Monday, September 20, 2010

Highlights of TCM Examinations and Treatments

Over the last few months I have had a wonderful introduction to Traditional Chinese Medicine (TCM) and many of the unique modalities used to bring the body back into health and harmony. Many of the examinations and treatments used in TCM are very different from what Western Medicine is used to. By using non-invasive procedures and knowledge of the five-element theory TCM can identify disharmonies and restore balance to the body.
A few of the diagnostic procedures and therapies new to me that we were able to explore and practice in class were: tongue and pulse diagnosis, moxibustion, cupping, and auricular therapy.

As far as I know, tongue examinations are not a common place practice in American healthcare. Until this class I had never cared or desired to inspect other people’s tongues. In TCM it is said that the appearance and health of ones tongue directly reflects what is going on inside the body. In other words, imbalances within the body that we cannot see will manifest on the tongue. What a fascinating concept! It does make a lot of sense if you stop and think about it since the tongue is the only internal organ that is easily accessible to look at. Once you start looking at tongues you realize how many different shapes, sizes, colors, textures, and coatings are possible, and they all mean something different. It takes practice and knowledge to become good at tongue diagnosis but it is a valuable skill to have. One peak at a person’s tongue can give you a lot of information. For example; an abnormally pale tongue indicates deficient blood or Qi; a red tongue that it much redder than normal indicates a heat condition in the body; scalloped edges from teeth along the sides indicates dampness in the body; pale tongue with depression at the root (back of tongue) indicates decreased Jing(essence) pointing to deficient Kidney Qi; thick mucus coating points to digestive issues. These are few of many possibilities. With a trained eye this form of examination can be very useful.

Another interesting examination used in TCM is that of the pulse. This is not what most people in the Western world would think of when it comes to checking ones pulse, the standard quantifiable beats per minute and systolic/diastolic pressures. Instead, this is in an in-depth analysis of the radial pulse. TCM has three different positions on each hand for taking the pulse with each corresponding to a different organ.
There are two different positions for the pulse of the kidneys. The left side represents the Kidney yin, whereas the right side represents Kidney yang. There are also different depths at which a pulse can be read, either superficial, middle, or deep. Over time and with patience you can begin to feel the subtle differences in people’s pulses and decipher what they mean. A slower pulse is a sign of cold or insufficient Qi to cause movement, where as a rapid pulse is a sign of heat. An empty pulse which lacks strength and feels weak is a sign of deficient Qi or blood, where as a full pulse which feels strong and pounds hard is a sign of excess. There are many different classifications of pulse and to become good at pulse diagnosis takes many years of practice and experience. It is truly an art.

After the examinations are complete a treatment plan can be put together that can include a variety of modalities such as acupressure massage, moxibustion, cupping, gua sha, acupuncture, auricular therapy and Qi Gong. Three that were new and unheard of to me were moxibustion, cupping, and auricular therapy.
Moxa is a dried and sifted form of the mugwart plant that is burned during moxibustion treatment. Moxa smolders, releasing smoke and creating a lot of heat and is burned either directly on or above the skin. Moxibustion is used to bring warmth, blood, and qi to a specific area such as a meridian, acupoint, or body part. This treatment aims to clear damp, free the movement of Qi and blood, coursing Qi, dispersing cold, and warming what is cold. Moxa treatment is great for deficiency syndromes and is greatly tonifying. There are different methods of burning moxa. A more direct method involves small cones that stick to the skin and are great for specific acupressure points alone or along a meridian. Moxa-irons are small metal boxes with a handle. The moxa is burned in the box and then rubbed over a client’s lower back to tonify the kidneys. There are also moxa sticks which can be used just above the skin. Energy work along with moxibustion strengthens the treatment and achieves better results. Treatment durations and amount used vary depending on client feedback and desired effect. Contraindications and cautions include pregnancy, heart condition or circulation disorders, signs of heat (a burn, rash, inflammation), on the face and sensitive areas, over a tumor, over damaged ligaments and tendons (until inflammation has gone down), and on persons who have just overeaten, are very hungry, or intoxicated (large shifts in energy can cause a person to pass out). Moxa also helps to boost the body’s immune system (wei qi).

Cupping is a method of drawing the skin up into cups using some form of suction over specific acupoints or areas of tension. Traditionally, fire was used to create a vacuum inside of a glass cup which would draw the patient’s skin up into the cup creating a nice suction grip. This method is still used but to avoid the dangers that fire can pose an alternative way has been developed. Now it is not uncommon to see the use of plastic cups with a small detachable hand pump that is used to draw the skin up into the cup getting the same desired effect. The purpose of cupping is to help dispel stagnations and relieve areas of tension and is usually prescribed in cases of excess, such as knots and pain. It relieves congestion and inflammation while opening up pathways to provide the smooth flow of Qi and blood to the area while eliminating toxins. Cupping is used in the West and in China to help an array of disorders from respiratory disease (chronic cough, asthma), paralysis, gastrointestinal tract disorders, frozen shoulder, depression, and soft tissue pain just to name a few. Cupping is preformed over fleshy areas of the body using different sized cups for the desired area. Although cupping is painless it can and usually does leave a mark. The suction that is used draws blood and toxins to the surface which can leave a mark that looks like an unsightly bruise. The mark usually disappears within a couple of days depending on how bad the stagnation was in the area. People with a lot of stagnation and tension will experience more blood and darker blood coming to the surface at the cupping site than those who do not have as much tension. Cups can be left on for anywhere between 8-15 minutes depending how quickly blood comes to the surface or until the desired effect is reached. The major contraindications for cupping include: inflamed areas on the skin (or any rash, open wound, ect..), high fever, convoulsions and cramping, easy bleeding (bleeding disorders, blood thinners), and areas over the lower back and abdomen during pregnancy.
Auricular therapy is a type of reflexology that involves the outside auricle of the ear. Just like there is reflexology for the hands and feet, there is also one for the ear. There are over 200 points in there ear that correspond to internal and external body structures and organs. Through these points a practitioner can stimulate all organs and functions of the body to help the body move back into a balanced state. This type of therapy was developed in China thousands of years ago but in the last century has been elaborated upon by the French. It has shown great results for helping with pain and pain management, stress and emotional disorders, addiction, common illnesses, chronic conditions, and much more. Stimulation of these points can be done through a variety of methods including needling (acupuncture), electrical stimulation, magnets, or ear beads (acupressure). Using ear beads was the method that was shown in class. Ear beads are very tiny round balls that can be made of gold, silver, or a small seed and have a small piece of adhesive to hold it in place over a selected point. A point combination of 5-8 points is selected for treatment in one ear and the beads are left in place for up to a week. The client is shown where each of the beads has been placed and is instructed to stimulate them manually up to 3 times a day. Auricular therapy using ear beads can be used to treat or help almost any ailment, disease, or condition since it has relatively no side effects and contraindications. Soreness at the point location and some possible temporary side effects such as nausea and dizziness can occur due to shifts in energy and changes in the body but these are usually brief and rare. Those who are pregnant, have just under gone an organ transplant or are in remission from cancer should consult their physicians before opting for any additional therapies.
I have learned so much about TCM in the last few months and it has been a very rewarding experience. Not just the new and exciting treatments but an entire new way of looking at and thinking about health and homeostasis. I have only barely scratched the surface here with this highlight of a few interesting examination and treatment methods but the foundation on which this knowledge rests goes so much deeper. The five element theory, which all of these treatments and diagnoses are based on, is truly a beautiful and elaborate web of the human microsystem. I encourage anyone who has an interest in these modalities for personal or practical use, or even just pure curiosity, look further into it. There are so many choices and possibilities when it comes to health treatment options, do not think that you are limited to only a select few!

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