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by Subhuti Dharmananda, Ph.D., Director, Institute for Traditional Medicine, Portland, Oregon
Cupping refers to an ancient Chinese practice in which a cup is applied to the skin and the pressure in the cup is reduced (by using change in heat or by suctioning out air), so that the skin and superficial muscle layer is drawn into and held in the cup. In some cases, the cup may be moved while the suction of skin is active, causing a regional pulling of the skin and muscle (the technique is called gliding cupping).
This treatment has some relation to certain massage techniques, such as the rapid skin pinching along the back that is an important aspect of tuina (12). In that practice, the skin is pinched, sometimes at specific points (e.g., bladder meridian points), until a redness is generated. Cupping is applied by acupuncturists to certain acupuncture points, as well as to regions of the body that are affected by pain (where the pain is deeper than the tissues to be pulled). When the cups are moved along the surface of the skin, the treatment is somewhat like guasha (literally, sand scraping), a folk remedy of southeast Asia which is often carried out by scraping the skin with a coin or other object with the intention of breaking up stagnation. Movement of the cups is a gentler technique than guasha, as a lubricant allows the cup to slide without causing as much of the subcutaneous bruising that is an objective of guasha. Still, a certain amount of bruising is expected both from fixed position cupping (especially at the site of the cup rim) and with movement of the cups.
Traditional cupping, with use of heated cups, also has some similarity to moxibustion therapy. Heating of the cups was the method used to obtain suction: the hot air in the cups has a low density and, as the cups cool with the opening sealed by the skin, the pressure within the cups declines, sucking the skin into itMoxa
A infrared heat lamp adds yang energy to the body to help fight diseases. When the infrared waves penetrate the body, they heat the cells and push the toxins from the cells and out through the pores of the skin. This treatment modality allows for expansion of capillaries, enhancing circulation. Far infrared lamps relaxes the tight muscles around a stiff neck or back. Many practitioners value their use for improving the health of the immune system. Infrared lamps are effective in treating medical conditions such as: back pain, arthritis pain, joint pain, chronic wounds, and skin conditions. The Far Infrared Lamp is ideal for chronic conditions. Toxins exit the body through the pores during exposure to the waves. Promoting circulation and relieving inflammation are the greatest benefits.
by Subhuti Dharmananda, Ph.D., Director, Institute for Traditional Medicine, Portland, Oregon
HISTORY AND GENERAL PRINCIPLES
Electro-acupuncture, the application of a pulsating electrical current to acupuncture needles as a means of stimulating the acupoints, was developed in China as an extension of hand manipulation of acupuncture needles around 1934. It is described, though only briefly, in most comprehensive texts of acupuncture (1-4). The procedure for electro-acupuncture is to insert the acupuncture needle as would normally be done, attain the qi reaction by hand manipulation, and then attach an electrode to the needle to provide continued stimulation. The benefits of using electrical stimulation are:
1. It substitutes for prolonged hand maneuvering. This helps assure that the patient gets the amount of stimulation needed, because the practitioner may otherwise pause due to fatigue. Electro-acupuncture may also help reduce total treatment time by providing the continued stimulus. During electro-acupuncture, the practitioner can attend to other patients.
2. It can produce a stronger stimulation, if desired, without causing tissue damage associated with twirling and lifting and thrusting the needle. Strong stimulation may be needed for difficult cases of neuralgia or paralysis.
3. It is easier to control the frequency of the stimulus and the amount of stimulus than with hand manipulation of the needles.
The main disadvantage of electrical stimulation of acupuncture needles is the lack of direct practitioner participation in this aspect of acupuncture therapy and the associated limited opportunity for the practitioner to respond to changes that are taking place during treatment. However, for practitioners who, after inserting and initially stimulating the needles, normally leave the patient to rest undisturbed without performing prolonged needle manipulation, electro-acupuncture can provide a significant benefit: replacing the missing stimulus that is recommended by most experienced acupuncturists in China.
Although electro-acupuncture may be used as a component of nearly all acupuncture treatments that require manipulation of the needles, according to the Chinese literature, especially good results are expected from electro-acupuncture treatment of neurological diseases, including chronic pain, spasm, and paralysis. In patients with serious cardiac diseases, however, the method should be used with caution. It is generally recommended to avoid placing electrodes near the heart, as the heart can respond adversely to electrical impulses, and the path between any two electrodes should not cross the heart area, despite the low current that is used. Some have suggested avoiding placing electrodes to needles on both sides of the spinal cord (e.g., for Hua Tuo or bladder meridian points), because of the possible effect of the electrical stimulus on the nervous system. Points are generally selected in pairs for electrical pulse stimulation, with 1-3 pairs at one time, and the pairs are usually on the same side of the body.
AN INTRODUCTION TO ACUPUNCTURE
AND HOW IT WORKS
by Subhuti Dharmananda, Ph.D., Director, Institute for Traditional Medicine, Portland, Oregon
There are two very different ways of looking at acupuncture: from the traditional Chinese perspective and from the modern international perspective. Each of these will be briefly described.
The understanding of how acupuncture works has evolved with its practice, but the descriptions set down a thousand years ago have largely been retained. The dominant function of acupuncture is to regulate the circulation of qi (vital energy) and blood. Approximately 2,000 years ago, the pre-eminent acupuncture text, Huangdi Neijing (Yellow Emperor's Classic on Internal Medicine), was written. In it, acupuncture was described as a means of letting out excess qi or blood by making holes in the body along certain pathways, called jingluo (meridians). For some of these meridians, it was advised to acupuncture in such a way as to let out the blood but not the qi; for others, to let out the qi, but not the blood. Many diseases were thought to enter the body through the skin, and then penetrate inward through muscle, internal organs, and, if not cured in timely fashion, to the marrow of the bone. By inserting a needle to the appropriate depth-to correspond with the degree of disease penetration-the disease could be let out.
Prior to the time when there were microscopes by which people could envision individual cells and before autopsies revealed the intricate structures within the body, doctors and scholars projected the internal workings of the body from what they could actually experience, which was the world outside the body. On this basis, the workings of the body were described in terms similar to those used to describe the visible world. One of the critical aspects of nature for humans living a thousand years ago, when Chinese civilization was well developed, was the system of water courses, which included tiny streams, huge rivers, man-made canals and irrigation systems, and the ocean. It was envisioned that the body had a similar system of moving, life-giving fluid. This fluid was the qi, and the pathways through which it flowed were the meridians.
Instead of discussing acupuncture in terms of letting something out of the body, physicians began describing it in terms of regulating something within the body. The flow of qi through the meridians, just like the flow of water through a stream, could be blocked off by an obstruction-a dam across the waterway. In the streams, this might be a fallen tree or a mud slide; in humans, it might be caused by something striking the body, the influence of bad weather, or ingestion of improper foods. When a stream is blocked, it floods above the blockage, and below the blockage it dries up. If one goes to the point of blockage and clears it away, then the stream can resume its natural course. In a like manner, if the qi in the meridian becomes blocked, the condition of the body becomes disordered like the flooding and dryness; if one could remove the blockage from the flow of qi within a meridian, the natural flow could be restored.
In a blocked stream, just cutting a small hole or crevice in the blockage will often clear the entire stream path, because the force of the water that penetrates the hole will widen it continuously until the normal course is restored. In the human body, inserting a small needle into the blocked meridian will have a similar effect. Just as a stream may have certain points more easily accessed (or more easily blocked), the meridians have certain points which, if treated by needling, will have a significant impact on the flow pattern. Many acupuncture points are named for geological structures: mountains, streams, ponds, and oceans.
Although this description of the basic acupuncture concept is somewhat simplified, it conveys the approach that is taught today to students of traditional acupuncture: locate the areas of disturbance, isolate the main blockage points, and clear the blockage. Of course, many layers of sophistication have been added to this model, so that the needling-which might be carried out in several different ways-can be seen to have subtle and differing effects depending upon the site(s) needled, the depth and direction of needling, and even the chemical composition of the needle (such as gold, silver, or steel). For example, some needling techniques are used for the primary purpose of increasing the flow of qi in a meridian without necessarily removing any blockage; other techniques reduce the flow of qi in the meridians. These tonifying and draining methods, as well as transference methods that help move qi from one meridian to another, are part of the more general aim of balancing the flow of qi in the body.
Ultimately, all the descriptions of acupuncture that are based on the traditional model involve rectifying a disturbance in the flow of qi. If the qi circulation is corrected, the body can eliminate most symptoms and eventually-with proper diet, exercise, and other habits-overcome virtually all disease.
When the human body was finally described in terms of cells, biochemicals, and specific structures (most of this accomplished less than 150 years ago), the Chinese method of acupuncture and its underlying concepts were evaluated in these new terms. As a first effort, researchers sought out physical pathways that might correspond to the meridians, and even a fluid substance that might correspond to qi. Neither of these were found. Nonetheless, the action of performing acupuncture was shown to have effects on the body that required some detailed explanation.
From the modern perspective, diseases and injuries are resolved by a complex set of responses; the responses are coordinated by several signaling systems. The signaling systems mainly involve peptides and other small biochemicals that are released at one site, travel to other sites, interact with cells, and stimulate various biologically programmed responses. Rather than blockages of circulation described in the old Chinese dogma, diseases are understood to be caused by microorganisms, metabolic failures, changes in DNA structure or signaling, or breakdown of the immune system. Some of these disorders are resolved by the cellular functions that are designed for healing, while others become chronic diseases because the pathological factors involved have either defeated the body's normalizing mechanisms or because something else has weakened the body's responses to the point that they are ineffective. For example, poor nutrition, unhealthy habits, and high stress can weaken the responses to disease.
Modern studies have revealed that acupuncture stimulates one or more of the signaling systems, which can, under certain circumstances, increase the rate of healing response. This may be sufficient to cure a disease, or it might only reduce its impact (alleviate some symptoms). These findings can explain most of the clinical effects of acupuncture therapy.
According to current understanding, the primary signaling system affected by acupuncture is the nervous system, which not only transmits signals along the nerves that comprise it, but also emits a variety of biochemicals that influence other cells of the body. The nervous system, with over 30 peptides involved in transmitting signals, is connected to the hormonal system via the adrenal gland, and it makes connections to every cell and system of the body.
In a review article, Acupuncture and the Nervous System (American Journal of Chinese Medicine 1992; 20(3-4): 331-337), Cai Wuying at the Department of Neurology, Loyola University of Chicago, describes some of the studies that implicate nervous system involvement. According to a report of the Shanghai Medical University, cranial nerves, spinal nerves, and their terminals were dispersed in the area surrounding the acupuncture points for about 5 millimeters. They also found that the nervous distribution of the Bladder Meridian points (which run along the spine) was in the same area of the spine as that of the corresponding viscera. In Japanese research, it was reported that when acupuncture points were needled, certain neurotransmitters appeared at the site. In laboratory-animal acupuncture studies, it was reported that two such transmitters, substance P and calcitonin gene-related peptide, were released from primary sensory neurons. Acupuncture analgesia appears to be mediated by release of enkephalin and beta-endorphins, with regulation of prostaglandin synthesis: all these have an effect on pain perception. One of the dominant areas of research into acupuncture mechanisms has been its effect on endorphins. Endorphins are one of several neuropeptides; these have been shown to alleviate pain, and have been described as the body's own "opiates." One reason for the focus on these biochemicals is that they were identified in 1977, just as acupuncture was becoming popular in the West, and they are involved in two areas that have been the focus of acupuncture therapy in the West: treatment of chronic pain and treatment of drug addiction.
According to traditional Chinese doctors, one of the key elements of a successful acupuncture treatment is having the person who is being treated experience what is called the "needling sensation." This sensation may vary with the treatment, but it has been described as a numbness, tingling, warmth, or other experience that is not simple pain (pain is not an expected or desired response to acupuncture treatment, though it is recognized that needling certain points may involve a painful response). Sometimes the needling sensation is experienced as propagating from the point of needling to another part of the body. The acupuncturist, while handling the needle should experience a response called "getting qi." In this case, the needle seems to get pulled by the body, and this may be understood in modern terms as the result of muscle responses secondary to the local nervous system interaction.
According to this interpretation, acupuncture is seen as a stimulus directed to certain responsive parts of the nervous system, producing the needling sensation and setting off a biochemical cascade which enhances healing. Some acupuncture points are very frequently used and their applications are quite varied: needling at these points may stimulate a "global" healing response that can affect many diseases. Other points have only limited applications; needling at those points may affect only one of the signaling systems. It is common for acupuncturists to combine the broad-spectrum points and the specific points for each treatment. Some acupuncturists come to rely on a few of these broad-spectrum points as treatments for virtually all common ailments.
This modern explanation of how acupuncture works does not explain why the acupuncture points are arrayed along the traditional meridian lines. At this time, no one has identified-from the modern viewpoint-a clear series of neural connections that would correspond to the meridians. However, acupuncturists have identified other sets of points, such as those in the outer ear, which seem to be mapped to the whole body. The description, in the case of the ear, is of a layout of the body in the form of a "homunculus" (a miniature humanoid form). Such patterns might be understood more easily than the meridian lines, because the brain, which is adjacent to the ear, also has a homunculus pattern of neurological stimulus that has been identified by modern research. Similarly, acupuncturists have identified zones of treatment (for example, on the scalp or on the hand) that correspond to large areas of the body, and this may also be more easily explained because there are connections from the spinal column to various parts of the body which might have secondary branches elsewhere. In fact, acupuncture by zones, homunculi, "ashi" points (places on the body that are tender and indicate a blockage of qi circulation), and "trigger" points (spots that are associated with muscle groups) is becoming a dominant theme, as the emphasis on treating meridians fades (for some practitioners). The new focus is on finding effective points for various disorders and for getting biochemical responses (rather than regulating qi, though there is no doubt some overlap between the two concepts).
During this modern period (since the 1970s) an increasing number of ways to stimulate the healing response at various body points have been advocated, confirming that needling is not a unique method (the idea that the needle would produce a hole through which pathogenic forces could escape has long been fading). In the past, the main procedures for affecting acupuncture points were needling and application of heat (moxibustion). Now, there is increasing reliance on electrical stimulation (with or without needling), and laser stimulation. Since the basic idea of acupuncture therapy is gaining popularity throughout the world while the practice of needling is restricted to certain health professions and is not always convenient, other methods are also becoming widely used. Lay persons and practitioners with limited training are applying finger pressure (acupressure), tiny metal balls held to the to the skin by tape, magnets (with or without tiny needles attached), piezoelectric stimulus (a brief electric discharge), and low energy electrical pulsing (such as the TENS unit provides with electrical stimulus applied to the skin surface by taped electrodes). Some of these methods may have limited effectiveness, but it appears that if an appropriate body site is stimulated properly, then the healing response is generated.
For many nervous system functions, timing is very important, and this is the case for acupuncture. The duration of therapy usually needs to be kept within certain limits (too short and no effect, too long and the person may feel exhausted), and the stimulation of the point is often carried out with a repetitive activity (maintained for a minute or two by manual stimulation-usually slight thrusting, slight withdrawing, or twirling-or throughout treatment with electrostimulation). It has been shown in laboratory experiments that certain frequencies of stimulus work better than others: this might be expected for nervous system responses, but is not expected for simple chemical release from other cells.
TRADITIONAL AND MODERN VIEWS COEXISTING
The traditional and modern understandings of acupuncture arise from significantly different world views and from application of different levels of technology. It is difficult to directly correlate the two, though one can say that many of the traditional observations and ideas have partial explanations by modern mechanisms. Still, the modern practitioner can become aware of and trained in the application of both approaches to acupuncture. A person to be treated can be analyzed from both perspectives and the treatment strategy can be devised according to the conclusions derived from each perspective. Certain aspects of the case may be more amenable to traditional analysis and corresponding treatment, while other aspects are better suited to modern analysis and treatment approach.
An individual who is suffering from a chronic pain syndrome might be analyzed in terms of which meridians are blocked: through treatment of appropriate points on the meridian, the pain might be alleviated. The same individual might be analyzed according to which muscle groups are involved in the painful area and might be treated by acupuncture at trigger points that specifically affect those muscles. An individual suffering from an autoimmune disorder might be analyzed according to which of the traditional organ systems are involved, with treatment of the associated meridians. The same individual might be analyzed in terms of the immune system disturbance and treated by stimulating points that have been recently identified as immune regulators.
Since the traditional acupuncture approach has been shown to be effective in clinical trials conducted in China (and elsewhere in the Orient), one can rely on the traditional methods. However, many practitioners in the West, with little or no prior exposure to Oriental philosophy but with experience and training in Western modes of analysis, may feel uncomfortable turning partly or completely to the traditional Chinese view, and will, instead, focus on the modern understanding of this healing technique.
Traditional Chinese medicine is not a static system, but an evolving one. Thus, in the Orient and in the West there are many doctors and researchers who are working on an integration of the earlier traditional approach and the modern understanding.
A FEW COMMONLY USED ACUPUNCTURE POINTS
In ancient times, the number of acupuncture points was established to be the same as the number of days in the year: 365. These points were mapped to 14 major meridian lines, one meridian for each of the 12 inner organs, one meridian along the spine (called the governing vessel), and another along the midline of the abdomen (called the conception vessel). More recently, the number of points identified by acupuncturists has exploded. There are extra meridians (some of them outlined in ancient times, others modern) with their own sets of points, there are special points (off meridians), and there are complete mappings of body structures and functions by points along the outer ears, on the nose, in the scalp, on the hands, on the feet, and at the wrists and ankles. Despite the growing number of treatment zones, most acupuncturists still utilize the traditionally-identified points on the 14 main meridians. On each meridian there are a small number of points used repeatedly, because of their versatility, for a wide variety of patients and diseases. One such point on each major meridian is mentioned below, sometimes with a second point also briefly described, for a total of 21. It is important to recognize that although a list of disorders and diseases treated by each point can be given, sometimes the points are selected entirely or primarily on the basis of the Chinese theory of balancing the flow in the meridians, so that the point might be used for other kinds of disorders, aside from those listed, because of its usefulness in this balancing process. For points not on the central line of the body, each point has a left and right side reflected location (the point is counted only once for enumeration purposes). For each point in this presentation, the name of the meridian, the number of the point, the number of standard points on the meridian, its designation by one of the number-based classification systems (two letters and the point number), and the Chinese name are given.
Large Intestine Meridian, point #4 of 20: LI4, Hegu
This point is located on the back side of the hand between the thumb and first finger. The dominant uses are to relieve pain and to treat constipation or other bowel disorders. However, this point is also utilized in the treatment of inflammatory and feverish diseases which have symptoms in the throat and head, because the large intestine meridian runs from the hand to the face. Another key point on this meridian is LI11 (Quchi), located at the elbow. It is used for many upper body disorders, such as sore throat, eye pain, lymphatic swellings, rashes, and difficulty moving the arms, and for intestinal disorders, such as diarrhea and intestinal cramping.
Lung Meridian, point #7 of 11: LU7, Lieque
This point is located above the wrist on the inside of the arm. It is used to treat several disorders of the upper body, including headache, neck stiffness, cough, asthma, sore throat, facial paralysis, and wrist problems.
Stomach Meridian, point #36 of 45: ST36, Zusanli
This point is located on the front of the leg, just below the knee. It is helpful for digestive disorders, including nausea, vomiting, gastralgia, and abdominal distention, and also for general weakness. Recently, numerous clinical trials have been conducted with treatment of this point alone, demonstrating positive effects in treating anemia, immune deficiency, fatigue, and numerous diseases.
Spleen Meridian, point #6 of 21: SP6, Sanyinjiao
This point is located on the inner side of the leg just above the ankle. Although it is on the spleen meridian, which generally influences the digestive system, this point is also valuable for treating hormonal disorders (irregular menstruation, impotence) and immune disorders. Another key point on this meridian is SP9 (Yinlingquan), located just below the knee. It is used in the treatment of urinary diseases, especially with fluid retention, abdominal and back pain, and female reproductive system disorders.
Gallbladder Meridian, point #20 of 44: GB20, Fengchi
This point is located at the base of the skull where it joins the neck in back. It used in the treatment of acute disorders, such as common cold, influenza, headache, neck pain, and fever. In addition, it lowers blood pressure and relaxes tension in the area of the eyes. Another key point on this meridian is GB34 (Yanglingquan), located on the outer side of the knee, and used for treating a wide range of injuries and disorders of the muscles and tendons.
Liver Meridian, point #3 of 14: LV3, Taichong
The point is located on the top of the foot, between the first and second toes. It is used to balance emotional energy, to regulate menstruation, to reduce tension and pain in the chest, treat eye disorders, alleviate headaches, and reduce high blood pressure. The adjacent point in the meridian, LV2 (Xingjian), at the webbing between the toes, is also considered quite important and is frequently needled along with LV3; it has similar uses, but is also incorporated into the treatment of lower abdominal disorders, such as urinary problems.
Pericardium Meridian, point #6 of 9: PC6, Neiguan
This point is located on the inner arm, just above the wrist. Like other points on this meridian, it is useful for cardiac disorders, such as heart palpitation and angina pectoris. It is also useful for nausea, vomiting, spasms, and convulsions.
Heart Meridian, point #7 of 9: HT7, Shenmen
This point is located on the outer side of the wrist. It is used in the treatment of a variety of mental disorders, such as absent mindedness, insomnia, disturbing dreams, hysteria, depression, agitation, and mental illness. It is also used in the treatment of heart disease and fatigue.
Urinary Bladder Meridian, point #40 of 67: BL40, Weizhong
This point is located at the back of the knee. It is utilized in the treatment of back pain, hip impairment, muscular atrophy, leg pain and immobility, abdominal pain, vomiting, diarrhea, and a host of other symptoms. Another important point on the bladder meridian is BL23 (Shenshu), in the lumbar area (hip level) near the spine; it is used in treatment of a wide range of disorders, including urinary problems, impotence, menstrual disorders, low back pain, knee weakness, dizziness, ringing in the ears, blurred vision, edema, asthma, and diarrhea. A large section of the bladder meridian is of importance because, as it flows along either side of the spine (in two parallel lines on each side), it associates with the internal organs in the vicinity.
Kidney Meridian, point #3 of 27: KI3, Taixi
This point is located just behind the inner ankle. It is used for disorders in several areas of the body, including sore throat and toothache, deafness and tinnitus, dizziness, asthma, thirst, insomnia, impotence, frequency urination, pain in the lower back, and menstrual irregularities.
Triple Burner Meridian, point #5 of 23: TB5, Waiguan
The triple burner is considered to be a special type of organ system that spans the entire torso. This point on the meridian is located on the outer side of the arm, above the wrist. It is mainly used in treatment of disorders along the pathway of this meridian, that is, of the fingers, hand, arms, neck, ears, cheek, and top of the head.
Small Intestine Meridian, point #3 of 19: SI3, Houxi
This point is located on the side of the hand, below the little finger. It is used for treating mental disorders, stiffness and pain in the neck, chest, and lumbar region, seizures, night sweats, and fevers.
Governing Vessel, point #20 of 28: GV20, Baihui
This point is located at the top of the head. It is traditionally applied in the treatment of various mental disorders, and for problems that occur in the head: headache, vertigo, ringing in the ears, nasal obstruction, difficulty with speech, etc. It is also used to treat prolapse, such as that of the rectum and uterus. Another key point on this meridian is GV14 (Dazhui), located just below the seventh cervical vertebrae (shoulder level); it is used for treating neck and upper back problems, feverish diseases, convulsions, cough, asthma, and common cold.
Conception Vessel, point #4 of 24: CV4, Guanyuan
This point is located a little below the navel. It is used for all types of lower abdominal disorders, including urination problems, hernia, menstrual disorders, gynecological infections, postpartum bleeding, diarrhea, rectal prolapse, etc. Another important point on this vessel is CV6 (Qihai), half way between CV4 and the navel. The applications are similar, but it is especially used in cases of accompanying fatigue.
Examples of Combining These Points to Produce an Effective Treatment
In the book Modern Clinic Necessities for Acupuncture and Moxibustion (by Zhang Ren and Dong Zhi Lin), several treatment strategies are outlined. For menopausal syndrome, the main points recommended are GV20 and GV14, CV4, BL23, HT7, SP6 and ST36; secondary points include PC6, LV3, and KI3. For bedwetting at night among young children, recommended points include CV4, BL23 and SP6; secondary points include LU7, KI3, CV6, and ST36. For hayfever, recommended points include GB20, LI4, and ST36; secondary points include GV14, LU7, LI11, and SP6. In her book Insights of a Senior Acupuncturist, Miriam Lee describes a combination of points that have wide application: ST36, SP6, LI4, LI11, and LU7. This set of points, with slight adjustments (e.g., leaving out one or two, perhaps adding or substituting one or two) is shown to be helpful for the majority of common complaints seen in the Western acupuncture clinic. A popular treatment for injury and stress is to needle the "four gates," the right and left side points LV3 (feet) and LI4 (hands), which opens circulation throughout the meridians.
SD November 1996
Gua Sha is a healing technique used in Asia by practitioners of Traditional Chinese Medicine, in both the clinical setting and in homes. It involves the cutaneous stimulation where the skin is pressured, in strokes, by a round-edged instrument; often a porcelain soup spoon, that results in the appearance of small red petechiae called 'sha', that will fade in 2 to 3 days.
Raising Sha removes blood stagnation considered pathogenic, promoting normal circulation and metabolic processes. The patient experiences immediate relief from pain, stiffness, fever, chill, cough, nausea, and so on. Gua Sha is valuable in the prevention and treatment of acute infectious illness, upper respiratory and digestive problems, and many other acute or chronic disorders.
Neuro-muscular re-education is a therapeutic technique that is used to improve balance, coordination, posture, kinesthetic sense and proprioception. There is no precise description of what neuromuscular reeducation entails. Treatment may include balance exercises such as one-legged standing and the progressive use of a wobble board. Tandem exercises along with a postural challenge may be utilized to evaluate stability. The individual receiving treatment is encouraged to feel the correct position of joints and to perceive the direction of movement of the body extremities.
Other areas of neuromuscular reeducation involve constraint-induced movement therapy for limbs. This technique involves restraint of a non-involved limb and extensive movement practice with the involved limb.
Separation of joint surfaces by a therapist to stimulate nutrition to flow around joints and encourage the extension of the surrounding conective tissues.
What is NET? The brief answer:
NET is a psychosomatic/somatopsychic stress
reduction intervention aimed at emotional and physical health improvement.
NET is a neuro-emotional intervention for organism (mind/body) health.
NET is a tool for mind/body practitioners who are seeking to restore health.
Custom Product Development: Herbal
After your complete health history is taken, your health picture may lend itself to a need for a custom designed formula to address several health concerns at once. The custom development takes as little as 20 minutes to as long as several days to research and write. This service is an additional fee for the research and development. ($47.50) The custom designed formula order has a minimum amount that must be ordered. For a powder format, this is 100 grams (at a minimum of $60.00) and for the same custom formula to be capsulated, there is a 4 bottle minimum (at a minimum of $36.00 per bottle).
Every single mineral in the body has an effect on all processes in the body. The physical body is made up of minerals which are the basis of all life, form and structure.
A hair analysis test is the best way to obtain a comprehensive and accurate mineral deficiency test.
Hair is the second most metabolically active tissue in the body. The hair tissue is affected by the blood, perspiration, environment, genetics, hormones and enzymes. The hair represents what is occurring inside the cells and the sub-molecular figures of the body. A blood test shows what is happening outside the cell and the waste material being discarded. The hair gives a reading of what is being stored in the body. For example, if mercury is high in the hair, a higher concentration of this element would also be found in organs like the kidney and liver.
All minerals need to be in balance for optimal health. For instance if calcium and magnesium are too low you may have muscle twitches or trouble sleeping. If sodium and potassium are too high you may have hyperactivity. If there is an elevated mineral toxicity, this means that your minerals are getting stuck in the connective tissues, instead of being utilized by your body. The key is that ALL of your minerals need to be in "balance" with each other so they can nourish your body properly.
Hair Analysis and Heavy Metal Toxicity
This hair test for toxins can show if toxic heavy metals have accumulated in the body. Some of the metals, which cause symptoms are mercury, chlorine, iron, aluminum, arsenic, copper, lead, cadmium and nickel. Surprisingly, heavy metal toxicity isn't uncommon. Toxic metals tend to damage the nervous system.
The U.S. Environmental Protection Agency concluded in a 1980 report that "human hair can be used effectively for the biological monitoring of the highest priority toxic metals - lead, cadmium, mercury and arsenic," and "For toxic exposure... (testing) hair appears to be superior to (testing) blood and urine."."
Allergy Testing: food, Pollens
Meridian Valley Laboratory uses a state of the art enzyme-linked immunosorbent assay technique (ELISA, 95-well format for best precision) to measure serum antibodies to foods. The E panel is the basic foods panel and consists of 95 commonly eaten foods. The A panel does not overlap with the E panel, and consists of another 95 less-commonly eaten foods and seasonings. The inhalants are region-specific panels of the most common tree, grass, weed and mold antigens from given regions of the continental USA (NW, SW, W, NE, SE). All inhalant panels include cat, dog, mite (environmental), and molds. All tests are in full compliance with rigorous Washington State Department of Health, Health Systems Quality Assurance standards.
Panel Of Tests
* E Panel: basic foods including 95 commonly eaten foods.
* A Panel: an additional 95 common foods and seasonings, with no overlap of the E Panel.
* Inhalants are region-specific, including panels of common tree, grass, weed, and mold from each region of the US (NW, SW, W, NE, SE).
* All inhalant panels include cat, dog, mite (environmental) antigens, and molds.
* Both IgE and IgG4 antibodies are measured for foods; IgE is tested for inhalants.
Allergy testing equipment
Common Indications list for Allergy related symptoms:
* Aphthous stomatitis
* Attention deficit disorder with hyperactivity
* Chronic fatigue syndrome
* Dermatitis herpetiformis
* Inflammatory bowel disease - ulcerative colitis, Crohn's disease
* Intestinal dysbiosis, Candidiasis
* Intestinal hyperpermeability
* Irritable bowel syndrome
* Migraine headache
* Multiple sclerosis
* Otitis media
* Peptic ulcer
* Seborrheic dermatitis
Comprehensive Stool and Digestive Analysis (CSDA)
The CSDA is a very useful diagnostic tool that should be employed in the initial assessment of every patient. Clearly, all aspects of our physiology depend on the provision of the correct nutrients and cofactors. Therefore, a dysfunctional gut may be at the root of any health problem, either directly, or indirectly. For example, a B12 deficiency due to insufficient gastric acidity may lead directly to neuropathy, and food allergy may indirectly aggravate an autoimmune condition such as lupus, by placing an additional burden on the immune system.
In general, the CSDA is useful for assessment of the digestive and absorptive capacities of the gut and for the identification of pathological states. Specifically, the test may yield useful information about the following areas: food allergies, gastric acidity, liver/gallbladder function, pancreatic function, presence of inflammation or neoplasm and the microbial status of the colon.
This test is a comprehensive, multifaceted stool analysis useful in a wide range of clinical problems. It consists of macroscopic and microscopic examinations with staining, chemical assays, parasitology and aerobic cultures. For cost-effective follow up, any of the component tests may be ordered singly or in combination.
Consists of visual inspection of sample, noting consistency, color, presence of fibers, undigested food remnants, mucous or gross blood. Light color can indicate liver malfunction; undigested food may indicate insufficient gastric acidity, insufficient pancreatic enzyme output or rapid transit time due to food allergy. Gross blood may indicate hemorrhoids, neoplasm or inflammation.
Looks for presence of undigested meat and vegetable fibers, cellular elements (white cells, red cells and yeast) and, with staining, presence of fat and starch globules. Undigested lipid, carbohydrate or protein may once again signify any or all of the following: insufficient gastric acidity, insufficient pancreatic enzyme output or food allergy. White cells may indicate inflammation, and red cells may indicate occult bleeding.
Tests for chemical parameters: trypsin, bile, urobilinogen, pH, steatocrit, butyrate, and occult blood. Rapid transit time due to food allergy may elevate trypsin, bile or urobilinogen. Steatocrit measures the fat content and inversely reflects the adequacy of lipase activity. Elevated urobilinogen may signify bacterial overgrowth. Low butyrate levels have been correlated with an increased risk of colon cancer. High pH (alkaline stool) may reflect insufficient gastric acidity and create an environment inhabitable for beneficial bacteria.
Includes assay to detect giardia antigen as well as microscopic exam for trophs, cysts, ova, and adult worms. If parasites are present in stool, the chance of identification from a single stool specimen is only 50%. Three separate specimens are recommended for best results. Inclusion of giardia antigen increases the probability of identifying giardia infection.
Assays the levels of normal flora including E Coli and Lactobacillus, and reports the presence of potentially pathogenic bacteria. Stool is also cultured for Candida albicans and other yeasts. Maintenance of adequate populations of normal flora prevents the growth of pathogens and contributes to proper synthesis of vitamins and suppression of carcinogen formation. An internal study of 600 consecutive stool specimens revealed that approximately 10% of specimens lacked both E Coli and Lactobacilli. This condition should be treated with exogenous replacement of these organisms.
Fecal Metals Analysis
This is an optional add-on that measures the stool concentrations of 13 potentially toxic elements including mercury, cadmium, lead and arsenic.
GUT MUCOSAL PERMEABILITY, CANDIDA, FOOD ALLERGY
AUTOIMMUNITY AND IMMUNODEFICIENCY: POSSIBLE LINKS
By Ari Wojdaru, Ph.D.
In recent years there has been increasing interest amongst both members of the medical profession and their patients in the possibility that food may be a cause of unexplained diseases. Unfortunately, this interest has produced more excitement and controversy than scientific research, and although evidence is now accumulating to support a role for diet in the management of conditions as diverse as migraine, eczema and Crohn's disease, the mechanisms of the relationship between food and disease remain poorly understood.
The purpose of this series of three articles is to clarify the present state of our knowledge in gastro-intestinal integrity and its relation to chronic Candidiasis, food allergy, autoimmunity and immunodeficiency.
The present article covers gut mucosa permeability as the origin of the problem, which will be followed in the next issues by Candida, food allergy autoimmunity and immunodeficiencies.
Assessment of Intestinal Integrity
Imbalance of Gut Mucosal Permeability is the Origin of the Problem
The development of the gastro-intestinal tract in mammals is characterized by the integrated maturation of its many functions. Digestion and absorption of nutrients, the critical factor for survival, depends on the state of development of the gastrointestinal tract. As well as digesting, absorbing and eliminating, the gut acts as a barrier between the internal and external environment.1,2
Control of macromolecular uptake is dependent on a number of factors present either within the intestinal lumen or on the intestinal mucosal surface.3 These factors include both nonimmunological and immunological processes. Nonimmunological factors (intestinal flora, secretion, gastric barrier, peristaltic movement and liver filtration) help to control the proliferation of microorganisms present in the gastrointestinal tract, aid in decreasing adherence of organisms to the gut surface and are important in limiting the available antigen mass that may otherwise overwhelm local immunological defense mechanism and penetrate the mucosal barrier or enter the systemic circulation.4-8 Mucosal immunological factors (secretory IgA, cell mediated immunity, other immunoglobulins), especially the common mucosal associated Lymphoid tissue (MALT), is present at all epithelial surfaces that are in contact with the external environment, is largely independent of the systemic immune response and is governed by antigenic stimuli at epithelial surfaces. A failure or abnormality in one of these mechanisms can result in symptoms such as anaphylaxis, rhinitis and skin rashes, classified as food allergy2
In normal conditions, factors within the intestinal lumen of the surface of epithelial cells and within the lamina propria combine to limit the access of antigens to systemic circulation. After macromolecular ingestion by the intestinal absorptive cells, most of the ingested material is broken down by lysosomal enzymes in digestive vacuoles9. That portion which escapes breakdown is transported out of the cell by an exocytotic mechanism. Any interference with intracellular capacity to digest macromolecules could therefore result in an increased intestinal transport of molecules.10 A number of factors can affect the stability and lability of lysosomes.11 For example, high concentration of vitamin A, radiation, bacterial and fungal endotoxins and exotoxins can increase the lability of lysosomes, causing the rupture of lysosomal membranes in various cellular systems. On the other hand corticosteroids stabilize the lysosomal membrane and can interfere with the normal digestive function of these intracellular organelles. Thus, inhibition of lysosomal function could in turn result in enhanced transport of intestinal antigens, by decreasing intracellular breakdown.
Mucosal immunodeficiency is another factor which may contribute to an enhanced macromolecular absorption. Secretory IgA is the predominant immunoglobulin present in intestinal secretions. This class of immunoglobulin acts to protect the intestinal epithelium from the uptake of intestinal bacteria, fungi and viruses, as well as of antigenic and toxic macromolecules.12.13 It is possible, therefore, that in the absence of secretory IgA, ingested proteins are absorbed from the gut in increased amounts and can stimulate a systemic immune response. The basis for possible immune-mediated disease in these cases may be the increased uptake of intestinal pathogens or macromolecules, which can interact with the circulating antibody and complement a target organ to produce characteristic autoimmune response.14 Furthermore, patients with selective IgA deficiency have a greatly increased incidence of Coeliac disease compared with the normal population. This is undoubtedly due to an increased uptake of gluten or its breakdown products.15 In a similar manner, intestinal pathogens or their byproducts can penetrate the intestinal mucosa, resulting in a generalized malabsorption.16
The proposed mechanisms by which viruses or bacteria may initiate autoimmunity is through sharing of a common antigenic determinant between a virus or other microorganism and a host cell component. Such shared epitomes can be though of as a three dimensional conformation site or a stretch of amino acids forming a peptide. Thus, an antiviral or bacterial immune response would recognize both the microorganism determinant and the shared host self antigen. These cross-reacting antibodies and immune cells generated by molecular mimicry may in large part be responsible for the presence of autoreactive antibodies and cells found in many infections in humans.17
Recently, there is considerable interest in the concept of enhanced intestinal permeability and its possible role in the pathogenesis and pathophysiology of a variety of intestinal and extraintestinal disorders.18 Bacterial flora is greatly influenced by eating habits, and chemical contamination of the foods plays a significant role in the integrity of intestinal mucosa. There are over 100 different microorganisms present in the digestive system. Most important are: Candida, Lactobacilli, Enterococci, Enterobacteria, Streptococci, Staphylococci, Bifidobacterium, Bacteroides, Clostridum and Peptococci. Under normal conditions these bacteria produce a variety of vitamins which are necessary for the human development and function.19 But due to the typical western diet (increased dietary carbohydrates) and usage of broad spectrum antibiotics, corticosteroid hormones and birth control pills, the internal environment has become "polluted" and the balance between humans and their microflora has changed significantly.20 This change in indigenous intestinal flora is mainly an overgrowth of Candida Albicans. Drug resistant aerobic and anaerobic bacteria or their toxins through one of the above mentioned mechanisms (effect on lysosomal enzymes, induction of IgA deficiency) can increase the permeability of gut mucosa. This observation could mean that the intestinal tract represents a potential site for the absorption of bacterial breakdown products, such as endotoxins and enterotoxins of proteolytic and hydrolytic enzymes or of ingested food antigen that normally exists in the intestinal lume.23 Excessive uptake of food, bacterial, fungal and viral antigens into the circulation can induce immune response in the form of IgG, IgM, IgA and IgE and may contribute to adverse reactions such as allergies and autoimmunities, which are manifested as clinical disease states.23 Therefore, the measurement of circulating antibodies against specified antigens of intestinal bacterial and fungal flora is of considerable importance in the pathogenesis of immunologically mediated diseases, including food allergies and autoimmunities.
1. Gruskay F.L. and Cooke R.E., The Gastroinstestinal Absorption of Unaltered Protein in Normal Infants and in Infants Recovering from Diarrhea. Pediatrics 16: 763-768, 1955.
2. Scadding G,K, and Brostoff J. Immunological Responce to Food, in Food and the Gut, Chapter 7. Edited by J.O. Hunter and V. Alan Jones, pp. 94- 112, published by W.B. Saunders, 1985, Sussex England.
3. Walker, W.A. Mechanisms fo Antigen handling by the Gut in Clinics, in Immunolgy and Allergy, Chapter 2, Edited by I. Ballieux R.E./ Brosto F.F. J., Fahey J.E., Fauci A., Reeves W.G., Seligmann M., Thompson R.A. and R. Wright. pp. 15-10, published by W.B. Saunders 1982, Sussex England.
4. Donaldson R.M., Normal Bacterial Populations of the Intestine and Their Relation to Intestinal Function. New England J. of Medicine, 270, 994- 999, 1964.
5. Strombeck D.R. and Harrold D. Binding of Cholera Toxin to Mucin and Inhibitation by Gastric Mucin. Infection and Immunity, 1: 1266. 1272, 1974.
6. Kraft S. C., Rothbert R.M. & Kramer C.M. Gastric Output and Circulation Anti BSA in Adults. Clinical and Experimental Immunology, 2: 321-326, 1967.
7. Dack G.M. & Petran E. Bacterial Activity in Different Levels of Intestine and in Isolated Segments of Small and Large Bowel in Monkeys and in Dogs. J. of Infectious Diseases, 54: 204-207, 1934.
8. Triger D.R., Cynamon M.H. & Wright R. Studies on Hepatic Uptake of Antigen. Comparison of Inferior Vena Cava and Portal Vein Routes of Immunization. Immunology 25, 941-950, 1973.
9. Straus W. Usew of Horse Radish Poroxidase as a Marker Protein for Studies of Phagolysosomes, Permeability and Immunology. Methods and Achievemants in Experimental Pathology 4, 54-91, 1969.
10. Jacques, P.J. Endocytosis in Lysosomes in Biology and Pathology, Chapter 13 (Ed.) Dingle, J.T. & Fell, H.B. pp. 395-420. Amsterdam: North Holland Publishing 1969.
11. Weissman, G. & Dukor. The Roll of Lysosomes in Immune Responces. Advances in Immunology, 112, 283-330, 1970.
12. Fubura, E.S. & Freter, R. Protection agianst Enteric Bacterial Infection by SIgA. Journal fo Immunology III, 395-399, 1973.
13. Ammann, A.J. 7 Hong, R. Selective IgA Deficiency: Presentatation of 30 cases and a Review of the Literature, Medicine. 50,223-236, 1971.
14. Petty, R.E., Palmer, N.R. & Cassidy, JJ., The Association of Autoimmune Disease and Anti-IgA antibodies in Patients with Selective IgA Deficiency. Clincial and Experimental Immunology. 27: 83-88, 1979.
15. Walker, W.A., & Isselvacher K.J., Intestinal Antibodies. New England Journal of Medicine. 297, 767-773, 1977.
16. Zinneman, H.H. & Kaplan, A.P. The Association of Giardiasis with Reduced Intestinal Secretory Immunoglobulin. Digestive Diseases. 17: 793-797, 1972.
17. Fujinamy R.S. Virus induced Disease and Autoimmunity: Molecular Mimicry. Presentation in the Congress of Neuroimmunology.
18. Jachson P.G., Baker R.W., Lessof M.H., Ferret J. & MacDonald D.M. Intestinal Permeability in Patients with Eczema and Food Allergy. Lancet 1: 1285-1286, 1981.
19. Donaldson R.M. Normal and Bacterial Populations of the Intestine and Their Relation to the Intestinal Absorption. New England Journal fo Medicine. 270: 994-999, 1964.
20. Crook W.G. The Yeast Connection: a Medical Breakthrough. P.O. Box 3494, Jackson, TN 38301: Professional Books, 1983.
The Comprehensive Female Profile I is a SALIVA and BLOOD SPOT test that measures the hormones estradiol, progesterone, testosterone, DHEA, Adrenal Function and Thyroid Function. Your results will include:
* Estradiol, progesterone, testosterone and DHEA levels (Sex Hormones)
* Morning, Noon, Evening and Bedtime Cortisol Levels (Adrenal Function)
* Free T3, Free T4, TSH and TPO levels (Thyroid Function)
* Symptoms Assessment Chart
* Physician comments about your results
The Comprehensive Female Profile I is recommended for women with signs and/or symptoms of PMS, Premenopause or Menopause, Adrenal Dysfunction and/or Thyroid dysfunction.
When to collect your sample.
* If you are postmenopausal or have had a hysterectomy, collect your sample on any day.
* If you are having a regular cycle, collect on day 19, 20 or 21 of your cycle. (Day 1 = First day of your period)
* If you have irregular cycles, collect 5 days before anticipated period or any time if periods are more than 2 months apart.
The Comprehensive Female Profile I is the best value for female hormone testing. It includes all of the tests contained in the Male-Female Saliva Profile III and Complete Thyroid Profile.
Neuro-Transmitter HPA Axis Test
Axis (HP/HPA): A direct connection between two or more points. The HP axis is a direct connection between the hypothalamus and the pituitary. The HPA axis is a direct connection between the hypothalamus, the pituitary and the adrenal glands. The plural of axis is axes for two and axii for three or more.
The body's Communication System is a marvelously intricate network that controls how we act and react to both external and internal events. When this system is balanced, we experience the harmony that constitutes our health and sense of well-being.
The Communication System integrates the body's physiological systems, including the nervous, endocrine, digestive, and immune systems. When the Communication System becomes imbalanced, the stage is set for many of the physical and emotional complaints and chronic ailments for which we seek help.
At the core of the Communication System is the Central Nervous System-the brain and the spinal cord-and the Peripheral Nervous System. These two systems rely on neurotransmitters-biochemicals that enable cells to "converse" with one another by providing instructions and feedback- to communicate with the muscles, organs and glands. For example, neurotransmitters are responsible for signaling the quickening pulse of the heart, the release of hormones from the endocrine system, and the release of enzymes in the digestive system.
Every activity performed by the body-cognition, circulation, respiration, exertion, digestion, reproduction-is controlled by the nervous and endocrine systems. Their communication pathways are dependant on balanced neurotransmitters and hormones; any interruption in a communication pathway will negatively affect function at the far end. Therefore, an inadequate or excess message release will result in a Communication System malfunction. Research has clearly demonstrated that interruptions in the body's Communication System can have serious health consequences.
In a healthy body, neurotransmitter levels are constantly monitored and kept in check. However, the balance of these biochemicals is subject to many forms of disruption. Because neurotransmitters are comprised of several amino acid building blocks that are supplied through proper nutrition, poor diet-or poor digestion-can rapidly deplete some neurotransmitters, thereby increasing the level of others. In addition, medications as well as illicit drugs may decrease stores, often, resulting in severely elevated neurotransmitter levels which are often evident in urine. Other factors also influence neurotransmitter levels; short-term stress can cause neurotransmitter levels to rise dramatically while chronic stress, on the other hand, can exhaust both neurotransmitters and the hormones they attempt to release. When a neurotransmitter is chronically induced into a synapse, it is subject to loss via enzymatic degradation and diffusion out of the synaptic space. Any condition that induces a neurotransmitter hour-after-hour, day-after-day can ultimately cause depletion.
The hormones produced by the body's endocrine system are another integral part of the Communication System. Just as the nervous system uses neurotransmitters to relay information, the endocrine system employs hormones in a similar fashion. These hormones are considered primary and critical to all metabolic function, and are produced under the direction of the master gland, the limbic hypothalamus, and its lieutenant, the pituitary. The hypothalamus and pituitary control the function of glands such as the thyroid, the adrenals, the ovaries and the testes as well as some lesser-known glands, such as the stomach's G cells that produce gastrin. Because neurotransmitters initiate many endocrine functions, a neurotransmitter deficiency affects not only neuronal function but also impacts endocrine function throughout in the body. Likewise, endocrine hormones can affect neurotransmitter levels. Imbalanced hormones can directly imbalance neurotransmitters. When one (or both) of these systems becomes impaired, the entire Communication System is compromised. Bringing the system back into balance is therefore critical to the restoration of health and well-being.
While the nervous and endocrine systems are the major components of the Communication System, the gut also plays an important role. The vital functions of digestion and absorption are modulated by both nerves and hormones. Imbalances in either can have a substantially negative impact on gut function. Also, in the presence of GI inflammation, it is impossible for the body to properly absorb and assimilate the nutrients necessary for the production of hormones and neurotransmitters. Because imbalance anywhere in the GI tract can have serious consequences on health, addressing gut issues is an important component in reestablishing balance within the Communication System.
Today, as the medical, psychiatric, and alternative-care communities grapple with treating chronic physical and emotional conditions that cross disciplinary lines, it is clear that the body's Communication System lies at the heart of our search for common understanding.
The urinalysis is used as a screening and/or diagnostic tool because it can help detect substances or cellular material in the urine associated with different metabolic and kidney disorders. It is ordered widely and routinely to detect any abnormalities that should be followed up on. Often, substances such as protein or glucose will begin to appear in the urine before patients are aware that they may have a problem. It is used to detect urinary tract infections (UTI) and other disorders of the urinary tract. In patients with acute or chronic conditions, such as kidney disease, the urinalysis may be ordered at intervals as a rapid method to help monitor organ function, status, and response to treatment.