Myths and Facts About Chinese Medicine II

Myth: Qi is energy

Fact: There is absolutely no historical basis for the translation of the word Qi as energy!

This one tends to ruffle a lot of feathers, so let me be clear. I’m not making a statement as to whether or not there is energy in the body. I’m merely stating that the word Qi, as used in the Chinese Medical classics, does not and never has meant energy.

So what happened? Why does everyone in the West seem to believe that Chinese Medicine is based on invisible energy circulating through invisible pathways that we somehow magically stick needles into?

First you have to understand that these Chinese Medical Classics are literally 4,000 years old! The language in which they were written was basically pictograms. Nobody, except those with a PhD in ancient Chinese, can read these classics as written. Even Chinese people must study translations.

The problem is that most people who get PhD’s in Ancient Chinese don’t know much about medicine, and most people who know about medicine don’t read Ancient Chinese. This creates a serious problem in the translation of an ancient medical text.

It so happens that a French gentleman, George Soulie de Morant,  who didn’t know much about medicine attempted to translate the most important Chinese Medical Text ever, the Huang Di Nei Jing. And in this attempt, he made the two most influential mistranslations ever. He translated the word Qi as energy and the word Mai (blood vessel) as meridian.

As a result of this mistranslation, most Westerners, including almost everyone studying in Chinese Medical school in the West, is taught that Chinese Medicine is about energy flowing in meridians.

So if Qi isn’t energy and the term meridian doesn’t exist anywhere in the classics, then what is Chinese Medicine?

If you saw the character for Qi painted on a big sign in China today, do you know what that would mean?

It indicates that there is a station for putting air into your car tires!

Why? Because Qi just means air—every Chinese person know this! Nobody gets confused and pulls their car over hoping to get some energy injected into their meridians!

In the context of the medical classics, we know they meant to be a bit more specific. So what do the classics say about Qi? The direct translation of “qi” is “vital air.” The Huang Di Nei Jing says that Qi is invisible and all around us (air) and that it is breathed in by the Lungs and the vital parts of the air are extracted by the Lungs and sent to the Heart to be pumped all over the body inside the blood vessels (mai)!

In case you don’t remember your anatomy and physiology, they’re talking about Oxygen! The Chinese were incredibly concerned with the flow of Oxygen (Qi), Blood (Xue), Nutrients (ying) and Immune cells (Wei) inside the Blood Vessels (mai) and Lymph system (jing ye) as well as with the functioning of each of the major organs (zang fu).

What this amazing revelation means is that rather than being concerned with some kind of psychic energy, Chinese Medicine is actually a PHYSICAL medicine which is primarily concerned with blood flow!

I’ve likely offended many devotees of Chinese Medicine who strongly believe in the energy and meridian concept. In reality, most Acupuncturists have only studied textbooks and never studied any of the what the classics actually say. And the amazing thing is that this difference in belief does not necessarily change the application of Acupuncture treatment. The difference is that with the circulation/blood vessel/anatomically based explanation, we suddenly realize that Chinese Medicine and Acupuncture are actually NOT in conflict with Western ideas or anatomy and physiology. The Chinese actually explained vital concepts thousands of years ago that were just “discovered” in the West a couple of hundred years ago. As soon as we let go of the mystical idea, we are free to see all of the commonalities that Chinese Medicine has with the modern Western approach.

The Huang Di Nei Jing describes such (at the time) unknown wonders such as the closed blood circulation system, hormones, the immune function of the intestines (just being corroborated in very recent research), the digestive function of the pancreas, referred pain patterns from organs (such as gallbladder pain referring to the scapula and heart pain referring down the arm). I could go on and on!

The best source for more information on this topic is a book called The Dao of Chinese Medicine. This book, with its seemingly mystical title, lays it all out in incredibly well-researched black and white. It was published by Oxford University Press, which is not some little alternative press looking to overthrow the dominant paradigm! It is a solid, valid piece of work at finally de-mystifying the medicine that continues to help millions around the globe.

Read Part I of this series

Read Part III of this series


Myths and Facts About Chinese Medicine Part I

Myths and Facts About Chinese Medicine

 

There are few things more misunderstood than Chinese Medicine is in the West. These days more and more people are hearing about and trying Chinese Medicine, most commonly Acupuncture, to treat their ills. As Chinese Medicine reaches into the mainstream, the misinformation is multiplying exponentially. I can’t speak to every errant idea out there, but I hope to cover some of the biggies in this article. If you’ve been wondering what the heck is going on with this seemingly mystical medicine, read on.

Myth: Acupuncture is Chinese Medicine

Fact: Chinese Medicine is a complete system of medicine, just like Western Medicine. It has a complete system of diagnosis and treatment for any possible dysfunction that may present. This is not to say that Chinese Medicine excels at treating every condition, just that it has a method of diagnosing and treating every condition.

Acupuncture is like the physical therapy of Chinese Medicine. It works with the nervous system, and its number one application is pain relief. In China, Acupuncturists are considered far less skilled than Herbalists.  All of the best and brightest doctoral candidates pursue Herbal Medicine.

Just as Western Medicine is comprised of both Physical Therapy and Medications, Chinese Medicine includes both Acupuncture and Chinese Herbal Medicine. Most internal conditions, conditions that relate to organ function, overall circulation and non-musculo-skeletal conditions, are treated primarily with Herbal Medicine. Just like drugs in Western Medicine, herbs allow your Chinese Medicine practitioner to affect organ function, inflammation and circulation.

The other major areas of Chinese Medicine are heat therapy (moxabustion), massage and joint mobilization (Tui Na) and Nutrition. Nutrition is the most important, and most overlooked, aspect of medicine in general. No medical treatment can override what you put in your body multiple times per day if that food/beverage/substance is actively harming you. True health can only result from personal responsibility and a life that supports life.

Read Part II of this series

Read Part III of this series


What Are Acupuncture Meridians?

In my practice, I commonly get asked the question, “How do you pick the points?” or “Are there specific spots where you put the needles?” In order to answer these questions, you have to understand the meridian system. In Acupuncture, the term Meridian comes from the French translation rather than from the original Chinese writings. The Chinese term more correctly translates into Channel or Vessel; it is the same term used for blood vessel. For the purposes of this article, I will use the term meridian—because as you’ll see in a moment it helps me explain what these things really are.

First let’s start with the usual definition. If you look this up elsewhere on the internet, you’ll find several versions of basically the same definition. The meridians are invisible pathways inside the body where the mystical, magical qi (pronounced chee) flows.

These invisible tubes can become blocked by stress or other invisible forces. You may or may not know this is happening. Acupuncture can remove these blockages, but you probably won’t know if it’s working or not. It will take a Licensed Acupuncturist to decode your pulse for you to know if your qi is now flowing smoothly.

Some other practitioners will probably be highly offended at the last paragraph, because this is exactly what they have been telling their patients for years. I know you hate me! But I must de-mystify this meridian business, so that we can all move into the 21st Century together!

Now let’s talk about some other things that have meridians. Have you ever seen a map? A globe? A nautical chart? All of these devices use the markers of latitude and longitude to show the relationships between locations. Another word for longitude is meridian—as in the Prime Meridian.

Now have you ever been in a plane and looked out the window? Have you ever seen one of these meridians drawn across the Earth? That’s right, NO.

So what does this mean? Does it mean Meridians aren’t real or useful or important? NO!

It means that Meridians are man-made devices, drawn by humans, to help us navigate. They are not an inherent part of the natural world. They are our interpretation of the natural world. And so it is with the Acupuncture Meridians.

The Acupuncture Meridians are lines drawn by humans to explain the relationship between different areas of the body. Different parts on the same Meridian are connected. But it goes further than that, each Meridian has a balancing relationship with specific other Meridians. This balancing relationship determines where to put the needles in order to heal the sick area.

So as an Acupuncturist, I only have to determine three things. First, the diagnosis, in other words which channel is sick and where? Second I need to know which channels will balance that sick channel. And third I choose the channel and area that I’m going to needle to balance the sick channel.

See! It’s not mystical at all! It’s actually quite systematic! So far I haven’t needed to use psychic healing on any one of my patients. The science of Acupuncture works just great!

 

 

Acknowledgements:

Thank you so much to Dr. Tan for teaching me this way of seeing our medicine! It has transformed my practice.

See more about his system here in this video:


What to expect at your first visit

Why the big exam? Why do I have to wait for Acupuncture? Can I get a treatment today?

While many Pensacola residents are interested in Acupuncture and generally favor it, people often confuse “natural” and “healthy” to mean ineffective or slow to produce results. At Gulf Coast Wellness, it is our mission to change the way people use Acupuncture. What is unique about us is that we do a thorough evaluation, formulate an individualized treatment plan and execute that plan using the most advanced treatment techniques available in order to get the results you deserve.

This approach puts a great burden on us to only accept patients we believe we can truly help. In many other Pensacola Acupuncture offices, you will walk in, spend 10 minutes explaining your issue (usually while lying on the treatment table) and immediately receive an Acupuncture treatment. “Great!” you say, “I want to get going right away.”

Admittedly it sounds good at first. Of course, you went to an Acupuncturist to get Acupuncture, so you’d want to get some Acupuncture right away. However, the most important step has been left out of this transaction, and that is proper evaluation and diagnosis. What if you went to the optometrist, and upon hearing that you are having trouble seeing things that are far away he promptly diagnoses you as near-sighted and writes a prescription. In some offices, you’d have your glasses in an hour or less. Hooray! Now you’ve quickly handled the matter of needing glasses. The problem is, no one checked to see if the actual prescription is correct for you. There were no tests run, so only a vague diagnosis was reached and not an actual thorough understanding of your problem.

This kind of problem presents especially often in Holistic Medicne. Holistic Medicine is incredibly individual. Its treatment strategies depend upon determining the underlying cause of an issue. This means that two people with identical complaints, for example migraines, may in fact have exactly opposite underlying causes and therefore opposite treatment approaches. This means that any new patient requires a bit of investigation before getting started.

In our clinic, we first pre-screen every patient. That is, you come in for a consultation with an Acupuncture Physician to first determine if the methods we use at Gulf Coast Wellness are entirely appropriate for you. If they are not, we promptly refer you to another practitioner who can adequately evaluate your condition. For example, I once had a patient come in with the chief complaint of shortness of breath. She felt that it was difficult to breathe. On face value, this is typically a problem that Acupuncture and Chinese herbs treat very well. Based on that, I recommended a full evaluation of her history and physical condition.

When I got to the physical exam, I listened to her lungs. In the vast majority of shortness of breath patients, there will be absolutely nothing physically wrong with the lungs that can be detected by any test, much less listening to lung sounds with a stethoscope. However, with such a complaint it is prudent to investigate every avenue. Upon listening (auscultation as we call it in medicine) I found that she had no breath sounds at all in her lower lobes. This is rather serious and indicates that the lower lobes are not involved in breathing for one reason or another—such as collapse or being filled with fluid. Based on her history I ventured a guess that it was probably fluid and promptly referred her to a pulmonologist to have the appropriate tests run. In fact, it was fluid, and it turned out that this patient had a very serious problem with her lymphatic system (your second circulatory system) that was causing her lungs to fill up. This was a surgical issue and out of my scope of practice. It also could have become life threatening very quickly. Due to the thorough exam, this patient’s life was probably saved.

So back to your first visit, this visit involves only two things: taking the pulse and talking. As an Acupuncture Physician, taking the pulse is my inside view on what is happening in your body. It tells me about the circulation in various areas of your body. Problems like not enough blood flow (blood deficiency), blood stuck in an area and not moving out normally, similar to a bruise or contusion (blood stasis), inflammation (heat) or constriction (cold) can all be detected in the pulse. The pulse taking often reveals issues that the patient has not even thought to mention. Then comes talking. This first visit involves just a simple interview. We will get the most basic facts about the problem that brought you in. The purpose is simply to come to one of two conclusions:
a. we can probably help you, and we are the best choice to treat this problem or
b. you will be better served by another approach.

We take our commitment to proper evaluation very seriously. You can absolutely rely on an honest and thorough opinion on your health issues and a clear directive of how to follow up for treatment.

 

 

Acknowledgements: I adapted the optometrist analogy from Brian Tracy’s The Art of Closing the Sale—he was using a medical example of misdiagnosis to explain sales, but I found that it fits medicine even better. http://www.briantracy.com/


Acupuncture Helps Arthritis

Many people in San Francisco are looking for a natural, drug-free way to treat their arthritis pain. We boast an incredibly active population in the Bay Area, and people don’t want to give up on being involved in life just because they now have arthritis. However, the desire to stay active can lead to a daily regimen of anti-inflammatory drugs. These drugs are primarily over the counter, so other than being bad for your stomach, most people assume they are safe.

If you were watching the news in 2004, you probably remember Vioxx being pulled off the market due to its connection with heart attacks. The FDA then recommended all similar medications be labeled as possibly dangerous to heart health. What most people don’t know is that medications like Advil (Ibuprofen) fall in this category as well. In fact multiple studies have shown that ibuprofen increases risk of death from heart disease in healthy people. It also interferes with the effectiveness of aspirin therapy in those with cardiac risk. Other studies have shown that NSAIDS (non-steroidal anti-inflammatory drugs) make arthritis worse! That’s right, they have been shown to impede tendon, cartilage and bone repair. “Wait!” you say, “I thought I was supposed to take these drugs for these problems, and now you’re telling me that I am making the problem worse?” Sadly, yes.

So now you want to remain active, even with your arthritis, but you don’t want to risk your stomach, heart and the cartilage you are trying to protect. What now?

Acupuncture has been shown to be wildly effective in the treatment of Arthritis pain. And the reason, in this author’s opinion, comes down to circulation. Arthritis basically consists of two problems: inflammation and low blood flow. The major types of arthritis, Osteoarthritis, Rheumatoid arthritis and Psoriatic arthritis have varying degrees of the two issues with Rheumatoid and Psoriatic being more inflammatory and Osteo being more related to poor circulation.

In Chinese Medicine, the terminology was determined before we had all of these medical explanations. Therefore we often use simple words to explain these conditions. A more inflammatory condition would be called “heat,” and a problem with lack of circulation would be called “cold.” In fact, if you take a thermal scan of a joint, you can, in fact, see that inflammatory conditions are hot (red) and low circulation conditions are cold (blue). We treat these problems with opposite methodology, therefore it is very important to properly evaluate the condition.

Once your arthritis has been properly diagnosed as hot, cold or some combination of the two, treatment can commence. That treatment will focus on correcting the issue. The answer to both problems is in the circulation.

Blood performs two basic roles:

1. To bring nutrients and oxygen to an area

2. To take debris or waste away and eliminate it

Let’s call #1 the milk man and # 2 the garbage collector.

Now the problem with the cold condition (low circulation) is that the milk man can’t get in to deliver the milk. Now the joint is starving. It doesn’t have the proper nutrient flow it needs to stay healthy. This results in a degradation of the tissue. Just like a lack of food would cause you to waste away over time.

With the inflammatory condition (heat), we have too much stuff stuck in one place (usually fluid), and we need the garbage collector to come and take it away. If the garbage collector is not removing the garbage, it will build up and rot. Believe me, your joints are not good place to store the garbage of your body, and your body will revolt if you leave it there.

While this is a vast oversimplification, it is a good illustration of the importance of blood circulation. So what does Acupuncture have to do with this?

Acupuncture’s entire job is to manipulate the circulation of the body. We (Acupuncturists) choose points that are designed to increase or reduce fluid, blood or oxygen in a certain area. That’s all we do. Through thousands of years of experimentation, protocols for affecting the circulation in specific areas (whether that be a joint or an organ) have been developed. As long as the condition is correctly analyzed and the practitioner is trained in the proper treatment approach, the chosen points will work to correct the circulation problem.

So what will this mean in the case of arthritis? How will you know your circulation has been brought back to normal? We could take a thermal scan, and these scans have been used to show the immediate effects Acupuncture has on circulation. But the most important issues to most people with arthritis are pain level and mobility. It turns out that these indicators are quite effective in determining the success of treatment. In other words, if you feel better and can move better we can assume that the Acupuncture is working to correct the circulation problem in your joints.

Link: what to expect at your first visit

For more on how to know when you’re better: link to Acupuncture Done Correctly Gets Results

Vioxx recall: http://www.fda.gov/drugs/drugsafety/postmarketdrugsafetyinformationforpatientsandproviders/ucm103420.htm

Articles on Acupuncture and Arthritis:

http://www.webmd.com/rheumatoid-arthritis/guide/arthritis-acupuncture

Beware of herb suggestions in this one, they’re not entirely accurate: https://www.acufinder.com/Acupuncture+Information/Detail/Acupuncture+for+Arthritis

 

I’d ignore the insurance coverage advice here. Often insurance coverage of Acupuncture is not what it appears to be: http://www.arthritistoday.org/treatments/alternative-therapies/complementary-therapies/acupuncture-gets-respect.php

http://www.livescience.com/8236-acupuncture-arthritis.html

http://health.usnews.com/usnews/health/briefs/arthritis/hb050103c.htm

We really don’t put all these needles in your face. They just love these pictures, because they are so dramatic: http://www.washingtonpost.com/wp-dyn/articles/A14316-2004Dec20.html

More on the heart and stroke dangers of ibuprofen:

http://www.drugs.com/ibuprofen.html

http://www.usatoday.com/news/health/2010-06-11-nsaids-heart_N.htm

Ibufprofen interferes w/ aspirin effectiveness: http://www.mayoclinic.com/health/heart-attack/DS00094/DSECTION=prevention

Ibuprofen causes cartilage damage:

http://www.chiroweb.com/archives/15/22/06.html

http://www.orthosupersite.com/view.aspx?rid=18588

You can find thousands more references on the internet if these are insufficient!

Acknowledgements:

Thanks to Bob Doane, LAc and his office manager Kim for changing my understanding of Acupuncture and circulation. http://www.acupuncturewellness.net/robert-doane/


Acupuncture Done Correctly Gets Results

People in Pensacola are busy—maybe busy fishing, sailing and surfing, but we’re busy. We don’t have time to spare for approaches that don’t produce real results. It’s great to lie down for a thirty minute Acupuncture treatment and relax to soothing nature sounds. But who has time for a nap if a little stress relief is all you get? You could go to the beach for that.

I’ve met so many new patients who have had Acupuncture in the past. When I ask if it worked, they reply, “I’m not sure.” Many of them aren’t even exactly sure what they were being treated for or what the desired outcome of the treatment was. This confusion comes about because people often equate “natural” or “holistic” with some kind of subtle, below the surface change that is not obvious. I myself have gone to the health food store and bought a homeopathic remedy (before becoming an Acupuncturist), say for muscle soreness, and not really been able to tell if it had an effect. This doesn’t necessarily mean homeopathy doesn’t work—I honestly don’t know if it does or not—but it reinforces the idea that drugs, whether I approve of them or not, produce obvious results and natural approaches do not.

This assumption is flatly false. Chinese medicine (this includes Acupuncture and Herbal Medicine) administered after a proper evaluation and diagnosis should show concrete results within the first month—at the longest. Many patients experience a positive change—for example an obvious reduction in pain—during or after the very first treatment. More complex problems, however, may require a series of treatments to start to see a positive effect. That brings up the question, how do you know you are getting a positive effect?

In most Acupuncture offices, the patient report is the only measure of progress. And that patient report may be as vague as the answer to, “How are you doing today?” As people tend to have various factors which would influence the answer to such a question, this is not a very accurate way to gauge success. For example, if your car got towed this morning, the answer would likely be fairly negative. What we do at Gulf Coast Wellness is create a set of data at the initial exam that we then measure success against at the follow-up exams. Of course, this approach would require actually doing exams.

So what is this data? It’s simply a combination of percentage improvement on chief complaints and number of tests that were originally positive and are now negative. Let’s look at what that means.

Chief complaints are the issues that you come in hoping to resolve. For example, if someone has low back pain and migraine headaches, and these are the two problems they most want to get rid of, these would be their chief complaints and the main focus of the treatment. Someone else may come in for digestive problems, insomnia and arthritis pain. The chief complaints vary with every patient. The improvement in chief complaints is measured either by comparing a survey of the current frequency and intensity of the problem or by patient report—that is, the patient says, “My back pain is 60% better than when I started.”

The tests done at the initial exam follow the chief complaints. Range of motion exams will be performed on any joint that hurts or that may be involved in causing a nearby area to hurt. This is similar to the exam you would expect to receive from an MD. The pulse and tongue will be examined on every single patient; these are Chinese Medicine’s secret weapons. They allow us to see what’s happening inside the body. At our office, we also perform palpation exams. This means that we press on a lot of Acupuncture points or organ reflex areas to see which are tender. The resulting pattern can help inform treatment. Blood pressure, weight, and other measurements are commonly taken as well.

Periodically, all tests are re-measured and compared to the initial result. This is called a re-examination. The results of this re-examination tell whether or not you are improving at the expected rate. The value of this is two-fold. One, we are not overly influenced by an optimistic patient. For example, someone reports feeling 80% better, but the more objective tests show only a 30% improvement. Two, we are not overly influenced by a patient who is discouraged. For example, their frequency/intensity survey shows a 70% reduction in the frequency of their pain. Today, however, is part of the 30% and they are feeling down about their results. This causes them to underreport their improvement. Weighing the subjective and objective against each other allows us to get a clearer picture.

Why get a clearer picture? Because this is where treatment adjustments should be made. If a patient is not progressing as expected, we had better change the treatment approach immediately. They may require a different point prescription (the Acupuncture points used in the treatment), the addition of a modality (herbal medicine or nutrition, for example), increased treatment frequency or a different approach altogether (such as a referral to a different practitioner). If the patient’s condition is resolving faster than expected, they may actually need less treatment than previously anticipated. In this case, a particular modality may be removed or the treatment frequency may be reduced.

At Gulf Coast Wellness we graph these results to obtain an easy to interpret picture of a patient’s progress. Anyone can understand that a graph moving steeply upward is excellent, and one moving downward is not good. Through experience, we know what kind of graph shape represents average, excellent and poor results, and we can use these shapes to help inform continuing treatment.

If diagnosis is correct, then treatment should be correct. If treatment is correct, results will follow. Therefore, by monitoring results, it can be determined whether or not diagnosis and treatment are actually correct. In other words, if you are getting Acupuncture, and you’re not sure if you’re getting results, it is likely that either diagnosis or treatment (or both) are incorrect.

 

Acknowledgments:

I didn’t make up tracking results all on my own. I was trained extensively by Curry Chadoir, LAc of Acupuncture and Holistic Health Associates http://www.holisticacupuncture.net/

I refined many of my methods through internship with Robert Doane, LAc of Acupuncture and Wellness Center http://www.acupuncturewellness.net/robert-doane/

Both of them are extremely generous with their time and expertise. If you are an Acupuncturist reading this, I highly recommend finding a way to learn what they have to teach.