Dr. Angelica Kokkalis, O.M.D L.Ac.

Zionsville Newspaper Features Dr. Angelica Kokkalis

Zionsville Current highlights Lafayette acupuncture by Angelica Kokkalis

On July 17, Zionsville Current published an article about acupuncture and Eastern medicine called From East to West. Dr. Kokkalis spoke about the arrogance of Western medicine due to it’s tendency to dismiss Eastern medicine even though it’s been used for much longer. “We need to be more humble as doctors; we are servants of people and God,” she is quoted as stating.

Angelica recalls her first experience with Eastern medicine in Greece where as a child her mother used alternative Eastern treatments that ultimately healed her of seizures. More on this story can be found in Angelica’s post, Merging East with West, but it was ultimately this experience that turned her onto the value of Eastern medicine, but it wasn’t until she discovered acupuncture in a French magazine that she found her life’s path.

“The seizure (and her unique recovery) brought up my interest in wellness, specifically in solving the problem rather than just management of disease,” she said. “The magazine had a face in it with acupuncture needles, and that was intriguing. I decided that’s what I wanted to do.”

She tells about her studies in China and the obstacles she had to overcome with the Greek and Chinese governments in order to be able to do that. Her desire to be an ambassador between East and West medicine overcame the objections of the Chinese government and allowed her to stay, study, and graduate with honors.

Dr. Angelica Kokkalis now practices acupuncture in Indianapolis near Zionsville and in West Lafayette, Indiana (view exact locations). To call for an appointment, dial 765-497-0817.

Acupuncture combined with Herbs as a Treatment for Alcohol and Drug Addiction in Juvenile Populations: A Pilot Study

Acupuncture has been used in China for at least 2,000 years to treat a variety of disorders. The use of acupuncture for the treatment of drug addiction was discovered serendipitously in 1972 by Wen, aHong Kongneurosurgeon conducting a series of studies on the analgesic properties of acupuncture. Heroin addicts who volunteered to be subjects reported that their opiate withdrawal symptoms were lessened on the days when they received their acupuncture treatments. Wen undertook a series of uncontrolled studies on the use of acupuncture in the treatment of opiate addiction and reported positive results. Over the last 30 years, numerous studies have been undertaken investigating acupuncture for the treatment of various addictions, including opiates, tobacco, and alcohol. Many of these studies report beneficial effects of acupuncture. Not infrequently however, investigations of acupuncture for the treatment of drug addiction suffer from problems of design and assessment.

In this study we would use the findings of Professor Han Ji Sheng ofBeijingMedicalUniversityinChina. Dr. Han reported that 30 minutes of stimulation of body points with his HAN stimulator was effective in relieving symptoms of drug withdrawl. Dr. Han also demonstrated by serial numbers of human CSF that specific frequencies of electrical stimulation caused the gene expression of endorphins and other neuropeptides. HANS stimulator reduced the amount of gas anesthetic required for surgery by 50%. He showed a cross-tolerance between acupuncture and morphine. Needles are no longer necessary, as conducting polymer pads suffice.

Introduction

The number of young people ages 12-17 suffering from substance abuse addiction is growing. There is also a corresponding increase in crime and suicide rates among the juvenile population. Teens are the future of this country, and solving the problem when it first starts is of utmost importance. No research on acupuncture has been done with juveniles, although a significant amount of research has been done with groups age 18 and older. Given t e limited success, to date, of pharmacologic treatments for drug addiction, and the urgency of the problem with young people, there is a need to evaluate less conventional treatment modalities. The reported clinical success of acupuncture for the treatment of alcohol and drug addiction and its increased popularity directed our efforts toward an investigation of acupuncture and herbal medicine intervention.

Aim of this study

Which method of Acupuncture is more effective for the treatment of drug and alcohol addiction: The NADA protocol alone, HANS stimulation, or NADA protocol plus HANS stimulation and Chinese herbal detox formula? Also, these three methods need to be compared to a control group.

Materials and methods

Participants: 100-200 juvenile drug and alcohol addicts, both male and female, different origin backgrounds, court ordered.

Inclusion and Exclusion Criteria

Inclusion criteria: The study would include juveniles under 18 years old, who have been diagnosed with cocaine dependence according to SCID fourth edition, who have evidence of recent cocaine use either by providing a cocaine positive urine screen at or within 2 weeks before screening or by self reporting abuse within 1 week prior. Or same age group has to meet DSM-IV criteria for alcohol dependence.

Exclusion criteria: Being dependent on ‘any substance other than alcohol, opiates, cocaine, or nicotine, currently taking a prescription benzodiazepine, currently taking any other psychotropic medication unless maintained in this medication for at least 90 days, pregnancy, clinically evident cognitive impairment, current medical conditions requiring treatment, currently receiving acupuncture in the previous 30 days, being actively suicidal or psychotic.

Control group

The control group would practice Tai Chi 45 minutes each week for 48 weeks.

Plus they would receive the helix needle insertion control. The points in the helix are as far removed from the NADA points as is possible within the compass of the auricle, and they are not located in the concha, avoiding vagal stimulation.

They also receive psychological treatment consisting of weekly individual counseling as well as weekly coping skills group.

Interventions

Compare three methods, each having a 30-minute duration for 12 weeks and follow up twice a month for the next 20 months:

1. NADA protocol (insert five needles into the auricle points Kidney, Lung, Liver, Shenmen and Sympathetic).
2. HANS stimulator (hegu, wai guan, bai hui, ren zhong).
3. NADA protocol, HANS stimulator, plus herbal formula for detox.

Outcome criteria

Drug and Alcohol use will be assessed during the study by urine toxicology screening 3 times weekly.

Measure both neurochemical and behavioral levels. Neurochemical measurements include: release of endogenous opioids, Serotonin (5HT), noradrenalin (nor epinephrine), cholecystokinin, and dopamine metabolism.

For alcohol addiction screen urine ethanol levels, 5-hydroxytryptophol, 3 times weekly. Weekly Serum GGT and CDT levels. Measure alcoholic seizures by using Mainz Alcohol withdrawal scales MAWS. For comparison between groups use ANOVA analysis. In exploratory analysis use Cox proportional hazards model.

The follow up of the study should be 2 years.

Quality assessment

Although we could score the study according to Riet et al, using a list of 18 predefined criteria, which include validation of outcome and duration of follow up, Riet et al was criticized for only having 18 criteria that limited the ability to adequately measure clinical trials (Birch, 2001; Lewith, 1995). Birch (2003) suggests a criteria range of 43, but remains unpublished. The maximum possible score is 100. The study could use Kaplan-Meier survival estimates for withdrawal’

Mechanism of Acupuncture

The mechanism by which acupuncture may constitute a treatment for chemical dependency has not been fully investigated, although it has been conjectured that acupuncture, perhaps mediated by the release of endogenous opioids, modulates neural circuits in the midbrain also affected by drugs of abuse. Traditional Chinese theories of acupuncture involving ‘the rectification of chi deficiency or excess in various organ systems have not been adequately tested within Western biomedical frameworks. Blum and colleagues (1996) suggested that stimulating the vagus nerve, which is located in the concha and at the Lung point on the auricle with the insertion of an acupuncture needle the hypothalamus is stimulated. In that effect hypothalamic neurons release serotonin (5HT) which activates methionine enkephalin, an opioid peptide. Met-enkephalin is released at the ventral tegmental region and interacts to inhibit receptors controlling the release of GABA. Met-enkephalin and/or other opioid peptides finely tune the system. Tht primary role of GABA is to control the output of dopamine in the ventral tegmental region. The result of inhibiting GABA is an increase in dopamine. Acupuncture acts to reduce craving, thereby assisting the drug addict into self­recovery.

U. S. Studies

Auricular acupuncture is an increasingly popular intervention for the treatment of cocaine addiction in theUnited States. Currently, approximately 200 clinics, in 32 states, offer auricular acupuncture for the treatment of this disorder (Smith 1991). Despite its increasing

opularity, auricular acupuncture has been evaluated in relatively few studies for the treatment of cocaine addiction (Lipton et aI., 1992, 1994; Margolin et al., 1992, 2002; Smith,1988, Otto et al 1998, Bullock et al 1997, 1999, Killeen et a12002, Avents et al 2000, etc). Clinical reports suggest that auricular acupuncture induces a feeling of relaxation that reduces craving for cocaine and facilitates patient participation in counseling and rehabilitation. There are few controlled studies of acupuncture for the treatment of cocaine addiction. One study conducted atLincolnHospital, (D. Lipton,V. Brewington, and M. Smith, unpublished data) another one from the Substance Abuse and Treatment Unit, Department of Psychiatry,YaleUniversityschoolofMedicine. Cocaine use was determined by urine toxicology screenings. Depression was assessed by using the Beck depression inventory. Self-representation was assessed using the modified selves Questionnaire, etc. The authors report a positive finding for acupuncture insofar as subjects who received real acupuncture and remained in treatment for over 2 weeks had significantly lower levels of benzoylecgonine in urine screens compared to the placebo group. Sixty-one percent of women and 36% of men who entered the study completed the entire 8-week course of acupuncture treatment. All of the women and 60% of the men who completed the study attained abstinence. Among the HIV-positive patients 38% completed the study, of these individuals 83% attained abstinence. In the pharmacotherapy trial, retention in treatment was excellent, and abstinence rates were modest. In the acupuncture study, the retention rate was lower, but the patients who remained in treatment did extremely well. No subject reported dropping out of the studies because of an adverse response to acupuncture treatments. Subjects who attained abstinence in these studies exhibited decreased Beck Depression Inventory scores, a shift in self-representation away from “addict” and toward desired “non­addict” self-schemata, decreased craving, and increased aversion to cocaine cues.

Treating Stroke with Traditional Chinese Medicine

The Chinese have been combining Traditional Chinese Medicine and western medicine for many years. Specifically, for stroke treatments they use Physical therapy, Electroacupuncture, Carotid Drug Injection, Chinese herbal formulas, Massage therapy and Craniosacral therapy. Research on this is available in the attached research study completed inHubeiProvincein 1996. Now western medicine is studying the effects of adding Traditional Chinese Medicine techniques to their medical repertoire. The cun’ent stroke research proposal seeks to duplicate some of the Chinese research in a western rehabilitation hospital.

1. Introduction to Traditional Chinese Medicine

The term “Traditional Chinese medicine” T.C.M., makes reference to a number of practices, especially acupuncture, moxibustion and herbal formulas and their theoretical basis that has developed in China during a period of about 2,500 years. A theory of nature — and of health and disease — was set forth in the concepts of two essential forces yin and yang, the five elements, six climatic influences, seven emotional factors, eight principles of therapy, fourteen meridians, and other notions numbered as an aid to memorizing the information.

1.1  Ancient but Still Alive

The Huang-di Nei-jing or Inner Classic of the Yellow Emperor is the source of all Chinese medical theory, the Chinese equivalent of Hippocratic corpus. Compiled by unknown authors between 300 and 100 B.C.E., it is the oldest of the Chinese medical texts. The knowledge and theoretical formulations it contains are the basic medical ideas developed and elaborated by later thinkers.

In China today, the primary textbooks used to train traditional doctors are contemporary interpretations and clarifications of Qing dynasty (1644-1911) formulas and commentaries.

These books are, in turn, clarifications of Ming dynasty (1368-1644) reworkings, which are also reworkings of earlier material. This process goes all the way back to Han dynasty (202 B.C.E.- 220 C.E). Such transmission through the dynastic pathway not only preserved and encapsulated the original sources, but also elucidated and reformed them.

The first book about acupuncture, translated into Dutch and Latin, appeared in the West during the 15^th Century. Europeans, most notably the French, have been involved in acupuncture therapy for the last 300 years.

Acupuncture has been known in the United Statesfor hundreds of years as well. Benjamin Franklin, during his career as Ambassador toFrancein 1781, received acupuncture treatments and even did experiments with it. After Nixon visited China in 1972, widespread interest in this healing art was revived in theUnited States.

1.2 The Yin–Yang And The Five–Element Theory In T.C.M.

T.C.M. considers everything has two sides, they are called Yin and Yang. The Yin and Yang are philosophical terms in ancient China, referring to the things or characters opposite to each other. The condition that appears as active, external, upward, hot, bright, functional, exciting and hyperactive is attributed to Yang. The condition that appears as asthenic, internal, downward, cold, dim, material, inhibitive and declining is attributed to Yin.

Yin- Yang theory is widely used in T.C.M. for explaining the physiological and pathological phenomena of the human body and for directing the diagnosis and treatment of a disease. For example superficial syndrome, heat syndrome, sthenic syndrome are attributed to Yang. Interior syndrome, cold syndrome, asthenic syndrome are attributed to Yin.

The five element theory is a theory based on philosophy in ancient China, classifying the material characters and the mutual relationship of the five elements, which are considered as the essential constituents of the material universe. Their motion is in accordance to certain rules (germination, restriction, etc). In T.C.M. the five element theory is chiefly used for explaining the properties of the five viscera organs (liver, heart, lung, spleen, kidney) of the human body, their mutual relations, physiological phenomena and pathological changes. It also serves as a guide for diagnosis and treatment. The five element cycle is arranged in a definite order.

T.C.M. considers that heart is fire, liver is wood, spleen is earth, lung is metal and kidney is water, which are the five viscera organ’.

The term for five viscera organs do not completely match those used in western medicine from the standpoint of anatomy and physiology. In T.C.M they are considered functional systems and their suffering causes disease. So the physiology and pathophysiology in T.C.M are very important.

1.3 Vital substances in T.C.M.

Vital energy (Qi), blood and body fluids are the vital substances in T.C.M. theory.

Vital energy (Qi)

Vital energy is the motive force of internal organs and the tissues of the body as well.

It has five functions: a) promotion function b) warming function c) defensive function d) checking function and e) nourishing function.

Blood

Blood is an important component of the body derived from the refined substance of the food through a series of complex processes. It circulates in the blood vessels to nourish all parts of the body.

Body fluids

Fluids in the body include sweat, saliva, stomach fluid, intestinal fluid, urine etc. Their function is to moisten the skin, the hair, the muscle, the throat, the joints etc.

Meridians

Meridians are important components of the human body. Meridians and their collaterals act as an important route for circulating vital energy and blood, connecting viscera with extremities, communicating the upper with the lower and the interior with the exterior and regulating the activities of viscera and other parts of the body. The meridians play an important role in joining the tissues and organs of the body to build up an organic entity.

There are fourteen regular meridians in the body and they are the main passages connecting different parts of the body in which the vital energy and blood circulates. The meridian energy flows through the meridians in regular cycle by definite order.

Selection of treatment based on the differential diagnosis

Making a diagnosis and selecting the treatment is based on the analysis and comprehension of the clinical data collected by the four methods of examination with the basic theories of the five viscera organs (liver, heart, lung, spleen, kidney) meridians and pathogens.

1.4 Four Methods of Examination:

1. Inspection: Observing the patient’s mental status, posture, appearances of the tongue and its fur, the quality of urine, feces and other excretions and secretions, etc.
2. Listening and smelling: Listen to patient’s voice during speaking, breathing, coughing and moaning, and to smell the odor of the secretion and excretion.
3. Inquiring: Interrogate the patient about his present illness, past history, menstruation and childbirth history, living and food habits, as well as age, native place, occupation and other related information.
4. Palpation: Various parts of body surface of the patient are palpated for the purpose of investigating the condition of the pulse, chest, abdomen and extremities to establish a diagnosis.

1.5 Major therapeutical methods in T.C.M.

A. Methods of treatment by Chinese herbal medicine

There are eight methods of treatment used in Chinese herb medicine.

1. Diaphoresis therapy: It possesses the actions of antipyretic, promoting eruption, reducing edema and antirheumatic by inducing perspiration.
2. Emetic therapy: Elimination of harmful substances from the throat, esophagus and stomach by the application of drugs or physical stimuli that can induce vomiting.
3. Purgation therapy: A treatment of eliminating the undigested food by the application of mild purgatives.
4. Regulating therapy: Includes various treatments such as the dispersion of stagnated liver-energy, the coordination of the functions of the liver and spleen or of the liver and stomach.
5. Warming therapy: Expelling cold by warming the meridians, rejuvenating the depleted Yang, lowering fever with drugs of sweet flavor and warm nature.
6. Heat – clearing therapy: A treatment of clearing away the heat with cold natured drugs, applicable to febrile diseases of heat – syndrome.
7. Invigoration therapy: A therapy for various types of asthenia syndrome, generally classified into invigoration of vital energy, toning the blood, invigoration of Yin and Yang.
8. Dispelling therapy: A treatment for dispersing stagnated energy, blood stasis, phlegm­wetness, undigested foods.

Herbal therapies are best for functional disorders, hormonal imbalances, and “organic problems” (change in tissue structure). The effects of herbs are usually seen after several days of regular use, rather than immediately, but once the effects are established, they often persist for a long time. The use of acupuncture plus herbs usually provides the most dramatic results.

B. Methods of treatment by acupuncture and moxibustion

Acupuncture therapy: Application of metal needles including the filiform needle, intradermal needle and plum-blossom needle are used to stimulate certain specific superficial definite locations for the treatment of a disease. In cases of blood transmitted disease or skin lesions electro-acupuncture or laser beam acupuncture is applicable.

Acupuncture is a very safe system of health care when done by a well-trained practitioner. It feels like a needle prick but nothing like getting an injection. During the treatment the patient will experience some sensations of energy movement, but not pain. Most people fall asleep when left with the needles, and wake refreshed and relaxed.

The number of treatments varies according to the condition. Acute problems may respond with just a few treatments. A chronic problem that exists for years may require a longer series of treatments. Treatments are usually once or twice a week.

Acupuncture therapy has wide applications. The world health organization has officially recognized acupuncture as suitable for the treatment of more than two hundred common clinical disorders. These would include: Gastrointestinal disorders, urogenital disorders, gynecological problems, muscle and joint pain, respiratory problems, circulatory disorders, immune system disorders, endocrine disorders, neurological disorders, headache, emotional problems, addictions, pediatrics, and supportive therapy dealing with chronic pain, basic energy enhancement and harmony.

Moxibustion therapy; A method of applying therapeutic heat produced by ignited moxa wool or roll over the well-defined skin surfaces. The moxa is made by an herb called “Artemisia bulgaris”.

Other methods of treatment

Massage: a) Also called pushing and grasping; a method of prevention and treatment of diseases by applying various massage manipulation, or by passive movements of extremities. b) One of the eight manipulations of bone setting, used for relaxing the muscles, dissipating blood stasis and promoting subsidence of swelling.

Qigong (breathing exercise): A mental and physical self training for the prevention and treatment of diseases and also for Health care and prolongation of life, by which life activities are self-adjusted and self-controlled with the help of the inducement of mind and the regulation of respiration and spirit.

Therapeutic exercises: Taiji (also called Tai Chi), Gong fu, jogging, five animal exercises and other exercises prevent disease and strengthen the human body.

1.6 Electroacupuncture, Carotid Drug Injection and Herbal Supplements as a Potential Treatment Option in Stroke Patients

Descriptions of stroke appear as early as in the Nei ling (Yellow Emperor’s Inner Classic, c.lOO B.C.). In Chinese medicine, the risk factors for stroke are explosive anger or protracted pent-up emotions; poor diet – especially one high in fat or sugar; excessive alcohol and tobacco use; long term stress and fatigue; lack of exercise; sudden physical over-exertion; change in season or climate. The common syndrome patterns include: movement of internal wind; excessive emotions transforming into fire; phlegm blocking the channels; irregularity of the Qi mechanism; and blood stasis.

Chinese medicine categorizes strokes into two types depending on severity. A channel stroke usually does not result in loss of consciousness. Headache, numbness of the extremities (unilateral), disturbance of vision and/or speech, are common presentations.

An Organ stroke is more involved and usually consciousness is impaired, with major neurological problems. Stroke is a condition that is known as “root-deficient, branch­excessive,” meaning that an underlying deficiency has caused the excess presentations. The treatment strategy is to first resolve the symptoms of excess during the acute phase; these symptoms can include wind, phlegm-heat, and blood stasis depending on the syndrome pattern. Then, during the recovery stage, the causal deficiency is addressed. Thus formulas used include ingredients to extinguish wind, transform phlegm-heat, invigorate the blood and tonify the constitution. As a general precaution, we always recommend to take herbs and drugs two hours apart to avoid any untoward interactions. The herbal formulas recommended for this study are attached to this proposal.

Over the past 40 years knowledge about the physiological basis of control of pain has increased more than at any time in the history. The growth has been based mainly on studies on the neural and neurochemical basis of inhibition of pain at various levels of the central nervous system such as the spinal cord, the brain stem, and higher subcortical center. Although acupuncture was introduced in the Western world as early as in the 1600′ s it remained largely unknown until the first reports of operations under acupuncture analgesia were reported from China. Research on the neurochemical mechanisms of acupuncture analgesia has been conducted in the Department of Physiology,Beijing Medical Universitysince 1965. More than 250 papers have been published, most of them in Chinese. There are over 50 scientific papers on the clinical observation of the curative effect on cerebral infarction with acupuncture. Electro­stimulation of the acupuncture points transmits into the central system through the sensory nerves and exerts effect. After the integration of the brain, the treatment works directly on the local cerebral tissue to dilate the cerebral vessels and to increase cerebral blood flow, subsequently improving the blood circulation, increasing the oxygen pressure of the cerebral tissue, improving the nourishment of the cerebral cells around the focus, and promoting the repair of the cerebral tissues. In addition, when the motor nerves are stimulated around the acupoints, the muscles twitch, consequently dilate and contract the vessels, promote blood circulation, increase the volume of the local cells and tissues and promote the recovery of the nerves and muscles of the paralytic limps.

Incorporating Carotid Drug Injection into the treatment of stroke is popular in China. The prescription of the Carotid Drug injection consists of 40ml sodium chloride of 0.9%, 6ml novocaine of 2% (containing O.12g), 2-4ml ligustrazine hydrochloride (containing 40- 80mg), O.5ml dexamethasone (containing 2.5mg). The above drugs were mixed up into 50ml that was used for carotid injection. In the prescription mentioned above, ligustrazine hydrochloride dilates the vessels to improve microcirculation and to inhibit platelet agglutination. Novocaine which dilates small vessels not only can relieve vascular spasm, but also activates carbonic acid in the blood, increases the density of C02 in the blood and eventually leads to reflexing dilation of the cerebral vessels and hence the increase of cerebral blood flow. Dexamethasone is powerful in anti­inflammation and dehydration, thus eliminating cerebral edema and improving cerebral anoxia. When the above drugs are added with sodium chloride and injected slowly into the cervical artery, the medicinal mixture flows into the anterior cerebral artery and the middle cerebral artery, directly exerting effect on the infracted region. As a result there is improvement of the cerebral blood circulation, softening and exfoliating of the focal plaque, dilation of the cerebral vessels, elimination of cerebral edema, improvement of the elasticity of the cerebral vascular wall and decrease blood viscosity. Increased cerebral blood flow will provide the oxygen supply needed to repair the function of the impaired cerebral cells and promote the functions of the affected limbs. For details of the exact procedure see the attached paper.

According to the paper the control group was treated by simple carotid drug injection while the observation group was treated by electroacupuncture plus carotid drug injection. The total effective group for the observation group was 96.2% and the control group 83.7%. The control group received more than just physical therapy because the Chinese do not use a treatment of just physical therapy for stroke patients. They are more advanced in that area and include electroacupuncture and herbs as a part of the standard treatment for stroke along with physical therapy.

2. Research Plan

The study will replicate part of the research described in the attached paper published in the Shanghai Journal of Acupuncture and Moxibustion in 1998.

2.1 Ideas for Discussing in the Study

The study will treat 120 patients with PNS (partial non progressive stroke) affected by the most common site’ for obstructive disease, the carotid artery. In Caucasians, the carotid artery is responsible for atherothrombotic stroke six to seven times more frequently than is the main trunk of the middle cerebral artery. In my experience the patients should have their blood pressure stabilized for at least a week before we start them in to this program.

The patients will be divided into four treatment categories:

1. Physical therapy, Electroacupuncture, Carotid Drug Injection, Chinese herbal formulas, Massage therapy and Craniosacral therapy
2. Physical therapy, Craniosacral therapy, Massage therapy
3. Physical therapy, Carotid Drug Injection, Craniosacral therapy and massage
4. Control group (Physical therapy only).

The first group will alternate carotid drug injection with electroacupuncture. Starting Monday with carotid drug injection, Tuesday electroacupuncture and so on. Herbal formulas will be taken continuously (9 pills per day) during the course of the treatment. Massage therapy and craniosacral therapy will be administered once a week. The physical therapy will similar to the control group’s physical therapy.

The second group will have craniosacral therapy and massage therapy once a week. Physical therapy will be similar to the control group.

The third group will have carotid drug injection every other day plus craniosacral therapy and massage once a week. Physical therapy will be similar to the control group.

And the fourth group will have physical therapy only.

3. Can modern and Chinese medicine be combined?

Not only can the two systems of medicine be combined, they can enhance each other’s effects. Chinese herbs may make it possible to take a lower dosage of modern medicines, to reduce their side effects, and obtain a better overall effect. Modern drugs may provide emergency relief for serious conditions that will allow long-term application of Chinese herbs the rest of the time. It is advised that modern drugs be taken at a different time (e.g. two hours apart) from herb combinations in order to avoid any chance of interaction, and that monitoring of the effects of the drugs be continued, and perhaps increased, while an herb therapy is being used. Acupuncture is compatible with virtually all modern techniques.

4. Concluding remarks

Traditional Chinese medicine can be considered an art, and it can claim to be a science. But the important question is: Does it work? Is Chinese medicine just an interesting philosophical curiosity or is it a viable system of healing? Can it treat what the West defines as real diseases? And can Western science measure its results and appreciate its Value?

Because of the unique history of modern China, traditional medicine has been the subject of comprehensive study and testing over the past fifty-five years.

Western clinical studies of traditional Chinese medicine, by proving its practical efficacy, have helped it win its battle for survival in the twentieth century, and promise it a place in the future of medicine.

Some English–Language Sources

Clinical observation of the Curative Effect on Cerebral Infarction of Elecroacupuncture Plus Carotid drug Injection. Wang Dajun et. al. 1997

Xing Hongyi. Commentary Summarization on the Mechanism of Acupuncture in Treating Cerebral Ischemia. China Journal of Acumoxi, 1996,-(5):57

Zhong Qi. Effect of Acupuncture on the Cerebral Blood Flow of the Patients with Ischemic Cerebrovascular Disease. Liaonig Journal ofTCM, 1991; (8): 11

Revision at the Second National Conference on Cerebrovascular Disease. Diagnosticlissentials on Various Cerbrovascular Diseases. China Journal of Neurology and Phys iq logy, 1987,-(1):60

Department of Philosophy of Medicine and Science, cornp. Theories and philosophies of Medicine. New Delphi:Institute ofHistory of Medicine and Medical Research 1973.

Fung, Yu-Lan. A History of Chinese Philosophy. 2 vols. Translated by Derk Bodde.Prinston,N.J.:PrinstonUniversity Press 1973.

Porckert, Manfred. The Theoretical Foundations of Chinese Medicine. M.LT. East Asian Science Series, Vol. 3.Cambridge,Mass.: M.I.T. Press, 1974.

Ted l. Kaptchuck. The Web That Has No Weaver. Congdon & Weed, Inc,New York, 1983.

i Mayer, DJ., Price, D.D. Rafii, A.1977. Antagonism of Acupuncture Analgesia in Man by Narcotic Antagonist Naloxone. Brain Research. 121 :368-72.

Mayer, D.l., Price, D.D. Rafii, A. 1975.Acupuncture Hypalgesia: Evidence for activation of a central control system as a mechanism of action. First World Congress Pain Florence, p.276 (abstr)

Mc Leennan, B., Gilfillan, K, Heap, Y. 1977. Some Pharmacological Observations on the Analgesia Induced by Acupuncture in Rabbits. Pain 3: 229-38.

Han, C. S., Chou, P.B., Lu, C.C., Jen, M. F. 1979. The Role of Central 5–hydroxytryptamine in Acupuncture Analgesia. Sci. Sin. 22:91-104.

Chan, Wing-Tsit, trans. and comp. A source book in Chinese Philosophy. Prinston, N.l.:

PrinstonUniversitypress, Prinston Paperbacks, 1963. Cited as Chinese Philosophy.

Mayer, H.L., Price, D.D. 1976. Central Nervous System Mechanisms of Analgesia. Pain 2:379-404.

Han 1.S., Terenius L 1982. Neurochemical Basis of Acupuncture Analgesia. Ann. Rev. Pharmacol. Toxicol. 22: 193-220.

Liu X. 1986. The Role of Nucleus Raphe Magnus in Acupuncture Analgesia and its Control by Some Higher Analgesia Structure. Acupuncture Research 9:91-100.

Huard, Pierre, and Wong, Ming. Chinese Medicine. New York, Toronto: WorldUniversity Library, McGraw-Hill, 1968.

Leslie, Charles, ed. Asian Medical Systems. Berkeley,Calif.:University of California Press.

Introduction to Chinese Medicine

The term “Traditional Chinese medicine” T.C.M., makes reference to a number of practices, especially acupuncture, moxibustion and herbal formulas and their theoretical basis that has developed in China during a period of about 2,500 years. A theory of nature –and of health and disease– was set forth in the concepts of two essential forces yin and yang, the five elements, six climatic influences, seven emotional factors, eight principles of therapy, fourteen meridians, and other notions numbered as an aid to memorizing the information.

Ancient but Still Alive

The Huang-di Nei-jing or Inner Classic of the Yellow Emperor is the source of all Chinese medical theory, the Chinese equivalent of Hippocratic corpus. Complied by unknown authors between 300 and 100 B.C.E., it is the oldest of the Chinese medical texts. The knowledge and theoretical formulations it contains are the basic medical ideas developed and elaborated by later thinkers. In China today, the primary textbooks used to train traditional doctors are contemporary interpretations and clarifications of Qing dynasty (1644-1911) formulas and commentaries. These books are, in turn, clarifications of Ming dynasty (1368-1644) reworkings, which are also reworkings of earlier material. This process goes all the way back to Han dynasty (202 B.C.E.-220 C.E). Such transmission through the dynastic pathway not only preserved and encapsulated the original sources, but also elucidated and reformed them.

The Yin-Yang and the Five-Element Theory in T.C.M.

T.C.M. considers everything has two sides, they are called Yin and Yang. The Yin and Yang are philosophical terms in ancient China, referring to the things or characters opposite to each other. The condition which appears as active, external, upward, hot, bright, functional, exciting and hyperactive is attributive to Yang. The condition which appears as asthenic, internal, downward, cold, dim, material, inhibitive and declining is attributed to Yin.

Yin-Yang theory is widely used in T.C.M., for explaining the physiological and pathological phenomena of the human body and for directing the diagnosis and treatment of a disease. For example superficial syndrome, heat syndrome,sthenic syndrome are attributed to Yang. Interior syndrome, cold syndrome, asthenic syndrome are attributed to Yin.

The five element theory is a theory based on philosophy in ancient China, classifying the material characters and the mutual relationship of the five elements which are considered as the essential constituents of the material universe. Their motion is in accordance to certain rules (germination, restriction, etc). In T.C.M. the five element theory is chiefly used for explaining the properties of the five viscera organs (liver, heart, lung, spleen, kidney) of the human body, their mutual relations, physiological phenomena and pathological changes. It also serves as a guide for diagnosis and treatment.

Vital Substances in T.C.M.

Vital energy (Qi), blood and body fluids

Vital energy (Qi)
Vital energy is the motive force of internal organs and the tissues of the body as well. It has five functions: a) promotion function b) warming function c) defensive function d) checking function e) nourishing function.
Blood
Blood is an important component of the body derived from the refined substance of the food through a series of complex processes. It circulates in the blood vessels to nourish all parts of the body.
Body fluids
There are fluids in the body. For instance, sweat, saliva, stomach fluid, intestinal fluid, urine etc. Their function is to moisten the skin, the hair, the muscle, the throat, the joints etc.
Meridians
Meridians are important components of the human body. Meridians and their collaterals act as an important route for circulating vital energy and blood, connecting viscera with extremities, communicating the upper with the lower and the interior with the exterior and regulating the activities of viscera and other parts of the body. The meridians play a important role in joining the
tissues and organs of the body to build up an organic entity. There are fourteen regular meridians in the body and they are the main passages connecting different parts of the body in which the vital energy and blood circulates. The meridian energy flows through the meridians in regular vicious cycle by definite order.

Etiology and Pathogenesis in Chinese Medicine

There are three kinds of pathogenic factors explained in the Chinese medicine, namely exogenous pathogenic factors, endogenous pathogenic factors and miscellaneous pathogenic factors.

Selection of Treatment Based on the Differential Diagnosis

Making a diagnosis and selecting the treatment is based on the analysis and comprehension of the clinical data collected by the four methods of examination with the basic theories of the five viscera organs (liver, heart, lung, spleen, kidney) meridians and pathogens.

Four methods of examination:

1. Inspection: Observing the patient’s mental status, posture, appearances of the tongue and its fur, the quality of urine, feces and other excretions and secretions, etc.
2. Listening and smelling: Listen to patient’s voice during speaking, breathing, coughing and moaning, and to smell the odor of the secretion and excretion.
3. Inquiring: Interrogate the patient about his present illness, past history, menstruation and childbirth history, living and food habits, as well as age, native place, occupation and other related information.
4. Palpation: Various parts of body surface of the patient are palpated for the purpose of investigating the condition of the pulse, chest, abdomen and extremities to establish a diagnosis.

Pulse Taking Chinese Style

A normal balanced pulse is felt mainly at the middle level. Normal speed is between four and five beats per complete respiration, amounting to about seventy to seventy-five beats per minute. The quality of a normal pulse is elastic and “lively” neither hard and unyielding, nor flaccid and indistinct.

Types of pulse

The distinctions between pulses that are most commonly made by physicians are depth, speed, width, strength, overall shape and quality, rhythm, and length.

Floating pulse is distinct at a superficial level of pressure, it is less perceptible when palpated at the middle and deep level. It signifies deficient yin.
Sinking or deep pulse is distinct only at the third level, when heavy pressure is applied. It indicates that the disharmony is internal, or that there is obstruction.
A slow pulse is one that has fewer than four beats per respiration. It is a sign of cold retarding movement or insufficient Qi to cause movement.
A rapid pulse is one that has more than five beats per respiration. It indicates that heat is accelerating the movement of blood.
A thin pulse feels like a fine thread but is very distinct and clear. It is a sign that the blood is deficient and unable to fill the pulse properly.
A big pulse is broad in diameter and very distinct, and suggests excess. It is commonly felt when heat is present in the stomach or intestines or both.
An empty pulse is big but without strength. It feels weak and soft like a balloon partially filled with water. It is felt at the superficial level and is often slower than normal. It signifies deficient Qi and blood.
A full pulse is big and strong, pounding hard against the fingers at all three levels. It is a sign of excess.
A slippery pulse is extremely fluid. It feels smooth, like a ball bearing covered with viscous fluid. It is a sign of excess, usually dampness or mucus.
A choppy pulse is uneven and rough, and sometimes irregular in strength and fullness. It is a sign of deficient blood and jing.
A short pulse does not feel the spaces under the three fingers and is usually felt only in one position. It is often a sign of deficient Qi.
A long pulse is perceptible beyond the first and third positions. If it is of normal speed and strength, it is not considered a sign of disharmony.
A knotted pulse is a slow irregular pulse that skips beats irregularly. It is a sign of cold obstructing the Qi and blood, though it may indicate deficient Qi blood
and Jing.
A hurried pulse is a rapid pulse that skips beats irregularly. It is usually a sign of heat agitating the Qi and blood.

Tongue Diagnosis

The diagnostic value of observation of tongue can be fully manifested only in clinical treatments in T.C.M. by using differentiation of syndromes. The facts verify that excess or deficiency of Qi and blood in viscera organs, depth of invasion of pathogenic factor, tendency of transmission and change in a disease can be understood through observation of tongue.It is declared by the modern research work that appearance of tongue looks like a window for seeing into internal organs of the body, can objectively reflect various physiological changes in the interior of the body, manifests the reaction and function of the body at the moment and brings the information of plentiful vital activities.

The content of tongue diagnosis:

Observation of tongue proper (body)
Observation is mainly focused on three aspects : color, appearance and mobility of the tongue. A normal tongue is light red in color, lustrous and moist, free in motion, and of proper size which is neither flabby nor thin and neither tough nor too tender.

Tongue color

Pale tongue: Is often seen in severe malnutrition, anemia chronic nephritis, etc.
Light red Tongue: Is often seen in a healthy person or a person with a mild disease. Sometimes it may also seen in a chronic disease which is not so severe.
Red tongue: Is often seen in the middle stage of a febrile disease with virus or bacteria in blood.
Deep red tongue: Is often seen in the advance stage of a febrile disease in which high fever, septicemia and some other severe conditions are present.
Green, blue or purple tongue: Is often seen in severe infection, extreme weakness in respiration or circulation, oxygen difficulty diffuse intravascular clotting, etc

Appearance of tongue

Sheen-withered tongue: A sheen tongue indicates vigor of the anti-pathogenic factor and adequacy of the body fluids. Withered tongue is often seen in wasting diseases, severe malnutrition, pernicious anemia, and the advanced stage of infectious febrile diseases.
Tough-tender tongue: A tough tongue indicates heat syndrome often seen in the peak stage of acute disease. A tender tongue indicates cold syndrome mostly seen in the advanced stage of chronic disease.
Cracked tongue: A cracked tongue is often seen in high fever, dehydration and malnutrition.
Thorny tongue: A thorny tongue indicates hyperactivity of pathogenic heat, which is often seen in high fever, severe pneumonia, scarlet fever etc.
Spotty tongue: Like red bayberry gathers at the front and in the middle of the tongue. Is often seen in the advanced stage of a febrile disease, burns etc.
Tooth printed tongue: Tooth prints appearing at the edges of the tongue is often seen in edema, anemia, chronic nephriris etc.
Double tongue: The vessels of the underside of the tongue are swollen up like another small tongue. Is often seen in inflammation or abscess of glandula sublingualis, tumor etc.
Haemorrhagic tongue: A tongue bleeding on the surface is often seen in leukemia and aplastic anemia.
Carbuncle tongue: Is seen in glossitis, tongue tumor and pyogenic infection.
Furuncle tongue: Which is hard and painful with a size of a soybean is often seen in glossitis and infections.
Boils tongue: Protruding painful boils on the surface of the tongue is often seen in ulcerous glossitis and stomatitis.
Fungus tongue

Mobility of tongue

Rigid tongue: Difficult to protrude is often seen in cerebrovascular accidents and nerve system damage of various causes.
Flaccid tongue: Is often seen in nerve dysfunction of tongue, nerve system damage or extreme weakness in the advanced stage of diseases.
Shrunken tongue: Shrunken and unable to protrude denotes a fatal sign. Is often seen in cerebrovascular accidents, severe lingual muscle atrophy, and extreme weakness in the advanced stage of diseases.
Deviated tongue: Which is deviated to a side is often seen in facial paralysis, hypoglossus paralysis, and some other nerve damage.
Tremulous tongue: Uncontrollable trembling often appears in tremulous paralysis and some severe nerve system damage.
Protruding and wagging tongue: Is often seen in high fever, blood disease with bacteria or virus, protruding tongue like dementia.
Numb and paralyzed tongue: Is a tongue without ability to move. They are seen in nerve system damage due to various causes.

Major Therapeutic Methods in T.C.M.

A. Methods of treatment by Chinese herbal medicine

There are eight methods of treatment used in Chinese herb medicine.

Diaphoresis therapy; It possesses the actions of antipyretic, promoting eruption, reducing edema and antirheumatic by inducing perspiration.
Emetic therapy; Elimination of harmful substances from the throat, esophagus and stomach by the application of drugs or physical stimuli that can induce vomiting.
Purgation therapy; A treatment of eliminating the undigested food by the application of mild purgatives.
Regulating therapy; Includes various treatments such as the dispersion of stagnated liver-energy, the coordination of the functions of the liver and spleen or of the liver and stomach.
Warming therapy; Expelling cold by warming the meridians, rejuvenating the depleted Yang, lowering fever with drugs of sweet flavor and warm nature.
Heat-clearing therapy; A treatment of clearing away the heat with cold natured drugs, applicable to febrile diseases of heat – syndrome.
Invigoration therapy; A therapy for various types of asthenia syndrome, generally classified into invigoration of vital energy, toning the blood, invigoration of Yin and Yang.
Dispelling therapy; A treatment for dispersing stagnated energy, blood stasis, phlegm-wetness, undigested foods.

Herbal therapies are best for functional disorders, hormonal imbalances, and “organic problems” (change in tissue structure). The effects of herbs are usually seen after several days of regular use, rather than immediately, but once the effects are established, they often persist for a long time. The use of acupuncture plus herbs usually provides the most dramatic results.

B. Methods of treatment by acupuncture, magnetic therapy prolotherapy and moxibustion

Acupunture therapy; Application of metal needles such as filiform needle, intradermal needle and plum-blossom needle are used to stimulate certain specific superficial definite locations for the treatment of a disease. In cases of blood transmitted disease or skin lesions electro-acupuncture or laser beam acupuncture is applicable.

Acupuncture is a very safe system of health care when done by a well-trained practitioner. It feels like a needle prick but nothing like getting an injection. During the treatment the patient will experience some sensations of energy movement, but not pain. Most people fall asleep when left with the needles, and wake refreshed and relaxed. The number of treatments varies according to the condition. Acute problems may respond with just a few treatments. A chronic problem that exists for years may require a longer series of treatments. Treatments are usually once or twice a week.

Acupuncture therapy has wide applications. The world health organization has officially recognized acupuncture as suitable for the treatment of more than two hundred common clinical disorders.

Magnetic therapy; Magnetism is an entirely natural event, it stimulates the body to heal itself. In injuries, magnetic treatment has been shown to decrease healing time by half or more. Although science cannot fully explain what takes place when the body is placed within such a magnetic field system, kinesiology (muscle strength) testing shows each acupuncture meridian in the body is functioning in harmony within fifteen minutes. Another effect of a magnetic field that is well documented and supported by the laws of physics is the enhancement of blood circulation and lymphatic drainage. Magnetic treatment is used in 45 countries around the world. In controlled tests carried out in Germany and Japan the complains of patients included insomnia, chronic headaches, neuralgia, arthritis, neck and back pains, skin allergies, bronchial asthma and travel sickness. Results were dramatic and showed magnetism to be 68% to93% effective.

Prolotherapy (Point Injection therapy); A combination of Chinese and Western medical practice, was developed on the basis of acupuncture. Disease is treated or prevented by the combined effects of needling and drugs. Chinese drugs such as Angelica root extract, Safflower extract, Western drugs such as aminophylline, procaine hydrochloride, antibiotics and Vitamins B1, B12, in small doses are injected into the points or painful spots.

Advantages of this therapy are its versatility, economy in the use of drugs, short course of treatment and effectiveness. Injection in small doses can also reduce the side effects of some of the drugs. Prolotherapy is widely and satisfactory applied in treating rheumatism, neuralgia, soft tissue injury, insomnia, hypertension, GI ulcers and lobar pneumonia.

Moxibustion therapy; A method of applying therapeutic heat produced by ignited moxa wool or roll over the well defined skin surfaces. The moxa is made by an herb called “Artemisia bulgaris”. Moxibustion has the function of removing obstruction from the channel and regulating the Qi and blood. It regulates the function of the endocrine and nervous system and promotes the function of the immune system. It also promotes the function of the Chong and Ren channels in controlling blood to nourish the fetus and correct improper fetus position. For instance, Wang Wen-shi used moxibustion on Zhiyin (UB67) to treat 2069 pregnant women with malposition of uterus. One treatment lasting 10-15 minutes was given every day. Four treatments were considered as one course. 90.32% were cured after one to five courses of treatment (1869 cases). Doctors from the third teaching hospital in Guang Zhou recorded 1218 cases of the same problem treated in 12 different hospitals. Their results were 80.2% cured cases. Laboratory research proved that this method can promote secretion from the suprarenal cortex and promotes the movement ofthe uterus. One hour after moxibustion the fetus movement reached a peak or in the evening of the day that the patient had received the treatment. Yie Qingfang has reported that an effective rate of 88.55 was achieved in treating 260 cases with lactation deficiency, by applying moxibustion on Tanzhong (Ren 17).

C. Other methods of treatment

Massage; a) Also called pushing and grasping; a method of prevention and treatment of diseases by applying various massage manipulation, or by passive movements of extremities. b) One of the eight manipulations of bone setting, used for relaxing the muscles, dissipating blood stasis and promoting subsidence of swelling.

Qigong (breathing exercise); A mental and physical self-training for the prevention and treatment of diseases and also for health care and prolongation of life, by which life activities are self-adjusted and self-controlled with the help of the inducement of mind and the regulation of respiration and spirit.

Therapeutic exercises; Taiji, Gong fu, jogging five animal exercises and other exercises prevent disease and strengthen the human body.

Commonly treated conditions

Gastrointestinal Disorders: Food allergies, indigestion, diarrhea, constipation, anorexia, peptic ulcer, gastritis, colitis, irritable bowel.
Urogenital Disorders: Urinary tract infections, incontinence, prostatitis, sexual dysfunction, infertility.
Gynecological Problems: PMS, menstrual difficulties (irregular, heavy or painful menstruation), infertility, morning sickness, fibrocystic disease, menopause problems.
Muscle and joint pain: Arthritis, tendonitis, brusitis, low back pain, neck and shoulder pain, whiplash, sciatica, TMJ problems.
Respiratory Problems: Asthma, emphysema, allergies, chronic bronchitis, sinusitis.
Circulatory Disorders: High blood pressure, angina, muscle cramps, anemia, palpitations, atherosclerosis.
Immune system Disorders: Chronic fatigue syndrome, AIDS, rheumatoid arthritis, candidiasis, lupus.
Endocrine Disorders: Diabetes, hyper/hypothyroidism.Neurological Disorders: Stroke, multiple sclerosis, trigeminal neuralgia numbness, tingling, dizziness.
Headache: Migraine, tension, sinus, cluster headaches.
Emotional problems: Stress, insomnia, depression, anxiety, phobias, bipolar personality disorder, compulsive behavior, poor self-esteem, irritability.
Addictions: Alcohol, nicotine, sugar, medications, recreational drugs.
Pediatrics: Bed-wetting, hyperactivity, asthma.

Can Modern and Chinese Medicine Be Combined?

Not only can the two systems of medicine be combined, they can enhance each other’s effects. Chinese herbs may make it possible to take a lower dosage of modern medicines, to reduce their side effects, and obtain a better overall effect. Modern drugs may provide emergency relief for serious conditions that will allow long-term application of Chinese herbs the rest of the time. It is advised that modern drugs be taken at a different time (e.g. an hour apart) from herb combinations in order to avoid any chance of interaction, and that monitoring of the effects of the drugs be continued, and perhaps increased, while an herb therapy is being used. Acupuncture is compatible with virtually all modern techniques.

In Chinese medicine, as in Chinese philosophy, one can not understand the whole until one knows the parts and can not understand the parts without knowing the whole. The patient is treated never for the cause, but for his or her unique configuration of signs and symptoms.

It is impossible to read into the Chinese system the classification of the West. The attempt to impose parallelism on the two systems is inappropriate and leads to misunderstanding. The Chinese system must be approached and dealt with on its own terms.

As a clinical construct, the Chinese concepts can be evaluated more easily. Western techniques can be used to see whether the practice derived from the theory really works. This has been done, and the results have shown that Chinese medicine can be very effective.

Concluding Remarks

Traditional Chinese medicine can be considered an art, and it can claim to be a science. But the important question is: Does it work? Is Chinese medicine just an interesting philosophical curiosity or is it a viable system of healing? Can ittreat what the West defines as real diseases? And can Western science measure its results and appreciate its Value?

Because of the unique history of modern China, traditional medicine has been the subject of comprehensive study and testing over the past fifty years. Western clinical studies of traditional Chinese medicine, by proving its practical efficacy, have helped it win its battle for survival in the twentieth century, and promise it a place in the future of medicine.

Some English-Language Sources

Chan, Wing-Tsit, trans. and comp. A source book in Chinese Philosophy. Prinston, N.J.: Prinston University press, Prinston Paperbacks, 1963. Cited as Chinese Philosophy.

Department of Philosophy of Medicine and Science, comp. Theories and philosophies of Medicine. New Delphi: Institute of History of Medicine and Medical Research 1973.

Fung, Yu-Lan. A History of Chinese Philosophy. 2 vols. Translated by Derk Bodde. Prinston, N.J.: Prinston University Press 1973.

Huard, Pierre, and Wong, Ming. Chinese Medicine. New York, Toronto: World University Library, McGraw-Hill, 1968.

Leslie, Charles, ed. Asian Medical Systems. Berkeley, Calif.: University of California Press.

Porckert, Manfred. The Theoretical Foundations of Chinese Medicine. M.I.T. East Asian Science Series, Vol. 3. Cambridge, Mass.: M.I.T. Press, 1974.

Ted J. Kaptchuck. The Web That Has No Weaver. Congdon & Weed, Inc, New York, 1983.

Mayer, D.J., Price, D.D. Rafii, A.1977. Antagonism of Acupuncture Analgesia in Man by Narcotic Antagonist Naloxone. Brain Research. 121:368-72.

Mayer, D.J., Price, D.D. Rafii, A.1975. Acupuncture Hypalgesia: Evidence for activation of a central control system as a mechanism of action. First World Congress Pain Florence, p.276 (abstr)

Mc Leennan, H., Gilfillan, K, Heap, Y. 1977. Some Pharmacological Observations on the Analgesia Induced by Acupuncture in Rabbits. Pain 3: 229-38.

Han, C. S., Chou, P.H., Lu, C.C., Jen, M. F. 1979. The Role of Central 5-hydroxytryptamine in Acupuncture Analgesia. Sci. Sin. 22:91-104.

Mayer, H.L., Price, D.D. 1976. Central Nervous System Mechanisms of Analgesia. Pain 2:379-404.

Han J.S., Terenius L 1982. Neurochemical Basis of Acupuncture Analgesia. Ann. Rev. Pharmacol. Toxicol. 22:193-220.

Liu X. 1986. The Role of Nucleus Raphe Magnus in Acupuncture Analgesia and its Control by Some Higher Analgesia Structure. Acupuncture Research 9:91-100.

Facial Rejuvenation By Acupuncture

This Fox news video show how acupuncture can be used to erase fine lines on your face. This video is from Scottsdale, but we serve the Indianapolis, Zionsville, and Lafayette areas of Indiana.

Dr. Christy Cline demonstrates an acupuncture technique to lessen fine facial lines and wrinkles without the risks of surgery. Dr. Angelica Kokkalis also does facial acupuncture for a face lift.