta blocker that I take may account for this. My tongue showed evidence of dampness, one of the Traditional Chinese Medicine pathogens in the body.  The acupuncturist said that based on my history and examination that I exhibited a Kidney Qi or yang deficiency with dampness and that I also suffered from cold, another pathogen.

The acupuncture prescription was aimed at tonifying Qi and yang as well as tonifying kidney and spleen which can cause the dampness.  He was also going to needle points specifically aimed at removing the dampness.  In addition he was going to needle points to calm my “shen” to aid me in my ability to sleep uninterrupted.  He said tonifying the kidney, in addition to needling some bladder points, may help with the urinary problems.  There are specific acupoints for treating all issues and complaints.  The joint pain in my thumb he would address as well.

 

I was anxious and excited to get started.  After all it isn’t every day that you ask someone to stick needles into your body.  

The first needle was inserted perpendicular to my skin about half way up my left leg.  The needle was so thin that it did not hurt as he tapped it through my skin however when he twisted the needle in deeper it caused a very mild “electric-like” shock. It wasn’t that it was painful but it was not a sensation that I am used to feeling. However, the next point he inserted a needle into in the right leg caused an even bigger shock that made my left leg jump a bit which is where I felt the shock.  A few needles later, at a point in the crook of my left arm upon insertion of the needle I felt a shock immediately in my left leg causing it to jump again.  

As I lay on the stretcher I was thinking, “What kind of magic is this that needles inserted on the right side can affect the left and on an upper limb can impact on a lower limb?”. When a needle inserted at the base of my right thumb caused a shock shooting to the tip of my finger I figured that it was a routine reaction when one moves Qi. I lay in the bed with the lights off for about 20-30 minutes very relaxed but a little disappointed when the acupuncturist returned to interrupt my rest and remove the needles.

I had class that evening and was in a great mood. In fact, one of the students asked why I looked so spiffy. It was not the way I was dressed. The next day, I felt great and was in a very good mood again. I cannot say whether I have no more dampness but the cough which plagued me my whole life was gone and that is even while having an upper respiratory infection.

I can say that today,  as a result of my experience with this acupuncture treatment, I am a little less skeptical that there are pathways of Qi in the body that may be manipulated to improve one’s health and well-being.

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Does this experience make you more or less likely to try acupuncture? Why?

 

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Infertility and TCM (Part 5) Channels and Points: TCM’s Gross Anatomy Equivalent

By David Kreiner MD

March 31st, 2014 at 2:05 pm

 

image courtesy of stuart miles/freedigital photos.net

 

As a new student in Traditional Chinese Medicine (TCM) and acupuncture one of the first and most important classes we must take is called “Channels and Points”. This to a former medical student is the TCM version of Gross Anatomy. Gross anatomy in medical school was my exciting introduction to the human body, essential to the study of medicine.  I owned the classic Gray’s Anatomy text which today is popularized by the TV show of the same name.  The course requires strict memorization of all the bones, nerves, ligaments, vessels and organs in the body.

Likewise, “Channels and Points” requires the memorization of the precise location of 365 points and the corresponding channels of Qi which course throughout the body and can be utilized in the practice of acupuncture.  How these channels and points relate to each other and to the different organs is important as that will also determine their usefulness in different clinical situations.  

It is believed that the location of the channels of Qi and their surface access points was discovered through centuries of observation of the existence of tender spots on the body during the course of disease.  Furthermore, it was observed that symptoms were alleviated when those points were stimulated by massage or heat.  

When a number of points became known, they were linked into groups with common characteristics and effects and hence a pathway for a channel was identified.  Knowledge accumulated over hundreds of generations documented in several ancient texts.  As information regarding the channels and points accumulated, theories evolved and often resulted in modifications of prior beliefs as more experience clarified more accurate placement and function of these channels and points.  

The first document that unequivocally described the channels and points in an organized system of diagnosis and treatment recognizable as acupuncture is The Yellow Emperor’s Inner Classic, dating from about 100 BCE. The information was presented in the form of questions posed by the Emperor, Huang Ti, and replies from his minister, Ch’i-Pai. The source of the text of his answers was likely a compilation of traditions handed down over centuries, presented in terms of the prevailing Taoist philosophy, and is still cited today in support of particular therapeutic techniques. There is evidence that acupuncture utilizing bronze, gold and silver needles was practiced around this time as well as moxibustion.  

A more contemporary view of the concepts of channels in which Qi flowed that was documented through the precise anatomical locations of acupuncture points developed later.  During the Ming Dynasty (1368–1644), The Great Compendium of Acupuncture and Moxibustion was published, which forms the basis of modern acupuncture. It includes descriptions of the full set of 365 points that represent superficial access to the channels through which needles could be inserted to modify the flow of Qi energy.

Unlike the bones, tendons, nerves and vessels of Gross Anatomy, the channels and points utilized in acupuncture do not have corresponding visible or palpable anatomic structures that may be identified in an effort to memorize.  These channels of Qi are not visible structures nor can they be felt through touching or palpation.  So how does the acupuncturist know where the surface access point is to direct his needle?  

The trained acupuncturist utilizes the surface anatomy such as bones, joints and ligaments to locate these acupoints.  The points typically are found between the ligaments, in bony crevices or between bones. Additionally, the body is divided into units of measure based on an individual’s own bone size.  The most basic unit, cun, is defined as the width of the individual patient’s thumb.  Two cun is the distance from second most distal or middle joint of the forefinger to the tip.  Three cun is the width of the forefinger to the pinky measured at the point of the middle joint of the fingers.  The arms are 9 cun from axilla to the transverse crease of the elbow and 12 cun from the elbow crease to the wrist crease.  The number of cun for every portion of the body is delineated so that the location of the acupoints is based on locating according to the distance by cun units from an identifiable spot on the surface anatomy of the patient and usually are found in between ligaments, bones or in the bony crevices which are palpated by the acupuncturist upon needle placement.  

There are also some points that are identifiable based on particular placement of the fingers and hands of either or both the acupuncturist and patient.  For example, if the acupuncturist places his finger on a patient’s styloid process then has the patient internally rotate his/her hand, the point is located where the acupuncturist’s finger ends up.  This point, currently my favorite, is Small Intestine (SI) 6 with the English name of Support for the Aged because it treats symptoms such as blurry vision, lumbar pain, neck pain and other aches and pains that affect individuals as they get older.  

Another critically important point and therefore given the distinction of being a Command Point for the head and nape of the neck is Large Intestine (LI) 7.  It is located when the acupuncturist places his/her index finger on the dorsal side of the patient’s hand and thumb on the ventral side in between the patient’s thumb and forefinger.  The acupuncturist will locate the point where the tip of his forefinger meets a groove in the anterior portion of the patient’s radius bone.  

How deep to place the needle and in what direction and angle are further issues to be learned another day.

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Are you finding this educational journey into TCM fascinating? Do you have any questions for Dr. Kreiner about this or any other TCM topic he has covered so far?

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TCM and Fertility: The Importance of Vital Substances and Maintaining Balance

By David Kreiner MD

March 20th, 2014 at 2:07 pm

 

image courtesy of stuart miles/free digital photos.net


Traditional Chinese Medicine (TCM) has presented such a challenge to my Western scientific perspective that I neglected to define the basic principles on which TCM is based. 

 

TCM, and life itself, according to Chinese tradition which developed over the past three thousand years starts with the vital substances, Qi and Essence, in addition to blood and body fluids.  Our human physiological functioning is dependent on these vital substances which the body attempts to maintain in balance between Yin and Yang.  The Qi and Essence, blood and body fluids will interact and perform their essential roles throughout the body dependent on the Zang-Fu and “extraordinary” organs and the states of Yin and Yang while traveling through vessels, channels, and branches that interconnect with each other.

The concept of Qi comes from the Chinese Taoist philosophy that has been described as a “life force” but is actually an aggregate of ideas that we Western thinkers like to separate to better understand.  To our way of thinking it likely is a form of energy, or electric potential that crosses cell membranes as it traverses from one part of the body to another.  Chinese tradition identifies many different forms of Qi each with different functions affecting physiology and life.  The acupuncturist studies the channels through which Qi flows in the body to modify its flow for a particular purpose… whether to eliminate pain or improve an individual’s health, both of which may be impacted by some pathology of Qi level or flow.

Essence (Jing) is considered one of the three treasures of TCM, along with Qi and Shen (spirit).  Jing is stored in the kidneys according to TCM and nourishes and fuels the body.  There is Prenatal Essence which is supposedly inherited much like DNA and cannot be renewed.  It is responsible for an individual’s constitution and congenital illness. Postnatal Essence can be replenished by food, herbs, acupuncture, or exercise such as T’ai Chi.  Total Essence is made up of both Prenatal and Postnatal Essence and is responsible for growth, development, and reproduction.  Effects of aging may be caused by a deficiency or deterioration of one’s Essence.

In Chinese philosophy, the concept of Yin and Yang is used to describe opposite yet complementary forces that are both interdependent and interconnected and give rise to each other.  Yin and Yang interact in a dynamic way.  Whenever one quality reaches its peak, it will naturally transform into the other.  In TCM, good health is directly related to the balance between Yin and Yang qualities within oneself. If Yin and Yang become unbalanced, one of the qualities is considered be either deficient or in excess… which can lead to illness and disease.

The traditional Chinese concept of human organs, known as Zang-Fu and “extraordinary organs”, are not primarily based on anatomical considerations.  They instead are defined as functional entities with a general location in the upper, middle, or lower Jiao separated by the diaphragm and the umbilicus.  The three Jiao (San Jiao) together is considered a functional organ in TCM and… in addition to separating the other organs into three cavities including chest, upper abdomen and lower abdomen… it functions in the transport of Qi and body fluids.  These Zang-Fu and additional “extraordinary” organs are interconnected with each other through channels of Qi in addition to vessels containing blood and body fluids.  As a result, a problem in one organ can affect the functioning of another.

TCM differs from Western Medicine mostly in its holistic approach as compared to our Western reductionist way of scientific thinking.  Disease and illness according to TCM is a result of a disharmony in the functions of Yin and Yang, Qi and its pathways or meridians, the organs (Zang-Fu and “extraordinary”), Essence, and/or the interaction between the individual and his/her environment.  Therapy is based on which disharmony pattern is identified and may include behavioral modifications including diet and exercise, treatments including herbs, acupuncture, and moxibustion, as well as other interventions.

 

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What TCM concept explained above is most fascinating to you? Which would you like to learn more about?

 

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