Advanced Techniques in Oriental Medicine E-Book

Skya Abbate

• Herausgeber: Thieme
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 394

Veröffentlichungsjahr: 2006

Beschreibung

Taming the Tiger "When you grasp the needle, do so with great care, firm strength and caution for the peril, as if holding a tiger’s tail: one wrong move and great harm could befall."--Huangdi Neijing This uncommonly useful guidebook presents an overview of all aspects of needling, from the parameters of the needle itself to the importance of treating and anchoring the patient’s spirit. Skya Abbate’s clear language and detailed descriptions guide you step-by-step through thirteen categories of disease, ranging from anxiety, geriatric and chronic degenerative diseases to those illnesses thought to be untreatable. Specialized chapters offer insight and guidance for practitioners seeking to enhance their treatment strategies with additional therapeutic techniques, including moxibustion, bleeding techniques, herbal liniments, infrared light, threading, and others. Rounding out the text is a practical appendix with a glossary of Chinese medical terminology, sample instructions for patients, as well as an index with more than 2,000 disorders. Skillfully weaving the time-honored principles of Oriental medicine into the cutting-edge reality of the clinic, Advanced Techniques in Oriental Medicine offers a wealth of simple, yet effective, treatment strategies.

Leseprobe

Library of Congress Cataloging-in-Publication Data

Abbate, Skya. Taming the tiger: advanced techniques in Oriental medicine/Skya Abbate.

p.; cm.

Includes bibliographical references and index. ISBN 3-13-143051-6 (GTV: alk. paper) ISBN 1-58890-493-8 (TNY: alk paper) 1. Medicine, Oriental. I. Title. [DNLM: 1. Medicine, Oriental Traditional. 2. Acupuncture Therapy. WB 50.1 A123t 2006] 610–dc22         200613393

Photos by Dr. Anthony Abbate, DOM Santa Fe, New Mexico, USA; with the exception of Figs. 1.2, 1.2, 4.1 and 13.1 provided by Seirin Europe/ 3B Scientific, Hamburg, Germany

Illustrations by Jaye Oliver, Santa Fe, New Mexico, USA

© 2006 Georg Thieme Verlag, Riidigerstrasse 14, 70469 Stuttgart, Germanyhttp://www.thieme.de Thieme New York, 333 Seventh Avenue, New York, NY 10001, USAhttp://www.thieme.com

Typesetting by Sommer Druck, Feuchtwangen Printed in Germany by Grafisches Centrum Cuno, Calbe 10-ISBN 3-13-143051-6 (GTV) 13-ISBN 978-3-13-143051-9 (GTV) 10-ISBN 1-58890-493-8 (TNY) 13-ISBN 978-1-58890-493-5 (TNY)              12 3 4 5 6

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Nevertheless, this does not involve, imply, or express any guarantee or responsibility on the part of the publishers in respect to any dosage instructions and forms of applications stated in the book. Every user is requested to examine carefully the manufacturers' leaflets accompanying each drug and to check, if necessary in consultation with a physician or specialist, whether the dosage schedules mentioned therein or the contraindications stated by the manufacturers differ from the statements made in the present book. Such examination is particularly important with drugs that are either rarely used or have been newly released on the market. Every dosage schedule or every form of application used is entirely at the user's own risk and responsibility. The authors and publishers request every user to report to the publishers any discrepancies or inaccuracies noticed. If errors in this work are found after publication, errata will be posted at www.thieme.com on the product description page.

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Dedication

Blood and qi are a human's spirit. It is not all right to not be careful in nourishing them.

“Treatise of the Eight Righteous Brilliances” in the Su Wen (Simple Questions)

To all those who work in the healthcare professions, especially those who selflessly care for the sick and the poor.

To Father Vidal Martinez for always reminding me to pray for the sick.

Acknowledgement

To my husband, Anthony, for always believing in my ability to write a textbook and for giving me the leisure to devote my time to writing.

All money derived from the sale of this book will be donated to the Missionary Oblates of Mary Immaculate.

Preface

When caring for a patient, concentrate on the situation without being distracted by the circumstances, as if standing on the brink of a gorge not wanting to fall in. When you grasp the needle, do so with great care, firm strength and caution for the peril, as if holding a tiger's tail: one wrong move and great harm could befall.

Huang Di Nei Jing

Ten years ago, my first textbook, Holding the Tiger's Tail: An Acupuncture Techniques Manual in the Treatment of Disease, was published. Since then that book has been used in many acupuncture colleges both in the United States and Europe as a beginners-to-intermediate textbook for acupuncture students and practitioners. Following that book, two specialized texts were published, a Japanese treatment book, The Art of Palpatory Diagnosis in Oriental Medicine both in English and Italian (Churchill Livingstone, 2001 and 2004 respectively), and a Chinese ear acupuncture book, Chinese Auricular Acupuncture (CRC Press, 2004).

As my final needle techniques book, Advanced Techniques in Oriental Medicine, this text covers more advanced skills in Oriental medicine with an emphasis on needle technique within the context of treating common illnesses. A section on adjunct therapies for the Oriental medical practitioner is also included.

The body of knowledge of Oriental medicine is elegantly simple, and easy to understand, and to diagnose and treat with the needle and supporting modalities. Students and practitioners of Oriental medicine know the power of Oriental medicine as a diagnostic and treatment style. Most practitioners start off their practice learning all the treatment of disease (or differentiation of disease) protocols in the books available at the time of graduation, or strategies learned from experienced instructors. How we end up treating in our clinical career is a function both of our interests or specialties, as well as the disorders of the patients who come to our door. However, treatments do not need to be long, complex, employ many needles, and of course, need not be painful. As in most things in life, what are requisite to treatment are clarity, consciousness, compassion, and kindness.

I hope these simple yet effective treatment strategies will allow you to deliver effective healthcare to those in distress and to increase your satisfaction with your practice by “taming the tiger,” through the mastery of the needle and the tools of Oriental medicine.

Skya Abbate2006

Foreword

When comparing acupuncture to Chinese herbal medicine, it is often said that the latter is more difficult to learn and to practice. I tend to disagree. Acupuncture is probably more difficult to learn and to practice because it involves so many variables.

To give an effective treatment, there are certain steps that are common to both acupuncture and herbal medicine, i.e.:

a correct diagnosis (whatever system or type of Oriental medicine is used)a correct treatment principlea correct choice of treatment.

With herbal medicine, if the diagnosis and treatment principle are both correct, the prescription practically picks itself because of the close identification of treatment principle with categories of prescriptions. For example, when we say that the treatment principle is to clear heat and cool blood we mean that we need to clear heat at the blood level: this automatically corresponds to the category of cooling blood prescriptions. Similarly, when we say that we need to resolve toxic heat it means that we need to choose a formula from the category of prescriptions that resolve toxic heat.

With acupuncture, the correspondence between treatment principle and choice of treatment is not as rigid or unequivocal. For example, there are only a few points that specifically cool blood (e.g., PC-3 qu ze). Therefore, cooling blood with acupuncture is achieved in a different way and without such a straightforward correspondence between treatment principle and categories of formulae as in Chinese herbal medicine.

The modality of working with acupuncture is profoundly different to that of Chinese herbal medicine. Chinese herbal medicine is based on the use of drugs of plant origin. These work in a different way to, and are intrinsically safer than drugs; however, they are drugs nevertheless. They contain active principles that affect the body's physiology in a similar way to drugs. For example, to resolve edema with Chinese herbal medicine we may choose the formula Wu Ling San, which contains herbs that are diuretic and resolve edema by stimulating urination.

Acupuncture works in a completely different way because it essentially works only by regulating qi. In contrast to herbal medicine, how can acupuncture resolve edema? How can we stimulate urination with acupuncture? Acupuncture can resolve edema only by regulating the ascending/descending and entering/exiting of qi in the water passages of the three burners.

When compared to herbal medicine, therefore, the acupuncture treatment is not rigidly determined by the treatment principle, and the choice of points is much more flexible.

Another important difference is that acupuncture is more subject to cosmic influences than herbal medicine. By that I mean that, being based on manipulation of a subtle energy such as qi, acupuncture is more subject to influences of the time of day, season, moon phase, the menstrual cycle in women, etc. For example, in an article in a Chinese medicine journal Dr. Chen Ming treated 43 patients with asthma by giving them acupuncture during specific solar terms and compared the results to those in 24 patients treated not according to solar terms.1

The solar terms are 24 periods of 2 weeks each in a year, beginning from the first day of the Chinese New Year (which would fall on a different date of the Western calendar each year). The solar terms during which the treatment was administered were:

Spring Equinox (4th solar term)Summer Solstice (10th solar term)Autumn Equinox (16th solar term)Winter Solstice (22nd solar term)

The FEV (Forced Expiratory Volume) was measured in each patient in each group, and the patients treated according to the solar terms registered a better improvement than those who were not.

__________1Chen Ming Preliminary Study on the Relationship between Acupuncture in Different Solar Terms and Changes in Pulmonary Function in Asthma in Chinese Acupuncture and Moxibustion. Zhong Guo Zhen Jiu. 2000;20(3):155.

The fact that acupuncture is subject to cosmic cycles is probably the reason why a patient never reacts in the same way when we apply exactly the same treatment. For many years I have noticed over and over again that when a patient has a very positive reaction to a particular acupuncture treatment, the reaction is never the same when we repeat that treatment.

After deciding on a treatment principle, an acupuncture treatment is subject to many more variables than herbal medicine. In fact, after choosing a treatment principle, we still need to work out a suitable point combination that takes into account many factors, such as the actions of the points in relation to the pattern treated, the harmonious combination of points, the time of day, season, and even moon phase.

In fact, when choosing points for an acupuncture treatment there are two different considerations:

the selection of points according to their actionthe combination of points according to channel dynamics.

Acupuncture works via the channels, not just via isolated points, so that each point should not only be considered for its individual action but also for its place within the channel system. Even if we master the action of each individual point, this is still not enough to give an effective acupuncture treatment, as each point must be seen within the dynamics of the channel system so as to attain a harmonious combination of points.

The balance of the point combination is essential to the success of an acupuncture treatment. Indeed, a balanced point combination is as important to the therapeutic result as the needling technique. The latter is, of course, very important to the success of an acupuncture treatment but the harmonious combination of points is often overlooked: they are both important because they reflect two different viewpoints. In a way, the stress placed on needling technique is based on a point-centered view of acupuncture, while the stress placed on the combination of points is based on a channel-centered view of acupuncture. Both these viewpoints are important and both need to be taken into account.

When giving an acupuncture treatment, there are very many practical variables, such as a correct point location, correct needling direction and depth, correct obtaining of de qi, and correct needling manipulation. In addition, more variables are introduced when moxa is considered: Should we use moxa? On which point? Which type of moxibustion?

For all the above reasons, I think that acupuncture is very difficult to practice: it is indeed an art. There are comparatively few books that deal with the techniques of acupuncture in a detailed and practical way. Advanced Techniques in Oriental Medicine is such a book, which makes it so welcome to students and practitioners of acupuncture, whatever the style practiced.

Dr. Skya Abbate is uniquely placed to introduce the reader to the complexities of acupuncture as she has long experience both as a practitioner and a clinical teacher. She is therefore aware of the needs of students and practitioners. Dr. Abbate's clinical and teaching experience is apparent in every page of the book.

The transmission of a medical tradition from one culture to another is always fraught with difficulties. When transmitting a medical system between two such different cultures as the ancient Chinese and modern Western cultures, the difficulties are even greater. I personally feel we should strike a balance between adhering firmly to the tradition and adapting this tradition to the needs of Western students and patients. Adhering rigidly and blindingly to tradition will not serve the needs of our patients, while adapting a medical system without fully understanding it first may create theories which have no basis in practice.

Dr. Abbate's book strikes such a balance as it presents the traditional techniques of acupuncture and creatively adapts them to the needs of Western patients. For example, there is an innovative and important chapter on the treatment of the spirit with acupuncture. She correlates spirit treatment with treatment of the blood level.

Dr. Abbate's book is an example of the kind of books needed to ensure a faithful and creative transmission of Chinese medicine to the West.

Giovanni Maciocia

About the Author

Skya Abbate, MA, DOM., Dipl Ac, Dipl CH, began her career as a medical sociologist serving as a Peace Corps volunteer in Brazil, and then later taught in the Sociology Department of the University of Rhode Island (1978–81). She holds a BA in Sociology from Salve Regina College (Newport, RI 1973) where she graduated summa cum laude and class valedictorian, and an MA in Sociology from the University of Rhode Island (1978).

Following pre-med studies at the University of Rhode Island, in 1983, Skya graduated from the acupuncture program of the Institute of Traditional Medicine in Santa Fe, NM. She then undertook two advanced clinical training programs with the Academy of Traditional Chinese Medicine in Beijing, China in 1988 and 1989.

Skya is a licensed Doctor of Oriental Medicine in the State of New Mexico, Executive Director of Southwest Acupuncture College with three campuses in Santa Fe and Albuquerque, NM and Boulder, CO. She was former President of the New Mexico Association of Acupuncture and Oriental Medicine and has served for over 6 years as an educational expert and Commissioner for the Accreditation Commission for Acupuncture and Oriental Medicine (ACAOM), the national organization that accredits professional degree programs in Oriental medicine.

Skya is the author of four additional books: Beijing: The New Forbidden City (Southwest Acupuncture College Press, 1991), Holding the Tiger's Tail: An Acupuncture Techniques Manual in the Treatment of Disease (Southwest Acupuncture College Press, 1996), The Art of Palpatory Diagnosis in Oriental Medicine (Churchill Livingstone, 2001) also published in Italian in 2004 as Palpazione Diagnostica in Medicina Orientale, and Chinese Auricular Medicine (CRC Press, 2004). She has authored over 36 journal articles published in such prestigious journals as the American Journal of Acupuncture, the Journal of Chinese Medicine, the New England Journal of Traditional Chinese Medicine, and Acupuncture Today where she served for 6 years as the needle technique columnist. Two final texts are in progress–The Spiritual Practice of Clinical Medicine, and a point location and energetics book, along with a book of poetry and numerous Catholic inspirational short stories. Her scholarship and knowledge of the field has made her a sought-after book proposal reviewer for Elsevier, Taylor and Francis, Mosby and other medical publishers. With over 20 years of private practice experience and teaching she is one of the most qualified, respected, and prolific writers in Oriental medicine in the Western world.

Skya teaches needle technique, diagnosis, and Japanese acupuncture systems at Southwest Acupuncture College. She also has a private practice integrating classical Chinese treatment with her sub-specialty in Japanese acupuncture.

Contents

I General Approaches to Treatment

1     The Needle

Needle Composition and Safety

Parts of the Needle, Lengths, and Gauges

Selecting a Needle

Angle of Insertion

Patient Positioning

The Insertion Tube

Clean Field

Bent, Broken, or Stuck Needles

Needle Shock and Managing Accidents

2     Thoughts on Needling within the Clinical Encounter

3     Treating the Spirit—Treating the Blood with Oriental Medicine

PC-6 Nei Guan (Inner Gate)

KI-6 Zhao Hai (Shining Sea)

KI-1 Yong Quan (Gushing Spring)

HT-7 Shen Men (Spirit Gate)

SP-10 Xue Hai (Sea of Blood)

II The Treatment of Specific Diseases

4     Gentle Treatment for General Anxiety Disorder, Post-traumatic Stress, and Episodic Anxiety

5     The Relationship between Bunions, Sugar, and the Spleen

6     An Oriental Medical Physician's Framework for the Understanding and Treatment of Cancer

Cancer in Western and Oriental Medicine: Etiology and Pathophysiology

Integrated Cancer Treatment Modalities—Western and Chinese

Conclusion

7     Geriatric Disorders: Clinical Considerations and Treatment Modalities in Working with Elderly Patients in an Institutional Setting

General Guidelines for the Treatment of Patients in Institutional Settings

Treatment Adaptations

Geriatric Pathology: Kidney Vacuity, Stagnant Blood, and Phlegm

Physical Limitations

Pain

Treatment Modalities

8     Help for Prolapsed Intervertebral Disks of the Lumbar Region (Herniated Disks)

9     Thyroid Disorders, a Study in Contrasts

The Early Diagnosis and Treatment of Hypothyroidism

Hyperthyroidism

10     The Management of Multiple Sclerosis with the Extraordinary Vessels

11     The Pathophysiology and Treatment of Peripheral Neuropathy of the Upper and Lower Extremities

12     Prolapses: Beneficial Treatment with Oriental Medicine

Energetics

Needling

13     The Treatment of Seasonal Affective Disorder (SAD): Classical Points for a Contemporary Condition

Advice for Patients with Seasonal Affective Disorder

14     A Simplified Approach to the Treatment of Scars

15     Shoulder Problems: A Quick and Comprehensive Approach

Auricular Acupuncture

Needle LU-7

Tuina (Lie Que) and/or Needles

Threading

Point Location Reminders

16     Repetitive Motion Disorders

III Other Modalities—Treatment Tools Complementary to Acupuncture

17     Bleeding Techniques: Ancient Treatment for Acupuncture Physicians

Clinical Notes

18     Liniments, Sprays, and Powders

19     An Overview of the Therapeutic Application of Moxibustion

Functions of Moxibustion

Physiological Properties of Moxibustion

Contraindications, Cautions, and Limitations

Methods of Application

Tonification and Dispersion

Moxa Modalities

Moxa Prescriptions

20     The Mineral Infrared Therapy Device

21     Practical Threading Therapy

Common Points to Thread

IV Specialized Use of Points

22     Multiple Uses of Auricular Points

Point Energetics

Supplementary Points

Techniques

23     The Ancient Use of ST-36 (Zu San Li) with Different Needle Techniques and Point Combinations

24     GV-14 (Da Zhui): Big Vertebrae—Central Reunion Point

25     Modern Use of the Six Divisions: A Practical Needling Strategy for Pain and Blockage

26     Anecdotal Point Usage

Discussion—Point Combinations Lung 5 (Lie Que) and Kidney 6 (Chi Ze—Foot Marsh and Zhao Hai—Shining Sea)

Discussion—Gall Bladder 34 (Yang Lin Quan—Yang Mound Spring)

Discussion—Spleen 6 (San Yin Jiao—Three Yin Crossing)

27     The Role of the Heart in Needling within the Treatment Process

Appendix

Home Care Protocols

Glossary

Suppliers

Further Reading

Subject Index