Dr. Angelica Kokkalis Plans to Attend 100 Year Celebration in China
In 1998 Beijing University celebrated it’s 100 year anniversary and this October 2012, Beijing Medical University will celebrate it’s 100 year anniversary. Dr. Angelica Kokkalis, Indianapolis acupuncture and Eastern medicine doctor, is planning to go to China for two weeks to attend the celebrations.
Dr. Kokkalis was invited to give a talk as one of the first foreign student medical graduates and she hopes she can collaborate with the university doing some research on the effects of acupuncture and autism. The department of Neuroscience and the leading world renown prof Ji Sheng Han have already great results from preliminary studies.
About Beijing Medical University (now called Peking University Health Science Center)
Established by the central government of China on October 26, 1912 in the city of Beijing, Beijing Medical University was the first of the kind in China to teach western medicine and train medical professionals. In 1923 it adopted the name Beijing Medical University, but in the year 2000 it merged with Peking University and is now named Peking University Health Science Center.
According to Wikipedia, “PUHSC offers a full range of courses for 8 specialties including basic medical sciences, clinical medicine, preventive medicine, stomatology, pharmacy, nursing, medical laboratory diagnosis and biomedical English. It has 57 accredited doctoral programs and 66 master programs. In addition to offering undergraduate and graduate programs, it also plays an active role in continuing education. PUHSC hosts 6 postdoctoral programs. PUHSC now has enrollment of 10112 students, including 927 doctoral students, 1036 master program students, 3196 undergraduates, 696 junior college students, 3994 adult learning program students, and 388 international students. It has many international students.
PUHSC has developed 20 disciplines that have gained national recognition. Besides, it has 1 national key laboratory, 10 ministry-level key laboratories, 23 joint research centers, and 20 research institutes at university level. PUHSC has 11 schools, 1 institute and 1 division, namely, School of Basic Medical Sciences, School of Pharmaceutical Sciences, School of Public Health, School of Nursing, School of Stomatology, the First School of Clinical Medicine (Beida Hospital), the Second School of Clinical Medicine(the people’s Hospital), the Third School of Clinical Medicine (the Third Hospital), Institute of Mental Health (the Sixth Hospital), the School of Oncology (Beijing Tumor Hospital), Peking University Shenzhen School of Medicine, Peking University School of Telemedical Education, and the Division of Humanity and Fundamental Sciences. In addition, 15 hospitals in Beijing serve as teaching hospital.”
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:
- NADA protocol (insert five needles into the auricle points Kidney, Lung, Liver, Shenmen and Sympathetic).
- HANS stimulator (hegu, wai guan, bai hui, ren zhong).
- 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.
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.
By Amy Patterson-Neubert Journal and Courier
For almost two years, Vicki Clark has suffered from frozen shoulder – adhesive capsulitis – a condition that inflicted shooting pain in her upper left back, shoulder and neck area.
Clark sought relief from a variety of specialists in traditional medicine but she finally found relief from ‘merging two worlds of medicine – East and West.
”A combination of acupuncture’ and intense physical therapy benefited me,” said Clark, whose treatment was under the guide of an Oriental and medical doctor, Dr. Angelica Kokkalis, and an occupational specialist, Dr. Joseph Sliwkowski, Kokkalis a West Lafayette resident who is the director of Chinese medicine at the Center for Complementary Medicine and Pain Management at St. Vincent’s Hospital in Indianapolis, also recommended that Clark incorporate massage therapy into her equation of wellness, to enhance the results of acupuncture. Acupuncture is a part of traditional Chinese medicine (TCM) that dates back 3,000 years. Acupuncture needles stimulate the nervous system, and its energy, to release pain-killing and inflammation-reducing substances to the blood. TCM believes that pain and disease are created when there is a blockage of energy; known as Qi’. More than 200 common clinical disorders benefit from acupuncture, according to the World Health Organization.
Millions of people are turning to nontraditional forms of therapy, complementary and alternative modalities known as CAM, from ingesting herbs to seeking chronic pain management with acupuncture or prolotherapy. Prolotherapy IS an osteopathic deep injection technique used to eliminate some chronic pain involving ligaments.
Some patients feel the traditional methods have let them down, and other patients are taking more of an interest in their health. The number of Americans who use alternative therapies has increased fro~ 33 percent in 1990 to 42 percent ill 1997, according to the National Center on Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health.
The institute has identified five major areas of CAM practices – alternative medical systems (acupuncture, Ayurveda, homeopathic medicine and naturopathic medicine); mind-body intervention (meditation certain uses of hypnosis, dance, music, art therapy and prayer); biologically based therapies. (herbal, special dietary, orthomolecular and individual biological therapies); manipulative and body-based methods (chiropractic and osteopathy); and energy therapies (Qi gong, Reiki and therapeutic touch).
Around for Centuries
In Lafayette, the Association of Complementary Therapists Inc. meets monthly to discuss alternative therapies. There are approximately 96 members in the group and 650 mailings are sent quarterly.
But alternative and complementary therapies aren’t new to the world. Many of these have been around for centuries and are more prevalent in other countries. For example, in Germany, St. John’s wort, an herb, is more popular than America’s No.1 prescription medication for depression, Prozac. In Europe, naturopathy is well-received, according to naturopath Dr. Claudia Hanau of West Lafayette, but in the Midwest, it’s a small faction of health care.
What’s new is the two worlds of treatment are integrating nationally, and in Clark’s case, locally also.
“I think despite both camps, it’s going to happen. Both sides were kind of arrogant and lofty in the beginning,” said Dr. Palmer MacKie, medical director at the Integrative Pain Center at Wishard Hospital in Indianapolis, and internist and clinical assistant professor of medicine at the Indiana University School of Medicine. The Integrative Pain Center at Wishard Hospital has been open for about a year.
The melding of the two worlds is happening more frequently on the East and West coasts and in the southern part of the country, more so than in the Midwest.
Dr. Joseph Sliwkowski, medical director of the Regional Occupational Care Center at Unity Healthcare, moved to Lafayette from Boston more than a year ago
to join Unity, a group that is building a dedicated outpatient center in southern Lafayette. When he left Boston, he left a rehabilitation hospital, where alternative therapies including acupuncture were integrated.
“I’d like Unity to have an integrated medicine component,” said Sliwkowski, who is pleased with Clark’s progress. “I’m not threatened by it, and it’s a great alternative to have and I’d like to see more of it here.”
Kokkalis has been at the Center for Complementary Medicine and Pain Management for five of the department’s nine-year history. Here, she is involved in an acupuncture and stroke study, in addition to treating patients.
“It’s a blessing to have alternative in combination to Western. They should look at it as complementary, not competition,” Kokkalis said.
Entering the mainstream But before that melding takes place nationwide, the fear and
stigma accompanying alternative and complementary medicine will need to be abandoned. Some of it originates from the difficulties in standardizing procedures or establishing regulations. For example, herbs are not approved by the FDA because they are considered dietary supplements, not drugs. And decades ago, physicians practicing alternative therapies lost their licenses and were even put in jail.
“We’re putting ourselves at risk to do this type of medicine, and we’re all aware of it,” said Dr. Charles Turner, a Lafayette family physician who started incorporating alternative therapies into his practice during the last few years. Turner advertises that is he is specializing in a holistic approach to the art of medicine.
The apprehension about alternative medicine also surfaces from misuse or false promises.
“There is a lot of nonsense and garbage in alternative medicine. I’m not promoting all of it,” said Turner.
But in response to the unknown, more reputable institutes, such as NCCAM, are leading studies and suggesting regulations, Turner is participating in a natural growth hormone study that was reviewed by the Food and Drug Administration and approved by the Investigational Review Board.
Turner expects the demand from young doctors for more alternative therapy education and their desire to practice it will make the treatments more mainstream.
But-he also expects many will “stick to the old party line.”
“There is more money in practicing medicine the regular way. Plus (alternative) takes longer to deal with patients,” said Turner, who sees 15 to 20 patients a day now. He used to see 35 to 50 daily. With alternative medicine, “You’re dealing with more sophisticated people, who are asking a lot of questions.”
By Sharon L. Martin
“Take her or heal her.”
It was her mother’s agonizing prayer that saved Angelica Kokkalis’ life and set her on a journey of healing others.
When Angelica Kokkalis was 3 years old, she began having grand mal epileptic seizures. The seizures became so severe that her physician prescribed Valium. It left the girl drooling and numb to the world.
“I don’t remember my childhood,”says Kokkalis, who grew up in Greece. She was enrolled in a special needs school where she showed signs of academic promise when not on her medication. This continued for nine years.
And it was when Kokkalis was 12 years old, that her mother uttered the prayer, “Take her or heal her.” “My mom was on the bus when someone mentioned that she needed to try therapeutic medicine with me,” says Kokkalis. “It would take 40 days. She was to put me on a strict vegan diet, drink a tea rich with enzymes, take me off my medications and pray.”
That’s what her mother did.
“On the 37th day, I had the worst seizure I ever had,” says Kokkalis. “I was comatose for three days and three nights. I don’t remember anything.”
She does remember waking and being thirsty. The therapeutic remedy had worked.
But on that day, her mother’s faith in the unconventional brought Kokkalis back to the living and would forever shape her future.
In 1979, when Kokkalis was 14, she was sitting in class when a magazine editor arrived as a guest speaker. It wasn’t the speaker that caught Kokkalis’ attention. It was the cover of the magazine depicting acupuncture. Kokkalis was hooked.
At the age of 17, she received a Sino-Greek Government Student Exchange Scholarship to study medicine in China, where she combined her education in conventional medicine with training in Traditional Chinese Medicine (T.C.M.). She learned how the least invasive treatment is best. She learned about herbs, acupuncture and other treatments that soothe the body in a more natural way.
“The Chinese philosophy considers the bone to be elastic,” explains Kokkalis. “Different herbal remedies combine to create collagen. Grapeseed extract, for example, is good for strengthening.”
Kokkalis enjoys figuring out what makes a person tick and then creating a strategy that gets results. “I see the unique characteristics and make a unique creation for that individual,” she adds.
Ann Malaska agrees. She has been seeing Kokkalis for nearly eight years. What started as a treatment for a foot problem has resulted in Kokkalis helping Malaska with other health issues as well.
“Everything about a person is interconnected,” says Malaska. “The whole person has to be addressed and she has a sense of that. Everything I’ve come to her for, she’s gotten me to a better level of healing.”
Kokkalis’ blending of medicines provides patients with technological advances of the West and time-honored traditions of the East. “Look at the word ‘dis-ease,’” says Kokkalis. “When you’re not at ease with yourself, you get sick.”
Kokkalis is a firm believer that good health begins with good nutrition. She encourages women to eat healthy, wholesome foods and as use as much organic meats and produce as possible. Once your diet is in order, Kokkalis will suggest treatments that best suit your personal needs.
Options could include acupuncture, Moxibustion therapy (application of therapeutic heat), Quigong (breathing and energy exercises) and cupping.
Cupping, pictured above, involves placing cups containing reduced air pressure (suction) on the skin.
“Therapeutic massage is the No. 1 prevention of disease,” she adds. Although Kokkalis has been in the field of alternative medicine for years when it wasn’t easily accepted in the Western culture, she says she has noticed a shift. “In the last 10 years, the attitudes toward alternative methods have shifted greatly.
People ask for more answers. I’m a bridge between Eastern and Western medicines. I’ll find the right information to make the best treatment options.”
