AP and Immunity
FEVER (1/2)
Kuang_X; Liang C; Liang Z; Lu C; Zhong G (1992) [The effect of AP on rabbits with fever caused by endotoxin]. Guangzhou Coll of TCM, Guangdong. Chen Tzu Yen Chiu 17(3):212-216. 48 rabbits were used to investigate the effect of AP needling at GV14, LI11 on the level of plasma endotoxin and the change of body temperature. The animals were assigned to groups: 1=Bu manipulation (reinforcing); 2=Xie manipulation (reducing); 3=EAP; 4=Endotoxin-Control; 5=Untreated Control. The different AP techniques had no effect on endotoxin levels or body temperature in endotoxin-induced fever.
Nezhentsev_MV1; Aleksandrov SI (1993) Evaluation of the antipyretic action of psychotropic drugs and their effect on the antipyretic effect of AP therapy. Biull Eksp Biol Med Mar 115(3):262-264. Dept of Pharmacology, Paediatric Med Inst, St. Petersburg, Russia. The effect of psychotropic drugs on antipyretic effect of AP was studied in rabbits with experimental fever. Haloperidol (0.5 mg/kg) and benactyzine (0.1 mg/kg) reduced body temperature in fever; amitriptyline induced no significant changes in fever; all drugs enhanced the antipyretic effect of AP. At 1 mg/kg by a single injection, haloperidol and benactyzine dropped body temperature; diazepam had no influence; at that dose, all drugs reduced the intensity and duration of the antipyretic effect of AP.
Nezhentsev_MV2; Aleksandrov SI (1993) Effect of naloxone on the antipyretic action of AP. Pharmacology May 46(5):289-293. Dept of Pharmacology, Paediatric Med Inst, St. Petersburg, Russia. The effect of the opioid antagonist naloxone on the antipyretic action of AP was studied in rabbits. When given iv before AP, naloxone (0.1-0.2 mg/kg) reduced the intensity and duration of the antipyretic action of AP only in the initial stage. An endogenous opioid system participates in initiation of different responses mediating the antipyretic effect of AP.
Nezhentsev_MVa; Aleksandrov SI (1991) [The influence of aminazine on the antipyretic effect of AP in animals]. Fiziol Zh SSSR Im I M Sechenova Dec 77(12):56-61. AP increased the hypothermic effect of aminazine in rabbits with a fever induced by pyrogenal (2 ug/kg iv). AP points LU11 and LI01 were used. Aminazine (0.5 mg/kg) exerted a little antipyretic effect, but when combined with AP, its effect became potentiated and longer lasting.
Nezhentsev_MVb; Aleksandrov SI (1992) [Febrifugal activity of AP and its strengthening by the effects of anaprilin]. Biull Eksp Biol Med Mar 113(3):288-290. The power and duration of antipyretic actions of AP under single or repeated stimulation of LU11 and LI01 were studied in rabbits. Under conditions of preliminary iv injection of propranolol (1-2 mg/kg), strengthening of AP antipyretic activity was revealed. This effect suggests participation of norepinephrine system in mechanism of febrifugal action of AP.
Nezhentsev_MVc; Aleksandrov SI (1994) [The current concepts of the humoral mechanisms of the analgetic and antipyretic actions of AP (a review of the literature)]. Vrach Delo Mar-Apr (3-4):39-42. Needling triggers adaptive mechanisms, this feature determining a broad range of effects directed towards correction of disturbances in the homeostatic systems of the body. At present peripheral and central levels of response to needling are recognized. In a review of the published literature mechanisms are discussed of analgetic and antipyretic effects of AP based on the latest findings in the field of neurochemistry.
Tan_D (1992) Treatment of fever due to Exopathic Wind-Cold by rapid AP. JTCM Dec 12(4):267-271. Beijing Coll of AP & Orthopaedics, PRC. 57 cases of common cold, influenza, acute tonsillitis and acute bronchitis were treated by rapid needling with filiform needles at GV14, GB20, and LI11. The indices for observation were first determined, and the 19 cases that manifested an axilla temperature drop of over 1oC after treatment and a ratio of <0.3 of the main symptom scores after treatment were regarded as markedly effective; the 27 cases that manifested an axilla temperature drop of 0.5-1.0oC and a symptom score ratio of 0.3-0.6 were regarded as effective, and the 11 cases that manifested an axilla temperature drop of <0.5oC and a symptom score ratio of >0.7 were regarded as failures. The total effective rate was 81%. After AP, body temperature, rate of respiration, pulse, blood pressure and AP point temperature all dropped, with a simultaneous increase in the % of T-lymphocytes. Numbers of peripheral blood leucocytes and lymphocytes did not differ significantly. The immediate effects were especially marked in fevers due to exogenous wind and cold.
Yang_Y; Zhi D (1994) The antifebrile effect of AP and its relationship to changes of AVP levels in the plasma and CSF in rabbits. Chen Tzu Yen Chiu - AP Research 19(2):56-59. Dept of the Physiology and Biochemistry, Lanzhou PLA Military Med Coll, PRC. The study monitored the effects of AP hypothermia and its relationship to the changes of arginine vasopressin (AVP) levels in the plasma and CSF of rabbits. Intermittent EAP clearly inhibited fever induced by endotoxin in rabbits; AVP levels in the plasma and CSF increased markedly in comparison with normal and febrile rabbits; injection of AVP-antiserum into the septal area markedly reduced effects of AP hypothermia. One of the mechanisms of AP hypothermia may be by promoting release of endogenous AVP.
Hu_Ja3 (1991) What are the common AP methods for treating herpes zoster?. JTCM Dec 11(4):302-303. Inst of AP and Moxibustion, China Acad of TCM, Beijing, PRC.
Kasahara_T; Wu YX; Wang Y; Sakurai Y; Oguchi K (1990) Modulation of lipopolysaccharide-induced cytotoxic factor and interferon production by moxibustion in mice. In Vivo Sep-Oct 4(5):289-291. Dept of Pharmacol Sch of Med, Showa Univ, Tokyo, Japan. Pretreatment of mice with moxibustion (Mox) modulated lipopolysaccharide (LPS)-induced endogenous cytotoxic factor (CF) and interferon (IFN) production in serum. CF was measured by the L929 cytotoxicity test and IFN by the cytopathic effect microassay on L929 cells with vesicular stomatitis virus. Significant inhibition of CF activity was observed when Mox and LPS were applied simultaneously.Its potentiation was maximal, circa 9 times the control level, when treatment intervals between Mox and LPS were 24-72 h, and declined thereafter. Mox treatment modified LPS-induced IFN production with a similar biphasic pattern but the onset of modification was delayed. This is the first report of modulation of cytokine production by Mox treatment.
Liao_SJ1; Liao TA (1991) AP treatment for herpes simplex infections: A clinical case report. AETRIJ 16(3-4):135-142. Boston Univ Med Sch, Massachusetts. Herpes simplex is a common skin disorder. There is no effective cure. The recent introduction of drugs, such as acyclovir, is indeed a great advance in its therapeutics. However, these drugs may only modestly reduce the length of an attack, but do not lengthen the remission nor prevent recurrences. Our very limited experience in 2 cases of herpes oral-labialis and 3 cases of herpes genitalis with AP treatment seemed to indicate the possibility of a marked reduction of an episode, a lengthening of the remission, and a prevention of recurrences. We encourage our colleagues to try AP in the clinical management of herpes cases and to study its immunologic effects.
Ma_Z; Wang Y; Fan Q (1992) [The influence of AP on interleukin 2 interferon-natural killer cell regulatory network of Kidney Xu mice]. Chen Tzu Yen Chiu 17(2):139-142. Shaanxi of TCM Coll, Xianyang, PRC. The influence of AP on IL2-IFN-NKC regulatory network was studied in KI Xu (Deficient) mice which received AP at ST36. The interleukin 2 (IL2), natural killer cell (NKC) activity and interferon (IFN) in KI Xu mice were lower than in normal mice. AP increased the levels of all the IL2 and NKC activity, AP promoted Newcastle disease virus (NDV) inducing the IFN of KI Xu mice, but also induced IFN directly. AP made positive adjustment to IL2-IFN-NKC regulatory network. This gives a new theoretical basis for the principles of AP theory on IL2-IFN-NKC regulatory network put forward recently.
Maciocia_G1 (1996) Myalgic encephalomyelitis (ME) and Chronic Fatigue Immune Dysfunction Syndrome (CFIDS): Part 1. Adapted from WWW (Acupuncture.com). [Mr Maciocia developed the East West Treasures line of tablets, which are distributed by Crane Enterprises (1-800-227-4118) on the East Coast and by East West Herbs (USA) Inc (1-800-575-8526) on the West Coast: WebMaster].
Myalgic encephalomyelitis (ME) is becoming more and more widespread in Western countries. ME is the name mainly used in the UK, while in the USA it is now called Chronic Fatigue Immune Dysfunction Syndrome (CFIDS). This Syndrome is also variously called "Chronic Fatigue Syndrome", "Postviral Syndrome", or "Postviral Fatigue Syndrome". I personally make a distinction between "true" ME and "not true" ME which I call "Postviral Fatigue Syndrome", and this distinction (and its significance) will be explained shortly.
Western view
WM generally does not accept or recognize ME as a "disease". The main reasons for this are that ME has no specific diagnostic test and that the same Syndrome may result from many different causative factors (e.g. enteroviruses, Epstein-Barr virus, etc). However, many doctors are researching the aetiology and pathology of ME. In UK, the researchers generally agree that ME is a chronic viral infection. A Coxsackie virus, which belongs to the family of enteroviruses, is thought to implicated. Other researchers think that all of the 72 enteroviruses discovered in the last 30-40 yr are no more than variations of the polio virus, and they believe that ME is nothing but a form of polio. Enteroviruses cause a fever and swollen glands in the acute stage; if not neutralized by the body's immune system, they cause a chest infection and then settle in the intestines where they form a reservoir of infection (hence their name; entero means intestinal). From the intestines, these viruses display a particular tropism towards nerve and muscle cells therefore settling in the muscles and brain: this explains 2 of the major symptoms of ME, e.g. poor memory and concentration, and muscle ache. Muscle biopsy samples of 140 patients with clinical symptoms of ME showed that 24% of subjects were positive for the presence of enterovirus RNA. This may not sound like a high % but it becomes very significant when compared with a control group of 152 subjects, none of whom showed the presence of enterovirus RNA in their muscle biopsies. Statistically, this is a highly significant finding.
CHINESE VIEW.
In TCM, two main Syndromes cause ME: residual pathogens and Latent Heat.
Residual pathogen
Residual pathogen in a common cause of the ME Syndrome. If External Wind invades the body and is not dispelled, or if the person fails to rest during an acute invasion of Wind, the pathogen may remain in the Interior (usually as either Heat, Phlegm-Heat or Damp-Heat). Here, on the one hand, it continues to produce symptoms and signs and, on the other, it predisposes the person to further attacks by External Pathogens because it obstructs the proper diffusing and descending of (causes Stasis of) LU-Qi. It also tends to cause Qi-Xu and/or Yin-Xu, establishing a vicious circle of pathogen and Xu (Weakness).
Apart from Heat itself, Damp-Heat is a very common residual pathogen after febrile disease. There are 2 main reasons:
1. Febrile disease upsets the ascending and descending movements of SP and ST, and thereby upsets the Jin-Ye. Because ST-Qi cannot descend, Ye (Turbid Fluid) is not transformed, and because SP-Qi cannot ascend, the Jin (Clear Fluid) cannot be transformed: this leads to the formation of Damp.
2. Heat burns the Jin-Ye, which can then condense into Damp. Once formed, Damp tends to be self-perpetuating. It further impairs the transformation and transportation functions of SP; this causes formation of more Damp, establishing a vicious circle.
Antibiotics are one of the main causes of residual pathogen in our society. Whilst they destroy bacteria, from the viewpoint of TCM they tend to "lock" the pathogenic factor into the Interior and do not release the Exterior in the early stages of External invasion, nor do they Clear Heat or resolve Phlegm in the later stages.
Latent Heat
Symptoms of ME appearing without an acute infection can be explained as a manifestation of Latent Heat. The "Simple Questions" in chapter 3 says: "If Cold enters the body in wintertime, it comes out as Heat in springtime." This means that a pathogen (which may be Wind-Cold or Wind-Heat) sometimes can enter the body without causing immediate symptoms. It then incubates in the Interior and turns into Heat; the Heat emerges later, moving to the Exterior and causing a person to feel a sudden onset of great weariness with dragging limbs and a slight thirst. The patient feels Hot and irritable, does not sleep well and passes dark urine. At this time the pulse feels Fine and slightly Rapid and the tongue is Red. This Syndrome (Latent Heat), is also called Spring Heat, although it can occur in any season, not just in springtime.
Latent Heat, besides causing the above symptoms and signs, also tends to injure Qi and/or Yin, thus establishing a vicious circle of Heat and Xu. In ME, Latent Heat usually takes the form of Damp-Heat. This process ("incubation" of an External pathogen in the Interior to emerge as Heat later) explains many cases of ME. Latent Heat may move outward to emerge on the surface by itself, as described above; alternatively, it may be "pulled" towards the surface by a new invasion of External Wind; there would also be some External symptoms such as shivering, fever, occipital headache, aches and sneezing, plus the above symptoms of Internal Heat. However, the pulse (Fine and Rapid) and tongue (Red), clearly point to Internal Heat. Emotional stress is another factor that may draw Latent Heat towards the surface. This may pull Latent Heat outwards, especially when it affects LV and causes Heat.
Thus Latent Heat occurs when an individual suffers an invasion of External Wind without developing immediate External symptoms; Wind pathogen remains and incubates in the Interior and turns into Heat that emerges out months later. KI-Xu is the usual underlying reason for this. In KI-Xu, due to overwork and excessive sexual activity, the body's Qi is too weak even to respond to the invading External Wind.
If the body condition and KI are good, a person develops symptoms at the time of invasion of External Wind. This is the healthy reaction. TCM taught that if the Jing-Essence is properly guarded and not dissipated, pathogenic factors can not enter the body and Latent Heat can not develop. "Simple Questions" (Chapter 4) says: "Jing-Essence is the root of the body; if it is guarded and stored Latent Heat will not appear in springtime." This concept is very important in practice; it implies that resistance to pathogens depends not only on LU-Qi (which influences Weiqi), but also on KI-Qi and KI-Jing.
Maciocia_G2 (1996) Myalgic encephalomyelitis (ME) and Chronic Fatigue Immune Dysfunction Syndrome (CFIDS): Part 2. Weiqi is spread by LU but it has its root in KI, specifically KI-Yang. Also, in chronic, recurrent infections such as ME, KI-Qi is often Xu, causing a decreased immune response.
Vaccination is another possible cause of Latent Heat. From the perspective of the 4 Levels of TCM, WM immunization consists of injecting a pathogen (albeit attenuated) directly into the Xue. Attenuated or inert forms of pathogens are injected into the body, by-passing the body's first line of resistance. In TCM, it is as if an External pathogen penetrated the body's Interior directly, completely by-passing the External levels. This can cause problems.
Latent Heat also can manifest as the Shaoyang (TH-GB) Syndrome, characterized by alternation of shivers and feeling of Heat, when the pathogen is "trapped" between the Interior and Exterior: for this reason, when it goes towards the Exterior the person feels Cold, when it goes towards the Interior the person feels Hot. This Syndrome is more common in teenagers and young people.
In all the above Syndromes the underlying cause is overexertion and lack of adequate rest as explained above.
To summarize, 3 factors can cause ME:
1. Residual pathogen (usually Damp-Heat) after invasion by an External pathogen
2. Latent Heat (usually also as Damp-Heat)
3. Shaoyang Syndrome (a form of Latent Heat).
The 4 groups of symptoms essential to diagnose ME are:
1. Chronic fatigue;
2. Poor memory and inability to concentrate to the point of forgetting words while speaking, a "muzzy" feeling of the brain;
3. A persistent and intermittent flu-like feeling with shivers, sensations of Heat, sore throat, swollen glands;
4. Muscle ache and fatigue after the slightest exercise.
I personally consider these to be the essential manifestations of what I call "true" ME, by which I mean one characterized by a persistent, chronic viral infection. If one or more of these 4 groups of symptoms are absent, I call the Syndrome "not true" ME or simply "Postviral Fatigue Syndrome", e.g. a state of fatigue after an acute febrile disease but without a persistent viral infection. Although the aetiology, pathology and treatment of ME and Postviral Fatigue Syndrome are exactly the same, I believe this distinction is important for prognosis as "true" ME is much more difficult to treat and will take longer to respond to treatment.
In TCM, muscle ache is directly related to Damp: the more Damp, the greater the muscle ache, and vice-versa. From a WM perspective, I relate the muscle ache intensity to the viral infection.
Treatment.
Every case of ME has both a Xu (Weakness) of Qi, Yang, or Yin and a Shi (Excess), usually of Damp or Damp-Heat. However, the Xu and Shi are never absolutely equal; one always predominates. One cannot differentiate between a Xu and Shi state on grounds of tiredness alone. Symptomatically, the more muscle ache, the more Shi. Pulse- and tongue- diagnosis are essential to distinguish between Xu and Shi states. Shi predominates if the pulse is Full and Slippery and the tongue has a thick coating; Xu predominates if the pulse is Weak or Fine and the tongue has no thick coating. In Damp (as in other Qi disorders), if Xu predominates, reinforce (nourish, tonify) by Bu method; if Shi predominates, disperse (drain, expel) by Xie method. (In Xu use Bu; in Shi use Xie).
Symptom-, Tongue- and Pulse- Differentiation between Xu and Shi in ME:
Xu No or little muscle ache, no pronounced flu-like feeling; T: Thin coating, not too Swollen; P: Weak, Choppy or Fine.
Shi Pronounced muscle ache and flu-like feeling; T: Thick coating, Swollen; P: Full, Slippery or Wiry.
Nam_TC; Chang CH; Park YH; Seo KM (1996) Therapeutic effects of AP in calf respiratory disease. Proc. World Buiatrics Congress, Edinburgh, July. Coll Vet Med, Seoul Nat Univ, Seodun-dong, Kwonson-Gu, Kyung Gi-Do, 441-744, South Korea, Fax: +82-331-293-6403. Traditional AP points used to treat respiratory disease include SanTai, FeiYu, An-fu and SuQi. Clinical, bacteriological, virological and immunological effects of AP were studied in 89 calves with respiratory disease, which were allocated to one of 5 groups for treatment by: 1=Medicine alone; 2=Medicine + AP at SuQi; 3=Medicine + AP at (SanTai + FeiYu + AnFu); 4=AP at SuQi alone; 5=AP at (SanTai + FeiYu + AnFu) alone. In the AP groups, needles were inserted into the points to a depth of 3 cm for 20 minutes daily for three days. Clinical recovery rates (Excellent to Good) were respectively: 1=59%; 2=83%; 3=73%; 4=83% and 5=63%. Virus isolation rate was significantly decreased in calves with viral respiratory diseases after AP. Otherwise, antibody response of calves given AP, especially at SuQi, was increased significantly. The % leucocyte subpopulation expressing MHC class II antigen, CD2, CD4, sIgM and N12 antigens were significantly higher in the calves with respiratory disease treated with AP. AP therapy reduced the clinical signs in calves with respiratory disease and promoted their immune responses. Therapy which combines medicine with AP could be put to practical use in field outbreaks of respiratory disease in calves.
Rothfeld_Gb1 (1996) Chronic Fatigue Syndrome (CFS): Part 1. Glenn Rothfeld MD. Adapted from WWW (http://www1.shore.net/~spectrum/articlesandstories.html).
Alternative view: patterns of disharmony (TCM Syndromes)
According to a recent study in the NEJM, millions of patients are turning to so-called Alternative Medicine to treat their conditions, many times without discussing their plans with their primary physician. The slowness with which orthodox medicine has acknowledged the existence of CFS, and the lack of a coherent pattern of diagnosis and treatment, have set many CFS patients along this course.
This paper will focus on one such alternative approach which is being used by many with CFS. TCM includes AP, Chinese herbal medicine, and Qigong exercises and massage techniques. These treatments are sometimes used separately and sometimes together. All are based on principles of TCM written some 2500 years ago and based on even older concepts.
The ancients studied the natural world, and described events in the human body in terms of those forces of nature. Because they revered their dead, they did not dissect or biopsy for information. Rather, their medicine was based on what they observed in the living patient, what the pattern of symptoms were.
One can see why TCM is an attractive way of approaching CFS. Firstly, TCM starts with the concept of Qi ("energy" or "life force"). For a patient whose primary symptom is Qi Xu (lack of energy), particularly fatigue which is highly variable, disabling, and invisible to the outside world, a system which at least acknowledges the existence of Qi as a concept is refreshing.
Secondly, there is no question of whether this is a "real" illness in TCM. That is to say, ANY combination of symptoms and patient presentation is seen in terms of Qi imbalance and treated as such. There is no division of mind and body (or of "spirit" for that matter: more on that later) in this medicine. An emotion is seen as the non-physical representation of an illness. There is no hierarchy of physical and mental, and no need for a patient to plead for a SPECT scan to prove that they don't need a psychiatrist.
Thirdly, because TCM focuses on Syndromes of presentation and on the interrelationship of body systems rather than on causative factors and discrete organ pathologies, one can easily explain the global effects of an illness such as CFS. The myriad symptoms of the neurologic, psychologic, gastrointestinal, reproductive, respiratory, haematologic, dermatologic, and immunologic systems can confound (and sometimes, cause "turf wars" between) WM specialists. For TCM, they are different hues to paint a more complete picture of imbalance.
Finally, since the forces of nature never change, the Syndromes described in CFS are familiar ones to a practitioner of Oriental Medicine. The diagnosis and treatment is based on the skill of the practitioner and does not change rapidly with advances in immunology and pharmacology.
A full discussion of TCM diagnosis is beyond the scope of this article. But, here are some Syndromes of disharmony commonly seen in CFS. The organ names (KI, SP, etc) are NOT referring to the anatomical organs, but to energetic functions related to the organs, as the Chinese understood them.
Yin-Yang disharmony: All of life involves an interplay of active and passive principles: day/night, summer/winter, hot/cold, exterior/interior, sympathetic/parasympathetic. The Yang part of the Qi is that part of us which is in movement, warms us, is active, external, and lifts us up. The Yin part is interior, replenishes, anchors and nourishes us, creates stillness, and is cool and fluid. Common Yin-Yang disharmony in CFS patients presents mainly as Xu (Deficiency) of Yin or Yang:
Yang Xu: collapsed fatigue, difficulty waking in the morning, cold limbs, sluggish digestion and other body processes, diminished libido; and/or
Yin Xu: restless fatigue and insomnia, hot flushes, stiffness and deep aching pain.
Shaoyin (KI) Disharmony: In TCM, the KI Qi is the deepest energy and holds the reserves and the will. Therefore, any chronic illness will eventually deplete the KI Qi (causing KI Xu), especially the Yin aspect which is like an underground spring: deep, refreshing, and liquid. KI Yin Xu is a common Syndrome in CFS, as it is in AIDS and in other chronic debilitating conditions. (The similarity of some AIDS and CFS symptoms cause confusion and frustration in the research, clinical and political worlds; in TCM they can be seen as different degrees of the same disharmony Syndromes). KI Yin Xu can show up as frequent urination, severe exhaustion, weak legs and knees, dizziness and tinnitus, dry mouth and throat, disturbed, restless sleep which does not relieve the fatigue, night sweats, fearfulness and lack of resolve and willpower. The Shaoyin Channel (HT-KI) also includes HT Qi, which holds the Spirit, or "Shen." This Shen, the spark of liveliness within us, is not really a mental process in TCM, but has to do with our potential to live life fully. I have had patients who have had their "spark" drained by their constant battle with chronic illness, such that they became flat and hopeless. Every so often, they awake feeling some energy, and they put a smile on and fill their day with activity. Yet, these patients are frequently treated as having endogenous depression, and given mood elevators.
Weiqi Disharmony: LU governs Weiqi, or Protective Qi, which prevents our receiving External Pathogens (the adverse climates, outside or foreign influences, viruses, toxins). Weak Weiqi will lead to repeated episodes of viral-like illnesses, scratchy throat, slight fever (especially later in the day), shortness of breath, and a dry cough, as well as exhaustion.
Damp-Heat Syndrome: This frequently comes from an infection (a common precipitant in CFS) or from unhealthy lifestyle patterns. Dampness is the term given to the waste products of metabolism and digestion, which can accumulate in the Qi Channels. This leads to aching and tiredness in the muscles, heaviness of body or head, fatigue after any exertion, bloating and sour digestion, and a lack of concentration and clouded feeling in the brain. With heat (from infection, or Yin Xu (Deficiency)) can come burning on urination, foul gas and vaginal discharge.
Pericardium-Circulation-Sex Syndrome: Five Phase AP, popularized in the West by Prof JR Worsley, includes the concept of PC (the Heart Protector, or Circulation-Sex Channel), which guards HT. Thus, when one's intimacy is breached (by rape, abuse or even "heartbreak") the PC (HT Protector) is adversely affected, so that external factors are allowed in which should not be, and those which should get in are kept out. This can manifest as environmental sensitivity (overreacting to things which should not be threatening), as issues involving intimacy, or as tightness in the chest and as coldness and paraesthesias of the limbs (Qi staying close to the HT).
Rothfeld_Gb2 (1996) Chronic Fatigue Syndrome (CFS): Part 2. Glenn Rothfeld MD.
Therapies
AP: There are approximately 8,000 AP practitioners in the U.S., 25% of whom are MDs. AP involves the placement and manipulation of thin needles in "points" along the Qi Channels. This facilitates the movement of stuck Qi, and helps repair the disharmonies. Points also may be stimulated by moxibustion, by electrical current, magnets, or lasers. A typical course of AP involves treatments 1-2 times/wk. CFS, as a chronic illness, takes a while to treat effectively, but common results after a few weeks of treatment are less heat sensations, less muscle and joint pains, and an increased sense of well-being.
Western perspective: AP was first introduced in the U.S. as an alternative to anaesthesia, and most of the Western research has still focused on this, somewhat peripheral, use. The discovery that AP needles stimulate the type 3 afferent muscle fibres to release endorphins, and that AP releases ACTH and TRH in the central nervous system helps to understand the effects which (unlike TENS machines) last for days after the needles are removed. However, it is the application of electromagnetic field theory and of quantum physics to the neuroendocrine system which is beginning to articulate a basis for understanding how AP works.
CHM: There are hundreds of Chinese herbs, and they are combined into formulas, which are then given in pill, powder or tincture form, or cooked whole until the liquid extracts the resins and is drunk. A course of therapy is usually several weeks, after which the prescription is altered according to response. An herbal prescription usually contains the herbs of main action (e.g. KI tonic herbs for treating KI Xu syndrome), secondary herbs to help correct the imbalances, and herbs to ameliorate any side effects (e.g. herbs to protect ST from irritation). This allows the herbalist to use smaller (and therefore safer) doses of any single herb, and still get a powerful cumulative effect. The current push in psychiatry toward poly-pharmacy, and the "step" approach in antihypertensive therapy use similar principles.
Western perspective: The current interest in the antineoplastic drug Taxol, produced from the Pacific Yew tree, and the investigation of trichosanthes (Chinese cucumber) and various mushrooms have brought Chinese herbal medicine to the attention of Western scientists. When studied, various herbs have antimicrobial (isatis, astragalus), antiparasitic, antineoplastic and antihypertensive effects. There are also resins called terpenes and saponins that are prevalent in herbs such as ginseng, astragalus and licorice, which have what is called an "adaptogenic" effect on the adrenal and other endocrine organs. However, studies of the prescriptions themselves rather than the component herbs, are just beginning to appear in Western journals.
Qigong: The PBS/Bill Moyers special "Healing and the Mind" has brought Qigong to prominence. Qigong literally means "energy exercise" and can include anything from Taiqi (a dance-like series of movements) to Gongfu and other martial arts. A Qigong practitioner will teach a patient exercises to build the Qi, and to encourage it to circulate within the patient's Channels. The exercise form is not stressful, and can be done by patients who are otherwise disabled. Qigong can also involve treatment with a form of massage called acupressure, which the patient can be taught to self-administer.
Western perspective
There is some controversy over the use of exercise in CFS. Qigong is actually similar to yoga in that the mind and the breath are used with gentle movements and postures. Whereas yoga and meditation have been studied some, studies of Qigong await the acceptance in the West that concepts like "energy" and "well-being" are real and tangible to patients.
Conclusion
In the 19th century, Dr Ehrlich began what is known as the search for the Magic Bullet. This paradigm, that there is an infectious cause of a disease and therefore a discrete curative substance which merely awaits discovery, has dominated medicine through the current century. This in turn has led to major medical successes over bacterial and related diseases. But it has also steered us down an increasingly expensive path of capsular protein antigen assays and fourth-generation antibiotics.
CFS, with its wide range of symptoms and of target organs, its insidious onset and variable course, and its focus on the patient's own report of their energy, poses an elusive and complex problem for this model. TCM and its therapies give CFS patients a different perspective of their illness, and offer some the hope of an effective adjunct or primary form of treatment. For more information please contact us by e-mail: spectrum@shore.net
Stone_Ae (1996) The Root, Branch and Smell of AIDS. Adapted from WWW: Al Stone e-mail: AcuCom@aol.com).
Treating AIDS is a symptomatic and systemic problem for the practitioner. But we have to extend the Chinese analogy of Ben and Biao, or Root and Branch to one more part of the tree, and that is "smell." I'm not referring to the smells that give the practitioner diagnostic information, but an ineffable cloud that hangs over a patient's life that the practitioner cannot fail to address, and that is the fear of death.
AIDS has given way to the euphemism "HIV" for 2 reasons.
1. A class of patients exists with a T-cell count >200 who are HIV positive but asymptomatic (not suffering from AIDS).
2. We prefer to say HIV instead of AIDS because we have decided, collectively and unconsciously, that HIV is a condition but AIDS is an incurable disease. (The latter need not be so: many methods can help, if not "cure" AIDS-sufferers).
AIDS is as much a medical differentiation as it is a thick dark cloud hanging over the most vulnerable place of the human psyche. Hence, when treating AIDS we have 2 jobs, one is to boost the immune system and provide symptomatic relief for specific manifestations of opportunistic infections, and the other service we provide is to poke a hole in that dark cloud of fear called AIDS. It requires not information found in a book, but confidence and compassion on the part of the practitioner.
We are often in a position to provide hope to those who have none. But hope is not empty words of encouragement. The more real it is within our hearts, the more of it can be provided to the patient. Qigong teaches that the Qi follows the Shen-Spirit (Qi follows our conscious intent). When our Shen-Spirit touches the heart of another, their body receives Qi through this interaction. This is why sincere encouragement of the practitioner will effect the patient. Western science might call this the placebo effect. TCM calls it External Qigong. Some Western religions call it the Power of Love.
The placebo effect is compassion made manifest.
Guan Yin, the Buddha of compassion, is sometimes shown with her hands held in a specific mudra, or meditative posture. This position, which has the tips of the middle (PC, Fire) and ring (TH, Fire) fingers touching the tip of the thumb (LU, Metal), has an energetic effect. The index (LI) and little fingers (HT, SI, Fire) are extended outward. The central energetic purpose of this mudra is that Qi is circulated back toward yourself, and extended out at the same time. In this way, we are reminded that Compassion is loving yourself, and recognizing yourself in another.
This is why, in order to adequately treat the fears of another, we must create an honest and courageous relationship with our own mortality. Clearing away the dark cloud of the fear of death that looms above the AIDS patient must first be cleared away within the mind of the practitioner. We must all die and we must all accept the divine timing inherent within our lives. It is difficult to say who is taken from us too early and who sticks around longer than is necessary. From the Oriental philosophical outlook, we all come at exactly the perfect moment and leave with that same perfection.
AIDS, the dark cloud, is too big for any one of us to treat, not because of its size, but because of its lack of substance. It is added to every time we turn on the television. AIDS is fear. Fear causes the Qi to descend and causes KI-Xu and Weiqi-Xu (weakens KI and immunity). Before AIDS was officially recognised, there were opportunistic infections. We practitioners can fight these with AP and herbs. However, we must also confront the fear that this little retro-virus has spawned.
Pain is inevitable, suffering is optional: pain comes from the physical condition. Suffering comes from fear. The needles and herbs can take away the pain, but it is up to us to remove the suffering (fear); we begin with ourselves.